1. GIS and Community Health

2. Some critiques of GIS emphasize the potentially harmful social consequences of the diffusion of GIS technology, including reinforcing the power of state agencies, facilitating surveillance, and promoting an, at best, naive, technocratic view of social problems (Goss, 1995; Sheppard, 1995; Campbell, 1996; Clark, 1998) GIS and Community Health

3. At the same time, the development of GIS and the hardware, software, databases, and networking systems they rely on have also made it possible for the general public to have greater access to health and environmental information and to visualize and analyze that information in new and innovative ways.

4. Institutional Context and Interests A range of institutions and organizations have adopted GIS as an information technology. These organizations have different program responsibilities and information needs, and as a consequence different reasons for using GIS The institutional context affects the kind and quality of geographic data available for GIS implementation.

5. Institutional Context and Interests Federal and state agencies develop foundation databases for their own use and public distribution Data vary from place to place, depending upon geographical conditions, state agency responsibilities, and state regulatory requirements Local agencies and community groups have access to detailed information about local conditions Databases developed by private concerns may be very detailed but are less likely to be available for public distribution

6. Institutional Context and Interests in GIS Development  Data Institution Collection I Management I Analysis I Distribution I Regulation I Scientific Research Federal agencies xx xxxx State agencies xx xxxx Local agencies xx xx Health care xx x Providers and Insurers Universities xx xx Research institutes Libraries andxx Clearinghouses GIS vendors x Community Groups xx xx

7. Institutional Context and Interests in GIS Development cont… Institution Education and training I Advocacy I Health service delivery I Software development Federal agencies State agencies x Local agencies x Health carex Providers and Insurers Universities xx Research institutes Libraries andx Clearinghouses GIS vendorsx x Community Groups xx

8. Public Participation GIS The expanding role of GIS in community-based health initiatives is connected to the broader movement to develop public participation GIS (PPGIS), linking the various institutions and organizations involved in GIS development

9. PPGIS Systems that facilitate and enhance participation of individuals and groups in society around issues of local concern (Sheppard, 1999) The systems enable participants to explore local environmental and social issues, asses their significance, and communicate openly and effectively in attempting to address those issues.

10. Cornerstones of PPGIS To accommodate an equitable representation of diverse views This implies enhancements to GIS design and functionality, as well as understanding of the sociopolitical contexts of community participation A key element of PPGIS is community involvement in the creation, evaluation, and analysis of spatial data.

11. Cornerstones of PPGIS Local knowledge in the form of narratives, photos, sketch maps, or video images that may be linked to and integrated with foundation spatial data. Some GISystems are now able to handle such diverse types of spatial information.

12. Web based GIS hold great promise for development of PPGIS. In PPGIS, participant involvement also extends into analysis and interpretation of spatial data. PPGIS can be designed in different ways, depending on the needs and goals of participants, along with technical and social constraints. Cornerstones of PPGIS

13. A more flexible approach allows participants to design their own queries, create new classifications, and even contribute data to the GIS; however, using these systems requires higher levels of skill and expertise on the part of community participants Cornerstones of PPGIS

14. PPGIS differ in the involvement of key interest groups or stakeholders. Because maintaining and operating GIS requires technical expertise, most PPGIS involve partnerships between community groups and academic researchers, students or trained public health professionals. Cornerstones of PPGIS

15. Local Planning Grassroots GIS efforts involve citizens more directly in mamaging their communities Broader community awareness of GIS and access to technology

16. Community-based public health GIS Difficult to review Usually deal with specific, localized communities, seek to document a wide range of neighborhood conditions, reflecting a broad view of health. GIS adapted by local groups as a tool to raise community awareness of neighborhood conditions and available services, to organize local residents, and ultimately to effect change.

17. Constraints on PHGIS Differences in community resources and capacity to adopt GIS technology. GIS represents a significant investment of money, time and staff, an investment that competes with other important needs for scarce community resources. Communities that lack resources and political clout are less likely to benefit from participatory health GIS.

18. Constraints on PPGIS Little is known about the performance and outcomes of PPGIS in diverse communities and the varying capacities of diverse groups to ensure that their health interests and needs are addressed. PPGIS facilitate community participation in analyzing local health problems, but do not guarantee that those problems will be addressed.