"Public
Health and GIS, Mismatch of Job Skills and Theoretical Training"
Abstract
escalation of geographical information system (GIS) application in several
fields such as environment analysis has been progressive in relation to
poverty, crime and education (Duecker and DeLacey, 1990, Huxhold, 1991, Harris
and Batty, 1993). However, public health lags behind these fields in its use of
GIS (Urban and Regional Information Systems Association, 1994). This limitation
had largely been highlighted in the literature (see Fuertstein, 1987; Drummond,
1995; National Association of Country
Clubs Off, 2002). However, the development of measures and strategies that
could enhance GIS in public health had been proposed in terms of location, area
and even in data processing (Queralt and Witte, 1998; McLafferty, 1998;
Rushton & Frank, 1995).
The area of GIS and Public
Health has risen to prominence in the past two years with the recognition that
health surveillance practices and health service allocations need to become
more sensitive to the needs of people in local geographic areas. The
collection, storage and manipulation of geographic information have undergone a
revolution in recent years with the development and widespread availability of
GIS software. Many health professionals can benefit from further education in
this area, and with their new knowledge, they can influence the progress of
health surveillance, environmental health assessment and the geographic
allocation of health resources.
development provide a significant catalyst for the advancement of public health
GIS and the use of geospatial data through the Internet (Croner, 2003). They
provide timely stimulus for the delivery of public health geospatial
information for community, state, and national uses. They portend important
changes. Based on emerging geospatial infrastructure in the twenty first
century.
A GIS can be a useful tool
for health researchers and planners because health and ill-health are affected
by a variety of life-style and environmental factors, including where people
live, characteristics of these locations (including socio-demographic and
environmental exposure) offer a valuable source for epidemiological research
studies on health and the environment. Scholten and Lepper (1991),
geographic information systems (GIS), a need has developed for accompanying
statistical routines to aid in the analysis and interpretation of geographical
data particularly spatial analysis. (Levine, 1996)
use GIS to isolate geographical areas, subpopulations, land uses, and road
systems according to various search criteria, extracting objects on the basis
of geographical or attribute conditions. The existing GIS packages are very
sophisticated tools for geographical and database operations. They can conduct
a wide variety of different overlay operations: creating buffers around
objects, selecting objects by their proximity to other objects, unioning
smaller objects into bigger ones and splitting larger objects into smaller
objects, as well as implementing a whole range of database functions (e.g.,
conditional queries, object queries). (Levine, 1996)
unique. Rather, the uniqueness of GIS lies in its ability to integrate pieces
of existing spatially-referenced information in unprecedented ways. Some go so
far as to say that, based on the new perspectives offered by GIS, it might even
constitute a new discipline (Goodchild, 1990).
Whether or not this is a realistic assessment, there is little doubt
that GIS offers great benefits in the constructivist, holistic model upon which
it is based--a perspective that is gaining attention among educators (Boyer and
Semrau, 1995).
Many geography educators hold
that enhancing geography education must include integrating spatial
technologies such as GIS (Nellis, 1994).
GIS research has in turn expanded to include theoretical and practical
questions about its place in the framework of education, (Suit, 1995) since
lack of such understanding would undermine the potential of the tool itself
(Donaldson, 1999). Likewise, if GIS is
to evolve into a significant force in education, more thought needs to be given
to how it is implemented and used in classrooms. Most geography educators
concur that successful GIS implementation will not be possible without a
combination of (1) acknowledgment of its usefulness by teachers and
administrators; (2) a concomitant level of financial support for this
technology; (3) the provision of teacher training; and (4) the creation of
networks to supply teachers and administrators with the entry-level and
advanced information they need to implement GIS.
This study shall investigate
the disparity
in terms of the curriculum of spatial methods in the Masteral level and what is
taught in Schools of Public Health using GIS (geographic information systems)
and what employers, particularly in the Public Health sector both private and
public expect these students to be able to do using spatial analysis tools
competency. Moreover, this study shall include the state and local public
health offices, public health research firms, and GIS educators in order to
determine if their employees coming out of these schools possess the
necessary skills or are they being taught on the job to use GIS.
