A brief description on Health Geographic Information System (GIS)

1. Colonel Zulfiquer Ahmed Amin
M Phil, MPH, PGD (Health Economics), MBBS
Armed Forces Medical Institute (AFMI)
(Geographic Information System)

2. What is GIS
A geographic information system (GIS) is a
system designed to
Capture
Store
Manipulate
Analyze
Manage, and present
all types of spatial or geographical data
Geography: The nature and relative arrangement of places and physical
features

3. Synonyms of GIS?
• Geographic Information System (GIS)
• Geographical Information Science
• Geospatial Information Studies

4. Geographic information systems (GISs) concentrate on combining
computer mapping capabilities with database management and
analysis tools.
Geographic Information Systems is a computer-based tool that
analyzes, stores, manipulates and visualizes geographic
information, usually in a map.
By relating seemingly unrelated data, GIS can help individuals and
organizations better understand spatial patterns and relationships.

5. Introduction
• Public health management needs information on various aspects
like The prevalence of diseases, facilities that are available in order
to take decisions on either creating infrastructure facilities or for
taking immediate action to handle the situation and so on .
• GIS is becoming a vital tool in healthcare applications covering
database management, planning, risk assessment, service area
mapping, location identifications etc.
• Further, GIS would assist us in better linking of environmental,
demographic and temporal factors with the health issues to
understand causes for such health hazards.
.

6. The connection between public health and geography can be traced
back to Hippocrates (c. 400 BC) who deduced that spatially varying
factors such as climate, elevation, environmental toxins, ethnicity and
race contributed to the spatial patterns of illness.
Roger Tomlinson (1933 – 2014) is also acknowledged as the "father of
GIS".
Maps have long been a useful tool for visualizing patterns in health
care. Public health efforts have been based on analysis and use of
spatial data for many years.
History

7. Dr. John Snow (physician), often credited as the father of
epidemiology, is arguably the most famous of those examples. Dr.
Snow focused on a map which overlaid cholera deaths with the
locations of public water supplies . His study area was London in
the mid-1850s. Removal of the pump handle led to a rapid decline
in the incidence of cholera, helping the medical community to
eventually conclude that cholera was a water-borne disease.

8. Dr. Snow's map showing cholera cases in London during the epidemic
of 1854.

9. What can we do with GIS?
GIS can be used as tool in both problem solving and decision making
processes, as well as for visualization of data in a spatial
environment. Geospatial data can be analyzed to determine:
- the location of features and relationships to other features,
- where the most and/or least of some feature exists,
- the density of features in a given space,
- what is happening inside an area of interest (AOI),
- what is happening nearby some feature or phenomenon, and
- and how a specific area has changed over time (and in what way).

10. How GIS Works
1. Mapping where things are. We can map the spatial location of
real-world features and visualize the spatial relationships among
them.
2. Mapping quantities. People map quantities, such as where the
most and least are, to find places that meet their criteria or to see the
relationships between places.
3. Mapping densities. Sometimes it is more important to map
concentrations, or a quantity normalized by area or total number.
4. Finding what is inside. We can use GIS to determine what is
happening or what features are located inside a specific area/region.
We can determine the characteristics of "inside" by creating specific
criteria to define an area of interest (AOI).

11. 5. Finding what is nearby. We can find out what is happening
within a set distance of a feature or event by mapping what is nearby
using geoprocessing tools.
6. Mapping change. We can map the change in a specific
geographic area to anticipate future conditions, decide on a course of
action, or to evaluate the results of an action or policy.

12. GIS aims to address and answer the following questions:
- Is this school's catchment areas optimized? Is it overstretched or
could we increase the catchment area?
- How do we allocate resources to where they are most needed?
- Is this hospital overstretched while this one is barely used? Why is
that?
- Where are recorded cases of a certain disease? Are we applying
medical resources in the right places to combat it?
- Are our roads in the right place? Should we build more? And
where?
Functions of GIS- Example

13. - Is our public transport network optimized? What is the
contingency if one route is cut off?
- Is aid going to the people who need it most in this disaster zone?
- Is it sensible to build houses here? (is it a floodplain and if so, what
would we need to do and how much money would we need to
invest ?)
- Can we legally build houses here? (Is the area an AONB (Area of
Outstanding Natural Beauty) or SSSI (Site of Special Scientific
Interest) or a conservation area?
- What is disease trend in Chittagong Hill Tracts? Why is it different
from plain land? How can we address the problem?
- Which countries, cities and areas are the biggest polluters? What
can we do about it? How do we plan our city to minimize pollution
of residential areas?

