Jill McElroyJill McElroySemahgn A. BelewSemahgn A. BelewSami J. AlsahharSami J. Alsahhar

Yoseph A. GetachewYoseph A. Getachew

GIS in Public HealthTechnical Assessment

GISC-6383 Management and ImplementationOctober 27, 2005

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GIS in Public HealthGIS in Public Health

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Examples of Disease Examples of Disease

Outbreaks Relating to LocationOutbreaks Relating to Location CHOLERA in areas lacking safe water CHOLERA in areas lacking safe water

suppliessupplies

MALARIA where there is a MALARIA where there is a proliferation of mosquitoes proliferation of mosquitoes

HIV/AIDS tends to spread where HIV/AIDS tends to spread where transportation networks connect to transportation networks connect to outbreak areasoutbreak areas

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Example of Managing Health Materials

In 2004, Nebraska utilized GIS to assess distribution of limited flu vaccines.

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Many different interpretationsMany different interpretations

Includes EpidemiologyIncludes Epidemiology:: “The branch of “The branch of medicine that deals with the study of the causes, medicine that deals with the study of the causes, distribution, and control of disease in populations. distribution, and control of disease in populations. ””

Includes less-complex functionsIncludes less-complex functions • Health SurveillanceHealth Surveillance• Disease Prevention and ControlDisease Prevention and Control• Public Health Planning Public Health Planning

What is Public Health?

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Needs for this AssessmentNeeds for this Assessment1)1) Health Analytic SupportHealth Analytic Support

for prevention and control of:for prevention and control of:• Communicable diseasesCommunicable diseases• Chronic diseasesChronic diseases• InjuriesInjuries

Analyses range from less complex, as in HealthAnalyses range from less complex, as in HealthSurveillance, to complex, as in Epidemiology.Surveillance, to complex, as in Epidemiology.

2)2) GIS capabilitiesGIS capabilities to enable management of to enable management of distribution of health services and materials. distribution of health services and materials.

3)3) Money.Money. Public Health organizations are often Public Health organizations are often on tight budgets.on tight budgets.

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Highlighted GIS SoftwareHighlighted GIS Software

GIS SoftwareGIS SoftwareDeveloping Developing OrganizationOrganization PricePrice

EpiInfo / EpiMapEpiInfo / EpiMap Center for Disease Center for Disease Control (CDC)Control (CDC)

FreeFree

HealthMapperHealthMapper World Health World Health OrganizationOrganization(WHO)(WHO)

FreeFree

SIGEpiSIGEpi Pan American Health Pan American Health Organization (PAHO)Organization (PAHO)

$100 Health Inst.$100 Health Inst.$500 Non-Profit$500 Non-Profit$1000 Private$1000 Private

ArcViewArcView Environmental Systems Environmental Systems Research Institute Research Institute (ESRI) (ESRI)

$1500 + Maintenance$1500 + Maintenance

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WHO: HealthMapperWHO: HealthMapper About HealthMapperAbout HealthMapper::

Original version 1993 by World Health OrganizationOriginal version 1993 by World Health Organization Supports range of infectious diseases in over 60 countriesSupports range of infectious diseases in over 60 countries

Public Health Needs Capable of AddressingPublic Health Needs Capable of Addressing:: Analysis of disease outbreaks, chronic diseases, injuriesAnalysis of disease outbreaks, chronic diseases, injuries Limited Management of distribution of health resourcesLimited Management of distribution of health resources Software is FreeSoftware is Free

Data Format SupportData Format Support:: Import and modify shapefilesImport and modify shapefiles Import and Link: Excel, Access, dBase, .CSV, .REC (EpiInfo)Import and Link: Excel, Access, dBase, .CSV, .REC (EpiInfo)

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

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WHO: HealthMapperWHO: HealthMapper

AdvantagesAdvantages:: Free: can be downloaded from WHO websiteFree: can be downloaded from WHO website Very useful in supporting health surveillance, disease Very useful in supporting health surveillance, disease prevention and controlprevention and control

DisadvantagesDisadvantages:: Limited complex statistical capabilitiesapabilities Publicly funded programsPublicly funded programs Limited Technical supportLimited Technical support

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EpiInfo / EpiMapEpiInfo / EpiMap About EpiInfo / EpiMapAbout EpiInfo / EpiMap::

Created by the Centers for Disease Control (CDC), in 1985Created by the Centers for Disease Control (CDC), in 1985 Latest Version: Epi Info™ Version 3.3.2, released Feb 2005Latest Version: Epi Info™ Version 3.3.2, released Feb 2005 Over 1,000,000 downloads in 180 countries Over 1,000,000 downloads in 180 countries

Public Health Needs Capable of Addressing:Public Health Needs Capable of Addressing: Meets most needs in epidemiological studies, such as Meets most needs in epidemiological studies, such as

disease outbreaks or other public health analysisdisease outbreaks or other public health analysis Software is FreeSoftware is Free

Data Format SupportData Format Support:: Import and modify shapefilesImport and modify shapefiles Compatible with ESRI ArcView, MS Access, Excel, dBase, Compatible with ESRI ArcView, MS Access, Excel, dBase,

CSV, XMLCSV, XML System Requirements:System Requirements: ((Windows 95/NT/98/2000/Me/XP)Windows 95/NT/98/2000/Me/XP)

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CDC: EpiInfo/EpiMapCDC: EpiInfo/EpiMap Advantages of EpiInfoAdvantages of EpiInfo::