Conceptual
Framework
by Arbia, G., Griffith, D. and Haining, R. (1999)
and error processes with simple but well-defined properties is to understand
better how different elements of the situation, individually and together,
contribute to the final propagated error. The problem with using real maps
(rather than artificially generated maps) is that real maps usually have
complex structures so that it may not be clear the extent to which aggregate
statistics computed to measure the severity of the error problem are an
aggregation across many types of quite different map segments with different
structures. Usually, real errors are not known for any data set, and unless
their structure is uniform across the map, the same problem for interpreting
aggregate statistics could arise.
simulation, means that where theoretical results can be obtained they can be
used to check simulation output before the simulation is used to obtain
properties that are not accessible to mathematical analysis. Furthermore it is
only through formal mathematical modeling, leading to closed-form expressions,
that a rigorous study can be undertaken that yields quantitative and
qualitative insights as to how different elements contribute individually or
interactively to error propagation. The formal expressions make the
contributions explicit, and regression (adding maps) and ANOVA (ratioing) are
used to quantify the relative contributions of each term in the expression.
Where theoretical results have not been obtained, as in the case of ratioing,
simulation alone, even with regression analysis of the outputs cannot produce
the same quality of evidence because of the dangers of model misspecification
in using regression. (Arbia, G., Griffith, D. and Haining, R., 1999)
Research Questions and Hypothesis
the spatial analysis models and in the public health sector and shall be
compared to what is taught in the masteral level. Essentially, the study shall
focus on the problems encountered in the spatial modelling and planning in the
public health and how the education system helps/lacks in the training of the
students.
answered: (1) What are the problems, factors and challenges facing the public
health sector in GIS spatial modelling and how does the training of the
masteral students addresses this problem? (2) Can the masteral training of the
public health practitioners support and address the spatial problems
encountered in the workplace application?
Hypothesis
Public Health
Schools provide inadequate GIS education for the actual applications of spatial
methods and analysis in the public health sector.
Significance of the Study
This
study shall determine the workplace practice and application of geographic information
system (GIS) in the public health sector and how the education provided in the
academe is compatible/incompatible with the actual practice of spatial
analysis. Furthermore, this study shall illustrate the importance of spatial
modelling and planning in the training of masteral level students in solving
the spatial problems encountered in the workplace. This will be beneficial to
educators, students and GIS practitioners alike in determining the capabilities
that are required in the public health sector.
Scope and Limitation
study will discuss the weaknesses and strengths of the masteral spatial GIS
education in the public health setting, the factors affecting the efficiency
and competence of the students in public health GIS and the improvements that
could be done.
Review of Related Literature
This chapter shall present
the related studies and researches in the areas of GIS in health planning,
spatial analysis in GIS, the disparity between spatial training in education
and in the public health workplace. These data shall be utilized as a
background of the research and shall provide the measures and the supporting
data regarding the spatial analysis of GIS in the health sector. This section
shall be divided into three areas: the introduction of GIS and GIS in the
health sector, the need for spatial tools in addressing the problems in GIS
mapping, modelling and planning and the disparity in the educational training
of students in spatial methods.
Arial'>Background of the Study
Geographic Information Systems (GIS)
is a computer-aided database management and mapping technology that organizes
and stores large amounts of multi-purpose information. GIS adds the dimension
of geographic analysis to information technology by providing an interface
between the data and a map. This makes it easy to present information to key
decision-makers quickly, efficiently and effectively.
Geographic information systems and
remote sensing from earth-observing satellites are sophisticated and powerful
technologies that are finding applications far beyond those originally
intended. According to the World Health Organization (2003), both are products
of the Cold War developed by the departments of defense for military purposes.
