Workshop - Health Geomatics, September 2008
Workshop themes include: general health geomatics; health services; space-time disease surveillance; environmental epidemiology; mapping health data; and privacy/data access
The workshop featured a series of presentations from internationally recognized experts including Professor David Briggs, Professor Andrew Lawson, Professor Mei-Po Kwan, Dr. Ellen Cromley, Professor Gerard Rushton, and Professor David Flaherty. Presentations were followed by breakout sessions where the experts interacted with participants in a series of moderated discussions. The following morning included those interested in charting an agenda for health geomatics education and training in BC.
Presentations
Challenges in using routine data to support policies on environmental health
Prof. David J. Briggs, Department of Epidemiology and Public Health, Imperial College London
Abstract
In the face of the complex issues that face society today, policy-makers derive the information they need to guide and justify their decisions from a range of sources, some informal and experiential, others objective and formal. One of the most important is via assessments - of the risks from environmental stressors, of the potential impacts of policies aimed at intervening to address these risks, and of the actual effects of current policies. These assessments in turn rely on knowledge provided by scientific studies of the relationships between environment and health - and in this context, especially, from environmental epidemiology. Underlying all these analyses are routine data. These take many forms, and are collected for different purposes. They include data not only on health, but equally on population and the environment. Over recent years, the utility of these data as a basis for both science and policy analysis has improved greatly, in part because of advances in data collection and reporting, but even more so because of major developments in geomatics (e.g. GIS, statistical methods, data mining techniques). Despite these, many difficulties remain in using routine data to inform environmental health policies. Based on extensive experience in building and using large databases in the UK Small Area Health Statistics Unit (SAHSU), and in a range of studies at European level, this presentation explores some of these challenges. Examples are given of problems inherent in different data sets, including national census data, routine health surveillance systems, and environmental monitoring data. Use of GIS and other modelling techniques, both to identify and to resolve these problems, at different spatial scales, is illustrated. Finally, suggestions are made about how better to link routine monitoring and surveillance, environmental epidemiology, and geomatics in order to support policies on environmental health.
Geomatics and Health Services
Ellen K. Cromley Ph.D, Senior Research Associate, The Institute for Community Research, Hartford, CT, USA; Adjunct Assistant Professor, Department of Community Medicine, University of Connecticut Health Center
Abstract
This presentation provides an overview of the role of health geomatics in health services delivery. The organization of health services is a key issue in public health applications of geomatics. The geography of health services and geographical factors that affect their utilization filter our understanding of population health patterns, and effective health services delivery is one means of improving people's health. Geomatics techniques for visualizing the distribution of vulnerable populations, measuring access to health services, and improving health services delivery are illustrated using examples for routine and emergency health services. Integrating geographic information systems technology with data systems to investigate and prevent disease outbreaks is also considered. Privacy and confidentiality issues for health services data are reviewed and specific proposals for addressing these issues are discussed.
Space-time Disease Surveillance for Public Health
Andrew B. Lawson, Professor of Biostatistics Department of Biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina (MUSC), Charleston
Abstract
In this presentation I will address the fundamental issues in the analysis of spatio-temporal disease data when interested in carrying out surveillance. Surveillance can be defined as the ongoing monitoring of health status. It is implied that the monitoring is prospective and also that it is real-time or near-real-time. In terms of disease, the major question being addressed is ‘What is unusual about current disease events?'. This prospective emphasis makes the subject focus quite different from conventional disease mapping. In essence it is the detection of change that is the focus. The talk will address the basic issues in this area: multi-focus objectives, the use of syndromic information to speed up inference, and the need for multi-stream data mining with linkage across streams. Detection of clustering, jumps in risk and cross-stream correlation will be examined. An EWMA approach to map surveillance will be demonstrated.
Reference
Lawson, A.B. and Kleinman, K. (2005) Spatial and Syndromic Surveillance for Public Health, Wiley, New York
Spatial Analysis in Public Health Practice and Research
Gerard Rushton, Professor, Department of Geography and Department of Health Management and Policy, University of Iowa, USA
Abstract
I will review seven questions important in the practice of public health for which methods of spatial analysis are useful. I first describe the question and its significance to public health and then illustrate with examples of implementations of these methods. My questions relate to making decisions on the spatial allocation of resources for preventing and controlling cardiovascular disease, infant mortality, colorectal, prostate and breast cancer. In all cases, I emphasize the use of geocoded disease and population data for very small geographic areas as organized in geographic information systems.
Privacy Issues and Protection of Geoprivacy in Healthcare Research
Mei-Po Kwan, Distinguished Professor, Social and Behavioral Sciences, Ohio State University, USA, and Adjunct Professor, Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, USA
Abstract
Spatial analysis and mapping of georeferenced individual-level data can help identify important geographic patterns or lead to significant knowledge for dealing with specific health issues in a particular area. However, given the need to protect personal privacy when using geospatial data, the possibility for undertaking geographic analysis on certain types of individual-level data is becoming increasingly circumscribed. This presentation addresses the common misuses of health data in mapping and spatial analysis. It discusses different methods for addressing the need to protect geoprivacy while making individual-level georeferenced data available. Geographic masking as a method for geoprivacy protection and the trade-off involved in using it in mapping and spatial analysis will be discussed. Future challenges and emerging trends will also be presented.
Tools for Privacy Risk Management for Health Research
David A. Flaherty, Consultant and Professor Emeritus, University of Western Ontario, and Chief Privacy Advisor for the Canadian Institute for Health Information
Abstract
The focus will be the need for privacy laws and policies, privacy training, confidentiality agreements, Frequently Asked Questions, Privacy Impact Assessments; privacy audits and site visits; and managing relationships with privacy advocates, the general public, and oversight bodies.