Extending Health Web Mappingusing Spatial Analytical Tools ORI GUDES (GRIFFITH UNIVERSITY) ISHARA KOTIAH (SPATIAL VISION)
Research problem and background 2There is growing evidence that new approaches and frameworks tohealth planning are required, that should be based on: Local information; Collaborative planning; and Evidence-based decision-making.(Murray, 2006; Scotch & Parmanto, 2006; Ashton, 2009; Kazada et al., 2009)This is important because health planning to date has not beensupported by sound evidence.For example, the cost of chronic disease to society remainssignificant, however current health planning methods have not madea substantial impact in addressing this issue.
Research problem and background 3According to the ABS In the last 5years there was growing evidencethat the Logan Beaudesert areaattained the highest rate in riskfactors of chronic diseases inAustraliaFrom a population of 270,000 1 in 4 people smoke 13% consume alcohol at a levelconsidered as high risk 60% are overweight
Research problem and background 4One of the responses by the Logan-Beaudesert community has been the Earlyestablishment of The Logan Beaudesert YearsHealth Coalition (LBHC) Optimal Multicultural Health The LBHC is a collaborative arrangement between government and non-government LBHC agencies, the private sector and community to Board develop and deliver health programs and services to the community Health GP Promotion Integration Information Management
Gap in the knowledge 5Lack of effective frameworks for integrating health information;Lack of effective frameworks for integrating health information;Lack of evidence for making informed decisions;Lack of evidence for making informed decisions;Lack of collaboration in decision-making processes; andLack of collaboration in decision-making processes; andLack of consensus in decision-making by health planners.Lack of consensus in decision-making by health planners.
Health assessment (health profile) framework 6Literature emphasises that I. FUNDAMENTAL II. INTERMEDIATE III.PROXIMATE IV. HEALTH & WELL-BEINGit is necessary for health (Macro level) (Meso/community level) (Micro/interpersonal level) (Individual or population levels)planners to develop athorough understanding of Natural environment Stressorseach individual community (topography, climate, Built environment Environmental, neighbourhood, Health outcomes water supply)(health profile) and factors Land use (industrial, residential, mixed use or workplace and housing conditions Infant and child health (low birth weight, leadthat influence health (the single use) Violent crime and safety poisoning) Transportation systems Police response Obesity Macro social factorsbroad social determinants Historical conditions Services (shopping, Financial insecurity Cardiovascular diseases banking, health care Environmental toxins Diabetesof health) Political orders Economic order facilities, waste transfer (lead, particulates) Cancers stations) Unfair treatment Injuries and violence Legal codes Public resources (parks, Infectious diseases Human rights doctrines museums, libraries) Respiratory healthThis framework Social and cultural institutions Zoning regulations (asthma) Buildings (housing, Mental healthsummarises the different Ideologies (racism, social schools, workplaces) Health behaviours All-cause mortality justice, democracy) Dietary practiceslevels of factors that Physical activity Health screeningimpact upon health Social context Inequalitiesoutcomes and, therefore, Distribution of material Community investment (economic development, wealthshould be considered in Distribution of maintenance, police Social integration and Well-being services) social support Hope/despairhealth planning initiatives. employment opportunities Policies (public, fiscal, Social participation and Life satisfaction environmental, integration Distribution of Psychosocial distress workplace) Shape of social educational Happiness Enforcement of networks and resources opportunities Disability ordinances (public, available within Distribution of political Body size and body environmental, networks influence image workplace) Social support Community capacity Civic participation and political influence Quality of education Health assessment framework Schulz and Northridge (2004)
Conceptual framework for planning healthy community using HDSS 7 Fundamental Factors Intermediate Factors Proximate Factors Health and well-being City level Community level Interpersonal level Individual or rofile (Macro) (Meso) (Micro) population levels actors H alth p IN IC T R SETS Natural environment Stressors F D AO Macro social factors Social context Health behaviours Health outcomes e Social integration Inequalities Built environment and support Well-being ealth D S S Health Decision Support System (Design and implementation of system for supporting decision-making processes) P cesses H ro Confident, effective policy and decision-making P licies City level policies Community level Interpersonal level Individual or population o (Macro) policies (Meso) policies (Micro) level policies Health public Innovation Community Intersectoral Political Commitment to re f lts A ao policy participation action decision-making health resu tcomes High health status Innovative city High degree of High degree of Encouragement of High health status economy participation participation connectedness Sustainable H alth ou Appropriate health Supportive Access to variety of Access to variety of ecosystem resources community resources ualities Basic needs Basic needs Encouragement of Encouragement of e connectedness connectedness Q Quality of Quality of environment environment Healthy community