Meets most needs in epidemiological studies Meets most needs in epidemiological studies Free, can be downloaded from CDC WebPages Free, can be downloaded from CDC WebPages With a little computer experience can do simple useful With a little computer experience can do simple useful

analysisanalysis

Disadvantages of EpiInfoDisadvantages of EpiInfo:: Lacks statistical spatial data analysis Lacks statistical spatial data analysis EpiInfo and EpiMap are two stand-alone programsEpiInfo and EpiMap are two stand-alone programs Publicly funded programsPublicly funded programs Limited Technical support - reference to available Limited Technical support - reference to available

manualmanual

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SIGEpiSIGEpi About SIGEpiAbout SIGEpi::

Developed by Developed by Pan American Health Organization Pan American Health Organization (PAHO), latest version 1.4(PAHO), latest version 1.4

Supports Multi-languages (Spanish and Portuguese)Supports Multi-languages (Spanish and Portuguese)

Public Health Needs Capable of AddressingPublic Health Needs Capable of Addressing:: Provides complex analysis methods for health dataProvides complex analysis methods for health data Management of distribution of health resourcesManagement of distribution of health resources

Data Format SupportData Format Support: : Reads and processes files in Shapefile and ArcInfo Reads and processes files in Shapefile and ArcInfo

coverage formats from ESRI; other formats include coverage formats from ESRI; other formats include Vector Product Format (VPF); CAD and EpiMapVector Product Format (VPF); CAD and EpiMap

SIGEpi has RDBMS that use MS Access and interchange SIGEpi has RDBMS that use MS Access and interchange in other formats (Dbase, Excel, Btrieve, EpiInfo)in other formats (Dbase, Excel, Btrieve, EpiInfo)

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

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SIGEpiSIGEpi Price:Price:

Health and Academic Institutions ($100)Health and Academic Institutions ($100) Non-Profit Agencies ($500)Non-Profit Agencies ($500) Personal and Private Agencies ($1,000) Personal and Private Agencies ($1,000)

AdvantagesAdvantages:: Offers a broad GIS platform with functions for statistical Offers a broad GIS platform with functions for statistical

spatial data analysis integrated into the programspatial data analysis integrated into the program Creates geographical layers based on geographic data from Creates geographical layers based on geographic data from

GPS receiversGPS receivers SIGEpi was built based on ESRI’s MapObjects

DisadvantagesDisadvantages:: It has limitations in editing geographic databasesIt has limitations in editing geographic databases Maintenance & Technical support via Discussion forum or Maintenance & Technical support via Discussion forum or

emails or reporting errors or recommendations emails or reporting errors or recommendations

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ESRI: ArcViewESRI: ArcView About ESRI ArcView:About ESRI ArcView:

Company started in 1969, founded by Jack and Laura Company started in 1969, founded by Jack and Laura Dangermond, pDangermond, privately held company

ArcView® 1.0 released in 1992ArcView® 1.0 released in 1992 Public Health Needs Capable of Addressing:Public Health Needs Capable of Addressing:

Analysis of disease outbreaks, chronic diseases, injuriesAnalysis of disease outbreaks, chronic diseases, injuries Management of distribution of health resourcesManagement of distribution of health resources

Data Format Support:Data Format Support: Direct read and import capabilities of more than 70 Direct read and import capabilities of more than 70

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

Price:Price: Single user license $1500Single user license $1500 Annual Maintenance:Annual Maintenance: $500 to $3,000$500 to $3,000 System RequirementsSystem Requirements:: Windows (98/NT/2000/Me/XP)Windows (98/NT/2000/Me/XP)

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ESRI: ArcViewESRI: ArcView Technical Assistance: Technical Assistance:

Free for initial year of purchaseFree for initial year of purchase Advantages:Advantages:

Industry leader in Public health sectorIndustry leader in Public health sector Many extensions built on ArcViewMany extensions built on ArcView Software is scalableSoftware is scalable Custom Scripting Capabilities - in VB, C++, .NETCustom Scripting Capabilities - in VB, C++, .NET

DisadvantagesDisadvantages:: Expensive application and maintenance package Need to have hands-on experience or extensive extensive

trainingtraining

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Data FormatsData 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

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Comparison MatrixComparison Matrix

HealthMapperHealthMapperEpiInfoEpiInfo/EpiMap/EpiMap SIGEpiSIGEpi ArcViewArcView

Health Health Analytic Analytic Support Support Needs Met?Needs Met?

YesYes YesYes YesYes YesYes

GIS GIS Capabilities?Capabilities?

LimitedLimited LimitedLimited YesYes YesYes

CostCost FreeFree FreeFree $100 Health $100 Health inst.inst.$500 Non-Profit$500 Non-Profit$1000 Private$1000 Private

$1500 single $1500 single useruser$500 -$3000 $500 -$3000 Annual Annual maintenance maintenance

Tech SupportTech Support NoneNone LimitedLimited NoneNone Free 1Free 1stst year year

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ConclusionConclusion

Our recommendations are based on:Our recommendations are based on: Health Analytic Support:Health Analytic Support:

HealthMapper (Health Surveillance)HealthMapper (Health Surveillance) EpiMap / EpiInfo (Epidemiology)EpiMap / EpiInfo (Epidemiology)

GIS capabilities:GIS capabilities: ArcViewArcView SIGEpiSIGEpi

Cost: Cost: HealthMapper and EpiMap / EpiInfo are freeHealthMapper and EpiMap / EpiInfo are free