Together, they allow near real-time access to data on temperature, soil,
elevation, patterns of land use, and phases of vegetation in addition to the
precise geographic location of water bodies, population centers, buildings,
roads, and other infrastructure. Their use for purposes ranging from the search
for natural resources to transportation engineering, urban design, and
agricultural planning was quickly recognized and exploited.
system, observations regarding the social, economic, political, and physical
environments can be referenced to a common geospatial data framework (Rushton,
Elmes and McMaster, 2000). This permits varying organizations to share spatial
data regarding these phenomena. Geographic information science has the
potential to create rich information databases, linked to methods of spatial
analysis, to determine relationships between geographical patterns of disease
distribution and social and physical environmental conditions. As the core of a
decision-support system, geographic information science also has the potential
to change the way that allocations of resources are made to facilitate
preventive health services and to control the burden of disease.
Geographic information systems and
remote sensing have capabilities that are ideally suited for use in infectious
disease surveillance and control, particularly for the many vector-borne
neglected diseases that are often found in poor populations in remote rural
areas (WHO, 2003). They are also highly relevant to meet the demands of
outbreak investigation and response, where prompt location of cases, rapid
communication of information, and quick mapping of the epidemic’s dynamics are
vital. However, until recently, the use of these tools in public health were
largely limited in use due to two major problems: the prohibitive cost of
hardware and the great complexity of GIS software that made it extremely
time-consuming as well as costly to extract information relevant to the
practical demands of disease prevention and control.
Map Errors
information. (Cressie and Gabrosek, 2002) Typically, there is also attribute information, whose distribution
depends on its location. Thus, error in location information can lead to error
in attribute information, which is reflected ultimately in the inference drawn
from the data. Data are considered spatial if they contain location
information. Typically, there is also attribute information available. The
distribution of the attribute varies from location to location. Attribute
information consists of the measured response (or responses), which can be
either discrete (for example, counts of animal populations) or continuous (for
example, soil pH). With the advent of optimal spatial linear prediction (that
is, kriging), the analysis of spatially dependent data has progressed rapidly
in the past forty years. (Cressie, 1990)
raises a distinct set of problems that go beyond traditional error analysis (
consist of attributes recorded at locations and, with the exception of lines of
discontinuity such as shorelines and urban/rural boundaries, attribute values
at adjacent locations are often similar (spatially correlated) because of the
continuity of ground truth. The error processes that can contaminate map data
also raise new problems. Attribute measurement error may not be independent
between adjacent locations and there may be errors in specifying the locations
of attributes. (Arbia, Griffith, and Haining, 1999)
GIS and Planning
GIS is to focus on the incorporation of local knowledge in GIS
planning. Some researchers (Craig & Elwood, 1998; Elwood & Leitner,
1998) have attempted to incorporate local knowledge in the building of GIS
databases, working to incorporate value-based, traditionally intangible
information, such as how residents value their homes or their feelings about
the uniqueness of a given area (Bosworth & Donovan, 1998). Because these
approaches seek to give local residents greater access to GIS, they are aligned
with other community-based uses of GIS (Elwood & Leitner, 1998). However,
they also add the attempt to incorporate resident, or local, knowledge.
Need for
Spatial Statistical Tools
planners, who often deal with a spatial relationship between one set of objects
and another that should be considered quantitatively rather than qualitatively.
(Levine, 1996) For example, housing experts may want to compare the
socio-economic characteristics of areas that do or do not contain public
housing projects, or transportation planners may want to relate traffic volume
measurements to characteristics of the surrounding neighborhood. Standard GIS
packages can quantify some aspects of this by, for example, assigning a census
tract's median household income to a housing project, or by associating a
particular road segment having high traffic volumes with the number of families
in the surrounding traffic analysis zone (TAZ). However, such relationships
cannot easily be generalized beyond the specific database operation.
can conduct these types of summaries much more easily than can the GIS
programs. In addition, generalizing the results beyond the specific data
requires a set of inferential testing procedures and a statistical theory.