How the HDSS conceptual framework was implemented 8 User satisfaction survey and HDSS usage statistics User information survey functionality & healthDecision-making GIS workshops scenarios workshops Decision-making survey survey Observational Observational data Logbook data
Please rate your level of requirement for Information Information Informationeach of the following information items essential to be is not now included in necessary Information items survey phase 2 based on available data (%) (%) (%) derived from Schultz and Northridge (2004) frameworkDemographic (100%) ___ ___Socio economic measures (90%) (10%) ___Sustainable Built and Natural (20%) (80%)Environments ___Terrain (10%) (70%) (20%)Public transportation (100%) ___ ___Recreation (100%) ___ ___Emergency (40%) (60%) ___Shops (80%) (20%) ___Roads (90%) (10%) ___Health facilities (100%) ___Education Facilities (90%) (10%) ___Community facilities (90%) (10%) ___Health Behaviours (e.g., Obesity) (100%) ___ ___Hospital admissions (100%) ___ ___Health data (e.g., health risk factors) (80%) (20%) ___
Feature / Function PurposeUser Login Screen for user to log into systemMap Navigation Basic Map Navigation, including zooming and panning Features and functionalityBase Map/ Imagery View Ability to select aerial imagery or street maps as a base view workshop 10Layers Ability to view health and demographic layers of the LBHCLayer list Ability to turn layers on or offIdentify attributes Ability to view details of attributes found at a certain locationOnline Help Accessibility to text on help notes for using the systemPrint Map Ability to print a mapMap Legend Ability to view an image indicating symbology used in the mapLayer Metadata Ability to view metadata (i.e., data on data) for each of the layers used in the systemSpatial Bookmarks Ability to store the extent of a view for quick PAR zoom in Cycle 2Simple Search Ability to undertake a simple geographical search of a name field on two spatial layers: SLAs (Statistical Local Areas) and community health centresRedlining and Measurements Ability to draw points, lines, polygons and text on the mapUser Feedback Ability for users to submit feedback regarding data set issues, updates or any other requirements of the system.Accessibility analysis Ability to compute the service area of two layers (public hospitals and GPs) based on driving or pedestrian travel timeProximity function Ability to find features in specified layers (public hospitals and GPs) within a specified buffer distance of a point entered by the user
Workflow Accessibility Function NameDescription The literature emphasises that accessibility to health facilities has been identified as a key determinant of health.Objective To test the effect of travel time to health facilitiesEnd Users LBHC members, Logan and Scenic Rim planners Workflows and healthOutcome To Identify gaps in the provision of health facilities in the communityWorkflow 1. User logs into HDSS Prototype. 11 scenarios sample 2. A map view is presented showing SLA boundary suburb names. 3. The user zooms in to a specific area. 4. The user selects a button on the interface to calculate service area catchments for a facility layer. 5. A form appears in which the user has the option to: 6. Pick a facility layer which may be one of three types: • Public Hospitals (default) • GP Clinics • Chronic Disease Centres 7. Pick a transport mode: • Pedestrian • Private Car (default) 8. Enter in travel time, (5,10, or 20 minutes) 9. Click on a button to show the service area. The system processes the request and updates the map to show travel time from the selected facility in the map view as polygons. 10. The user can visualise gaps between polygons which highlight areas not serviced. 11. The user sends the map to the printer.Optional The user turns on a layer of population statistics to compare demographicWorkflow data to the accessibility to facilities.GIS layers • Street map/aerial imagery • SLA • Suburbs • Public hospitals • GP Clinics • Chronic diseases centres • Population statistics (optional)
HDSS Scenarios• Accessibility to Health Services• High Risk Zones of Chronic Disease• Proximity Analysis
SummaryChallenges • Data Availability & Quality • Privacy and confidentiality • End User TrainingBenefits • Integrate Disparate Data Sources • Identify Location Profiles for Disease Incidence • Confirm/Disprove links between Disease and Risk Factors • Identify areas of inequities and gaps • QA records • Provide an evidence-based approach to Health Planning