Applications of GIS Technology in

Professional Health
Christian Connections for International Health
Annual Conference, May 27 29, 2006

Scott A. Todd

Global Mapping International

What is GIS

(Geographic Information System)

Geographic Maps

Information Database

System Hardware, Software, Data,

People, Plans/Programs

GIS combines the intuitive visual clarity of a map together with

the information structuring, searching and analyzing power of a
database.
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What is not GIS:

GPS - The Global Positioning System

A GPS receiver is a tool used

for data collection,
determining your position on
the earth, or wayfinding
GPS coordinates can be a
type of data input for a
Geographic Information
System

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How GIS Works. . .

Features, Attributes & Operations

Data

The Main Ingredient

Vector points, lines, polygons (areas)

Raster images (aerial photos), grids

Tabular databases, spreadsheets

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Features

(Vector data)

Points Village, Facility, Household, Patient

Lines Roads, Rivers, Utility Line

Polygons Parcel, Census Tract, Service Area

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Attributes

(Tabular Data)

Events/Objects Village name, Facility type,

Household size, Patient condition
Route/Network Road capacity, River name,
Sewer main size, Boundary length
Area/Region Parcel size (Acres), Demographics,
Service Area (number of patients)
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Operations - Geoprocessing

Data Integration Collection, Conversion, Rectification,

Correlation/Confirmation
Management Data update/maintenance, Joining w/
other databases, Merge data sets
Analysis Selection/Extraction, Proximity, Distribution,
Relationships, Overlay, Change/Trends
Reporting Printed Maps, Tabular Reports

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So What . . .

A Geographic Information System is not just a fancy tool for

making attractive, detailed maps.
GIS provides a dynamic visual representation of the information
contained in a database, along with the power to query and
manage the database.
GIS tools support the creation and integration of various kinds of
data sets to analyze and better understand existing patterns,
distributions and relationships between features.
GIS analysis can generate new data to support clearer insight
and communication for needs assessment, decision making for
strategic planning and data management for implementation,
monitoring and evaluation of programs and initiatives.
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Global Mapping International

Who Uses GIS

Archaeology
Agriculture
Banking
Defense and Intelligence
Education
Electric and Gas
Engineering
Fire/EMS/Disaster/Homeland
Security
Forestry
Government (Federal, State,
County, Local)
Health and Human Services
Insurance
Landscape Architecture
Law Enforcement and Criminal
Justice

Libraries and Museums

Location Services
Logistics
Marine, Coast and Oceans
Marketing
Media
Mining and Earth Sciences
Natural Resources
Petroleum
Real Estate
Retail Business
Telecommunications
Transportation
Universities
Water and Wastewater
Weather

Source: Environmental Systems Research Institute Geography Matters, White Paper, 2002

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Health Geography
It is useful to divide the geography of health
into two interrelated areas:
1

The geography of disease, which covers the exploration,

description and modelling 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;

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.

Source: Boulos, Kamel MN - Geographic Informatics in Health, School for Health, University of Bath Bath BA2 7AY, UK

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GIS Health Software

GIS Software

Developing Organization

Price

EpiInfo / EpiMap

Center for Disease Control Free

(CDC)

HealthMapper

World Health Organization Free

(WHO)

SIGEpi

Pan American Health

Organization (PAHO)

$100 Health Inst.

$500 Non-Profit
$1000 Private

ArcGIS

Environmental Systems
Research Institute (ESRI)

$1500 + Maintenance

Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

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WHO: HealthMapper

About HealthMapper:
Original version 1993 by World Health Organization
Supports range of infectious diseases in over 60 countries

Public Health Needs Capable of Addressing :

Analysis of disease outbreaks, chronic diseases, injuries
Limited Management of distribution of health resources
Software is Free

Data Format Support:

Import and modify shapefiles
Import and Link: Excel, Access, dBase, .CSV, .REC (EpiInfo)

System Requirements:

Windows (98/NT/2000/Me/XP)

Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

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WHO: HealthMapper

Advantages:

Free: can be downloaded from WHO website

Very useful in supporting health surveillance, disease
prevention and control

Disadvantages:

Limited complex statistical capabilities

Data not provided with software
Publicly funded programs
Limited Technical support

Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

Global Mapping International

EpiInfo / EpiMap

About EpiInfo / EpiMap:

Created by the Centers for Disease Control (CDC), in 1985

Latest Version: Epi Info Version 3.3.2, released Feb 2005
Over 1,000,000 downloads in 180 countries

Public Health Needs Capable of Addressing:

Meets most needs in epidemiological studies, such as disease outbreaks or

other public health analysis
Software is Free

Data Format Support:

