Chetan Tiwari, Ph.D.Assistant Professor — Geography

chetan.tiwari@unt.edu

Using Maps as Public Health Decision Support Tools

What is Geography?

Pitcairn Islands

(Borrowed from http://blogs.msdn.com/b/willy-pter_schaub)

Geographic Processes

And then came GIS!

=Elvis LoversElvis LikersElvis Who?Elvis DislikersElvis Loathers

Maps are not keeping up with the technology!(and data)

Does risk change as you go from one county to the next?

Maps That Only Present Data

Same Data, Different Maps!

Tuberculosis Burdens in Tarrant County, TexasLighter shades of yellow represent lower TB burdens

And...

• Population structures are different

• Socio-economic groups tend to cluster together

• Environmental risks are uneven over geographic space

• Disparity in access to health care

• Certain groups are more vulnerable to risky behaviors

• Representative of the phenomena

• Control for differences in populations

• Provide a “place” context

• Automate

• And, be easy to use

Making Maps to Support Better Public Health Policy

Continuous Representations

0.18 - 1.26

1.26 - 1.91

1.91 - 2.55

2.55 - 4.7

4.7 - 55.06

TB Incidence Rate (per 100,000)

Continuous Representations

0.8 - 5.6

5.7 - 8

8.1 - 12

13 - 19

20 - 310

HIV Incidence Rate (per 100,000)

Control for Differences in Populations

0.8 - 5.6

5.6 - 8

8 - 12

12 - 19

19 - 1329

HIV Incidence Rate (per 100,000)

What if every place had the same population structure?

Control for Differences in Populations

0 - 1

1 - 2

2 - 4

4 - 10

SIR

What if every place had the same risk of disease?

Provide a Place Context

Cumulative Incidence of HIV/AIDS from 1999-2000, DFW Metroplex, TexasAll areas treated equally

0 - 34

34 - 69

69 - 120

120 - 4370

Poverty Areas(per 100,000)

Provide a Place Context

Automate as Much as Possible

Easy To Use

http://www.webdmap.comBuilt using FOSS

Breast Cancer Incidence Rates

1998 - 2001 2002 - 2005

Do More Than Just Map Diseases

1. Link to environmental models and visualize risks in the context of disease outcomes

2. Provide a flexible geospatial platform for integrating data and models

3. Provide better decision making/information dissemination tools

Hazard Surveillance

Exposure Surveillance

Outcome Surveillance

Environmental Modeling

Geocoding and Exposure Assessment

Disease Mapping

Environmental Surveillance

WebDMAPFramework

There Are Many Unanswered Questions

Examining the geographic distributions of those phenomena (and doing it correctly) are crucial steps in understanding the processes that result in the outcomes we see and experience, and will therefore lead to better decision making.