14. Applications of GIS (Real World Example )
Disaster Management
Hurricane Katrina is seen by many as the first time that GIS was used
as a disaster management tool. Thanks to newly available technology,
the first responders on the ground shared a great deal of data about
street plans - particularly which streets were and were not accessible
and the extent of the flooding. The efforts of data transmission both
prior to and during initial relief efforts were vital to relief efforts.
Crime Statistics
GIS is now vital to law enforcement and planning in terms of crime
statistics. Though most police forces in the USA have used them for a
long time, automated and digital mapping of reported crime has
made the process much easier, especially when looking at different
types of crime from different departments in larger cities.

15. Archaeology
GIS is now critical to many elements of archaeology as it takes on
more elements and characteristics of an environmental science.
Civic Planning
GIS has been a tool for rural and urban planning, planning desirability
and mapping social deprivation, where new roads could go or which
should be prioritized for repair.
Health / Medical Resource Management
Last year, it was found that Kathalbagan Area of Dhaka was mostly
affected by Chikugunya. Thus planning was initiated about why it
happened and what needed to be done, basing on spatial pattern of
the disease.
Transport
Through GIS data, govt decides which area of the city needs a fly
over.

16. Role of GIS in Public Health

17. Health geography
Health geography is the application of geographical information,
perspectives, and methods to the study of health, disease and
healthcare.
It is very useful and customary to divide the geography of health
into two interrelated areas:
1.Geography of health and diseases
2.Geography of healthcare system

18. 1. The geography of disease:
Which covers the exploration, description and modeling of the
spatio-temporal (space-time) incidence of disease and related
environmental phenomena, the detection and analysis of
disease clusters and patterns, causality analysis and the
generation of new disease hypotheses.
2. The geography of healthcare systems
Which deals with the planning, management and delivery of
suitable health services (ensuring among other things
adequate patient access) after determining healthcare
needs of the target community and service catchment
zones.

19. Essentials of Geographic Informatics
It is possible, for example, to overlay and integrate the following
data to perform different types of health-related analyses:
Population data, e.g., census and socio-economic data;
Environmental and ecological data, e.g., monitored data on
pollution and vegetation (satellite pictures);
Topography, hydrology and climate data;
Land-use and public infrastructure data, e.g., schools and main
drinking water supply;
Topography: the arrangement of the natural and artificial physical features of an area

20. Essentials of Geographic Informatics
Transportation networks (access routes) data, e.g., roads and
railways;
Health infrastructure and epidemiological data, e.g., data on
mortality, morbidity,
Disease distribution and healthcare facilities; and
Other data as needed to perform different types of health-related
analyses.

21. Essentials of Geographic Informatics
▪ As a modeling and decision support tool, GIS can help
determining the geographical distribution and variation of diseases
(e.g., prevalence, incidence) and associated factors, analyzing spatial
and longitudinal trends, mapping populations at risk and stratifying
risk factors.
▪ GIS can also assist in assessing resource allocation and
accessibility (health services, schools, water points), planning and
targeting interventions, including simulating (predicting) many
“what-if” scenarios before implementing them, forecasting
epidemics, and monitoring diseases and interventions over time.

22. Components of GIS
A GIS is an organised collection of :

23. GIS for Spatial Health Information
• Mapping where things are
• Mapping quantities
• Mapping densities
• Finding what is inside
• Finding what is nearby
• Mapping changes

24. GIS to find the right site for:
• PHC in a village
• Hospital locations
• Alignment transportation network
• Disease distribution
• Healthcare facilities and work force
• Blend client location with health data

25. GIS in Health planning
• Assessing resource allocation and accessibility
• Targeting intervention
• Forecasting epidemics, and monitoring diseases (Surveillance)
and intervention over time
• Emergency dispatch system

26. 4 Ms of Health GIS
• Mapping
• Measuring
• Monitoring and evaluation
• Modeling

27. GIS Data Models (Types)
1. Raster Model
- In its simplest form, a raster consists of a matrix of cells (or pixels)
organized into rows and columns, where each cell contains a value
representing information, such as temperature. Rasters are digital aerial
photographs, imagery from satellites, digital pictures, or even scanned
maps.
- Simplifying slightly, a digital photograph is an example of a raster dataset
where each pixel value corresponds to a particular colour.