Import and modify shapefiles

Compatible with ESRI ArcView, MS Access, Excel, dBase, CSV, XML

System Requirements: (Windows 95/NT/98/2000/Me/XP)

Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

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CDC: EpiInfo/EpiMap

Advantages of EpiInfo:

Meets most needs in epidemiological studies

Free, can be downloaded from CDC WebPages
With a little computer experience can do simple useful
analysis

Disadvantages of EpiInfo:

Lacks statistical spatial data analysis

EpiInfo and EpiMap are two stand-alone programs
Data not provided with software
Publicly funded programs
Limited Technical support - reference to available manual

Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

Global Mapping International

SIGEpi
About SIGEpi:

Developed by Pan American Health Organization (PAHO), latest

version 1.4
Supports Multi-languages (Spanish and Portuguese)

Public Health Needs Capable of Addressing:

Provides complex analysis methods for health data

Management of distribution of health resources

Data Format Support:

Reads and processes files in Shapefile and ArcInfo coverage formats

from ESRI; other formats include Vector Product Format (VPF); CAD
and EpiMap
SIGEpi has RDBMS that use MS Access and interchange in other
formats (Dbase, Excel, Btrieve, EpiInfo)

System Requirements: Windows (98/NT/2000/Me/XP)

Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

Global Mapping International

SIGEpi

Price:

Advantages:

Health and Academic Institutions ($100)

Non-Profit Agencies ($500)
Personal and Private Agencies ($1,000)

Offers a broad GIS platform with functions for statistical spatial

data analysis integrated into the program
Creates geographical layers based on geographic data from GPS
receivers
SIGEpi was built based on ESRIs MapObjects

Disadvantages:

It has limitations in editing geographic databases

Maintenance & Technical support via Discussion forum or emails or
reporting errors or recommendations

Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

Global Mapping International

ESRI: ArcGIS

About ESRI ArcGIS:

Company started in 1969, founded by Jack and Laura

Dangermond, privately
held company
p
ArcView 1.0 released in 1992

Public Health Needs Capable of Addressing:

Analysis of disease outbreaks, chronic diseases, injuries

Management of distribution of health resources

Data Format Support:

Direct read and import capabilities of more than 70 different

formats, including rasters (images) and ODBC
Import, edit, and export of shape files

Price: Single user license $1500

Annual Maintenance: $500 to $3,000
System Requirements: Windows (98/NT/2000/Me/XP)

Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

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ESRI: ArcGIS

Technical Assistance:

Advantages:

Free for initial year of purchase

Industry leader in Public health sector
Many extensions built on ArcGIS
Base data provided with software
Software is scalable
Custom Scripting Capabilities - in VB, C++, .NET

Disadvantages:

Expensive application and maintenance package

Not specifically oriented toward Health Applications
Need to have hands-on experience or extensive training

Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

Global Mapping International

Data Formats

Each offers Free Online Training Manuals

Each product offers Data format support for:

Shapefiles (.SHP)

Excel

.CSV

MS Access

dBase

.REC

Each product can read data from a GPS

Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

Global Mapping International

Comparison Matrix
HealthMapper

EpiInfo
/EpiMap

SIGEpi

ArcGIS

Health Analytic
Support Needs
Met?

Yes

Yes

Yes

Yes

GIS
Capabilities?

Limited

Limited

Yes

Yes

Cost

Free

Free

$100 Health inst.

$500 Non-Profit
$1000 Private

$1500 single user

$500 -$3000
Annual
maintenance

Tech Support

None

Limited

None

Free 1st year

Source: Alsahhar, Belew, Getachew, McElroy - GIS in Public Health, University of Dallas, Oct 2005

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The Future of GIS in Health

HealthQuery: An online
healthcare
services/access
application.
Collaborative project of
Good Hope Medical
Foundation, California
Department of Health
Services Centre for
Health Statistics, the
National Health
Foundation (NHF),
ESRI, Oracle and Sun
Microsystems
This figure shows a
search for the nearest
hospitals within a 5mile radius around
92373 (Zip code, CA,
US).
HealthQuery found 4
locations.
Source: Boulos, Kamel MN - Geographic Informatics in Health, School for Health, University of Bath Bath BA2 7AY, UK

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GIS Demonstration

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Contact:

Scott A Todd
scott@gmi.org
610-617-0195
Global Mapping International
15435 Glen Eagle Drive, Suite 100
Colorado Springs, CO 80921 USA
info@gmi.org

Sources:

Alsahhar, Belew, Getachew, McElroy - GIS in Public Health

University of Dallas, Oct 2005
Boulos, Kamel MN - Geographic Informatics in Health
School for Health, University of Bath, Bath BA2 7AY, UK

Global Mapping International