GIS use in Public Health 1

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Geographic Information Systems (GIS) use in Public Health Douglas Morales, MPH Epidemiologist/GIS Coordinator Office of Health Assessment and Epidemiology Epidemiology Unit Objectives Define GIS and justify its use Analyze data spatially and temporally Apply GIS to Public Health and health outcomes Review historical medical mapping examples in disease outbreaks Introduce to LA County Department of Public Health (DPH) Use of GIS in DPH Career Options My first map El Norte 1

VB Corona Virus Disclaimer! 4 What is GIS? Integration of: Hardware, Software & Data Purpose: capture, manage, analyze and display geographically referenced information Cartographic, graphic and statistical approach 5 2

Why use GIS? To visualize, understand, question and interpret data To reveal spatial and temporal relationships, patterns and trends Facilitates the integration and analysis of data from different sources for better decision making Tobler s First Law of Geography Everything is related to everything else, but near things are more related than distant things Waldo Tobler Why use GIS in Public Health? Epidemiology The basic science of public health Epi means upon Demos means people as in democracy Logos the study of the study of what is upon the people Definition (Last, JM) The study of the distribution and determinants of healthrelated states or events in specified populations and the application of control of health problems 7 Why use GIS in Public Health? To reveal relationships, patterns and trends about the interaction between host, agent, vector and the environment Epidemiology Triad Demographic and Geographic characteristics of host and pathogenic communities encourage and inhibit disease 8 3

GIS in Public Health: Dengue 9 Medical Mapping Examples 10 Arrieta: Bubonic Plague (Bari, 1694) 10 miles Districts where plague had be active 11 4

Bubonic Plague Pandemic (1347 1900) Spatiotemporal distribution of 6,929 documented plague outbreaks. 12 Leonhard Ludwig Finke, 1792 Nosological Map of the World Drawn but not published because Finke was afraid that work would be too expensive Attempted to describe a broad topography of disease in Germany First use of phrase Medical Geography 13 Seaman: Yellow Fever (New York, 1798) 7 8 S 6 4 1 S S S 2 3 14 5

Shapter Cholera (Exeter, 1832) 15 Edwin Chadwick (Leeds, 1842) 16 John Snow and Spot Maps (1854) Father of Modern Epidemiology Cholera London Broad Street Pump Chlorine in Water 17 6

John Snow Cholera (London, 1854) 13 water pumps 574 cholera fatalities in 10 days Multiple deaths at single address stacked black line Snow proved those affected drank water from the Broad Street Pump 18 John Snow Cholera (London, 1854) John Snow Cholera (London, 1854) 7

John Snow Cholera (London, 1854) John Snow Cholera (London, 1854) John Snow Cholera (London, 1854) 8

Polio Distribution, 1910 24 25 Obesity Trends* Among U.S. Adults BRFSS, 1990, 2000, 2010 (*BMI 30, or about 30 lbs. overweight for 5 4 person) 1990 2000 2010 No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30% 9

2010 State Obesity Rates State % State % State % State % Alabama 32.2 Illinois 28.2 Montana 23.0 Rhode Island 25.5 Alaska 24.5 Indiana 29.6 Nebraska 26.9 South Carolina 31.5 Arizona 24.3 Iowa 28.4 Nevada 22.4 South Dakota 27.3 Arkansas 30.1 Kansas 29.4 New Hampshire 25.0 Tennessee 30.8 California 24.0 Kentucky 31.3 New Jersey 23.8 Texas 31.0 Colorado 21.0 Louisiana 31.0 New Mexico 25.1 Utah 22.5 Connecticut 22.5 Maine 26.8 New York 23.9 Vermont 23.2 Delaware 28.0 Maryland 27.1 North Carolina 27.8 Virginia 26.0 District of 22.2 Massachusetts 23.0 North Dakota 27.2 Washington 25.5 Columbia Florida 26.6 Michigan 30.9 Ohio 29.2 West Virginia 32.5 Georgia 29.6 Minnesota 24.8 Oklahoma 30.4 Wisconsin 26.3 Hawaii 22.7 Mississippi 34.0 Oregon 26.8 Wyoming 25.1 Idaho 26.5 Missouri 30.5 Pennsylvania 28.6 27 Where does GIS fit within the Department of Public Health 28 29 10

Office of Health Assessment and Epidemiology (OHAE) Units Epidemiology Health Assessment Data Collections and Analysis IRB http://publichealth.lacounty.gov/ohae/ 30 Epidemiology Unit Epidemiology Support & Training Demographic, Childhood Obesity, Life Expectancy Data Special Studies & Health Reports Geographic Information Systems http://publichealth.lacounty.gov/epi/index.htm 31 Office of Health Assessment and Epidemiology Epidemiology Unit GIS Unit Aida Angelescu/Douglas Morales Data Requests/Web GIS Officially the Unofficial GIS Unit Quarterly Health GIS meetings Next meeting: May 28 32 11

8 Service Planning Areas (SPA) 4 Area Health Officers One per 2 SPAs 26 Health Districts (HD) with the 8 SPAs Built upon Census Tracts 14 Public Health Centers (PHC) 88 Incorporated Cities in Los Angeles County Is Panorama City a City? East LA? Lennox? GIS Data Requests Spatio Temporal Analysis 35 12

36 37 Results consistent with Study that showed three LA restaurant hubs Who is more likely to complain? First time these data were spatially enabled 38 13

What are potential Sites for a Warehouse Median Center is downtown LA Standard Deviational Ellipses Can factor in traffic conditions and routing 39 Eliminating downtown LA as a candidate Pasadena location a good alternative? 40 41 14

3/4/2014 42 43 Skid Row Project Guidelines Map locations of: Los Angeles City Public Restrooms Trash cans Rodent Burrows Feces Urine Problem! No GPS device 44 15

3/4/2014 45 46 47 16

WNV + Animal Distribution Legend WNV+ Birds Year 2008 2009 2010 2011 2012 Mean Center Median Center Standard Devational Ellipse WNV + Geographic Distribution 2008 2009 2010 2011 2012 Legend WNV+ Birds Year 2008 2009 2010 2011 2012 Mean Center Median Center Standard Devational Ellipse 17

SPA 6 Demographics (Census 1990) SPA 6 Demographics (Census 2010) 18

MLK, Jr. PHC Demographics (Census 1990) MLK, Jr. PHC Demographics (Census 2010) Web GIS Application 56 19

DPH GIS Map Viewer http://gis.lacounty.gov/dph Internet application Open to the public Interactive experience Latitude Geographics Geocortex Essentials Geocortex Viewer for Silverlight (v. 1.2) 57 LA County Health View Under development Added tools New/Updated data Latitude Geographics Geocortex Essentials Geocortex Viewer for Silverlight (v. 1.9) HTML5 Viewer (TBD) ios/android compatible 58 59 20

60 61 62 21

63 VB Corona Virus Experience using geographic information systems (GIS) software to create thematic maps and conduct spatial analysis. 65 22

Career Options 66 **New** GIS Job Series Not Public yet 67 Recommended GIS Books 68 23

GIS Classes, Degrees and Certificate Programs http://www.esri.com/what is gis/learn gis 69 http://mappingideas.sdsu.edu/geotech/ 70 Think Spatially! Douglas Morales, MPH dmorales@ph.lacounty.gov 213 989 7223 http://publichealth.lacounty.gov/epi/ https://www.linkedin.com/profile/view?id=273605976 71 24