28. 2. Vector Model
Vector data is split into three types: polygon, line (or arc) and point data.
- Polygons are used to represent areas such as the boundary of a city (on a
large scale map), lake, or forest.
- Line (or arc) data is used to represent linear features. Common examples
would be rivers, trails, and streets.
- Point data is most commonly used to represent nonadjacent features and
to represent discrete data points. Examples would be schools, points of
interest, bridge and culvert locations.

29. 3. GIS Models - Combined
- We’ll use a combination of
raster imagery and vector layer
files to build our geo-database
- Let’s see a real-world
application

30. Benefits of GIS in Healthcare
1. Identifying Health Trends
The software offers healthcare professionals the ability to identify
health related trends and more thoroughly target healing efforts
based upon those results. eg, Cancer Surveillance Program.
2. Tracking the Spread of Infectious Disease
One of its most powerful aspects is its ability to use geography and
other inputs to identify where diseases are most likely to spread
next. Maps can play a significant role in the
management of disease outbreaks.

31. 3. Utilizing Personal Health Information
The collection of large quantities of accurate personal data is
expected to reveal a great deal about personalized healthcare, but it
can also greatly impact broad regional treatment plans. It has the
potential to uncover long-term geographic trends in the health of
certain demographics of people or of individuals living within certain
regions.
4. Improving Services
GIS technology can enable community leaders and developers to
work more closely with hospitals to take larger steps in addressing
national healthcare needs. The system can help identify which
neighborhoods are in greater need of specific health services such as
more rehab centers or senior care facilities.

32. 5. Uses in Public Health
- Determining geographical distribution of diseases
- Analyzing spatial and temporal trends
- Mapping of population at risks and stratify risk factors
- Assessing healthcare needs of a community and resource
allocation
- Planning and targeting intervention
- Monitoring disease and intervention over time
- Forecasting epidemics

33. 6. Tomorrow's Health Care
Use of GIS for business function--marketing, sales, and facility and
materials management will continue to grow.
7. Infectious Disease Detection and Prevention:
Part of the reason to use geospatial data for tracking infectious
disease is that environmental factors are known to play a role in
health outcomes. By applying GIS technology to this issue,
researchers can address disparities in outcomes for various
populations, identify environmental (Spatial and temporal factors)
factors responsible for occurrence of certain health disorder and
promote preventing measures.

34. 8. Health insurance:
Health insurance companies are continually striving to better
understand healthcare costs. By applying location data, they’re able
to explore such questions as whether patients who live close to
polluted areas — bus depots, chemical plants, airports — trend
toward requiring increased healthcare premiums.
9. Hospital marketing:
Hospitals and other medical centers can use geospatial data to
better understand the community they serve and anticipate needs
in their service area.

35. 10. Promote following service provisions:
- Identifying areas with access to a health care service.
- Identifying the best location for a new service.
-Epidemiological investigation.
-Disease surveillance
-Establish health promoting facilities
-Identify high risk community
-Forecasting impending disease threat.

36. Present Uses of GIS
1. WHO GIS Program (HealthMap):
In 1993, the WHO/UNICEF Joint Program on Health Mapping & GIS
(HealthMap) was created to service the mapping and monitoring
needs of the Dracunculiasis Eradication Program with the help of GIS.
The GIS is based on the accurate mapping of all former and current
endemic villages in Africa and the development of epidemiological
and programmatic maps for use at national and local levels. The
maps also highlight where operational outreach activities for case
containment must be strengthened, where there still remains a need
for safe water supply, and where health education sessions could be
intensified through a school based approach.
2. WHO is also using GIS technology in its Leprosy Elimination
Program (LEP)

37. 3. GIS in Malaria (The MARA/ ARMA Initiative)
- Mapping Malaria Risk in Africa (MARA)
4. HealthQuery- Healthcare Service/ Access Application.
Web-based public domain tools designed to assist California
residents and health organizations in making more informed health
decisions.

38. Commonly Used GIS Programs
• Atlas GIS
• ArcView GIS
• ArcInfo GIS
• MapInfo

39. Conclusions
Understanding the relationship between location and health can
greatly assist us in understanding, controlling and preventing
disease, and in better healthcare planning, with more efficient and
effective resource utilisation. Thus an understanding and
application of GIS can facilitate better healthcare provisions, and
health outcomes for everyone.
Professional education and hands-on training courses in geographic
informatics are extremely important in achieving this goal.