Jill McElroy Semahgn A. Belew Sami J. Alsahhar Yoseph A. Getachew GIS in Public Health Technical Assessment GISC-6383 Management and Implementation October 27, 2005

2 GIS in Public Health

3 Examples of Disease Outbreaks Relating to Location CHOLERA in areas lacking safe water supplies CHOLERA in areas lacking safe water supplies MALARIA where there is a proliferation of mosquitoes MALARIA where there is a proliferation of mosquitoes HIV/AIDS tends to spread where transportation networks connect to outbreak areas HIV/AIDS tends to spread where transportation networks connect to outbreak areas

4 Example of Managing Health Materials In 2004, Nebraska utilized GIS to assess distribution of limited flu vaccines.

5 Many different interpretations Many different interpretations Includes Epidemiology: “The branch of medicine that deals with the study of the causes, distribution, and control of disease in populations. ” Includes Epidemiology: “The branch of medicine that deals with the study of the causes, distribution, and control of disease in populations. ” Includes less-complex functions Includes less-complex functions Health SurveillanceHealth Surveillance Disease Prevention and ControlDisease Prevention and Control Public Health PlanningPublic Health Planning What is Public Health?

6 Needs for this Assessment 1) Health Analytic Support for prevention and control of: Communicable diseasesCommunicable diseases Chronic diseasesChronic diseases InjuriesInjuries Analyses range from less complex, as in Health Surveillance, to complex, as in Epidemiology. 2) GIS capabilities to enable management of distribution of health services and materials. 3) Money. Public Health organizations are often on tight budgets.

7 Highlighted GIS Software GIS Software Developing Organization Price EpiInfo / EpiMap Center for Disease Control (CDC) Free HealthMapper World Health Organization (WHO)Free SIGEpi Pan American Health Organization (PAHO) $100 Health Inst. $500 Non-Profit $1000 Private ArcView Environmental Systems Research Institute (ESRI) $ Maintenance

8 WHO: HealthMapper About 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: 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: Data Format Support:  Import and modify shapefiles  Import and Link: Excel, Access, dBase,.CSV,.REC (EpiInfo) System Requirements: Windows (98/NT/2000/Me/XP) System Requirements: Windows (98/NT/2000/Me/XP)

9 WHO: HealthMapper Advantages : Advantages :  Free: can be downloaded from WHO website  Very useful in supporting health surveillance, disease prevention and control  Disadvantages : apabilities  Limited complex statistical capabilities  Publicly funded programs  Limited Technical support

10 EpiInfo / EpiMap About 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: 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: 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) System Requirements: ( Windows 95/NT/98/2000/Me/XP)

11 CDC: EpiInfo/EpiMap Advantages of EpiInfo : 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 : Disadvantages of EpiInfo :  Lacks statistical spatial data analysis  EpiInfo and EpiMap are two stand-alone programs  Publicly funded programs  Limited Technical support - reference to available manual

12 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)

13 SIGEpi Price: Price:  Health and Academic Institutions ($100)  Non-Profit Agencies ($500)  Personal and Private Agencies ($1,000) Advantages: Advantages:  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 ESRI’s MapObjects Disadvantages: Disadvantages:  It has limitations in editing geographic databases  Maintenance & Technical support via Discussion forum or s or reporting errors or recommendations

14 ESRI: ArcView  About ESRI ArcView:  Company started in 1969, founded by Jack and Laura Dangermond, p  Company started in 1969, founded by Jack and Laura Dangermond, privately held company  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 Price: Single user license $1500 Annual Maintenance: $500 to $3,000 Annual Maintenance: $500 to $3,000 System Requirements: Windows (98/NT/2000/Me/XP) System Requirements: Windows (98/NT/2000/Me/XP)

15 ESRI: ArcView Technical Assistance: Technical Assistance:  Free for initial year of purchase Advantages: Advantages:  Industry leader in Public health sector  Many extensions built on ArcView  Software is scalable  Custom Scripting Capabilities - in VB, C++,.NET Disadvantages: Disadvantages:   Expensive application and maintenance package  extensive training  Need to have hands-on experience or extensive training

16 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

17 Comparison Matrix HealthMapperEpiInfo/EpiMapSIGEpiArcView Health Analytic Support Needs Met? YesYesYesYes GIS Capabilities? LimitedLimitedYesYes CostFreeFree $100 Health inst. $500 Non-Profit $1000 Private $1500 single user $500 -$3000 Annual maintenance Tech Support NoneLimitedNone Free 1 st year

18 Conclusion Our recommendations are based on: Health Analytic Support: Health Analytic Support:  HealthMapper (Health Surveillance)  EpiMap / EpiInfo (Epidemiology) GIS capabilities: GIS capabilities:  ArcView  SIGEpi Cost: Cost:  HealthMapper and EpiMap / EpiInfo are free