(Leviune, 1996)
distribution on a map can be informative, its usefulness is limited. All kinds
of distortions are produced by visual display; Tufte's classic work illustrates
this wonderfully (Tufte 1983). It is very hard to look at a distribution and
say whether it is similar to or different from another. Then, too, since most
mapping programs are two-dimensional, a visual display can be overwhelmed by a
large amount of data. In short, there are limits to database operations and to
visual display. Spatial statistics allows for degrees of quantification and
inference that are much more rigorous and less prone to misinterpretation.
Neither the existing GIS programs nor statistical packages provide quantitative
measures of spatial relationships such as dispersion, concentration, or spatial
autocorrelation.
Spatial
Analysis and Health
uncertainty. When creating maps, location is of paramount interest. At the
other extreme, many statistical analyses take no account of location, modeling
data as if it were statistically independent. Geostatistics is between these
extremes. Geostatisticians use location to model trend and correlation between
attribute values over a geographic region; however, they ignore uncertainty in
locations.
The advent and then
ubiquity of geographic information systems (GIS) has led to an explosion of
information available from spatial databases. The easy storage and quick
retrieval possible within a GIS requires concomitant development of spatial
statistical methodology. Incorporation of attribute-error analysis is often
handled through geostatistics, but there is an urgent need for statistical
research and software developments to deal with both location error and
attribute error (for example, Griffith, Haining, and Arbia 1999).
Geographers and users of
raster-based GIS often model the effects of location error in spatial data by
assuming that the attribute value is discrete (often a gray-scale value) and
that the spatial domain is a fixed grid of pixels. A commonly used model for
the Bayesian restoration of images, attributed to Geman and Geman (1984), has
been adapted by researchers working with GIS to investigate how errors in
source maps propagate through a GIS to output maps (for example, Goodchild
1989; Arbia, Griffith, and Haining 1998). Output maps result from overlay
operations that combine two or more source maps at potentially different scales
of spatial resolution.
The Need for GIS in Public Health
Access to health
care is an important issue across populations who face substantial barriers in
obtaining care, and health care policies and imperatives affected by the
location, quality, and quantity of services available with concomitant effects
on access. Access describes people’s ability to use health services when and
where they are needed (Aday and Anderson, 1981). Furthermore, health care
decisions are strongly influenced by the type and quality of services available
in the local area and the distance, time, cost, and ease of traveling to reach
those services (Goodman, Fisher, Stukel and Chang, 1999; Haynes, Bentham Lovett
and Gale, 1999). For medical conditions that require regular contact with
service providers, travel, time and distance can create barriers to effective
service use (Fortney, Rost, Zhang and Warren, 1999; Haynes, Gale, Mugfort and
Davies, 2001).
new technological development. The remarkable increase in use of the Internet
is creating new standards, and challenges, for the efficient use of the
Web-based geospatial applications (Longley, Goodchild, Maguire and Rhind,
1999). GIS and Web technologies offer emerging opportunities to analyze complex
geospatial data, solve problems, and present data in a graphical format that
public health decision makers and the public can easily see and understand
(National Association of Country Clubs
Off, 2002).
varied, and concern a great number of questions linking social and physical
problems (transport and agricultural planning, environment and natural
resources management, location/allocation decisions, facilities and service
planning (education, police, water, and sanitation), and marketing).
Generally, the objectives of a
GIS are the management (acquisition, storage, maintenance), analysis
(statistical, spatial modeling), and display (graphics, mapping) of geographic
data. Even if a few general concepts are presented, the GIS discussed here will
be seen from a health perspective. Thus, GIS will be considered as a tool to
assist in health research, in health education, and in the planning,
monitoring, and evaluation of health programs.
As health is largely
determined by environmental factors (including the sociocultural and physical
environment, which vary greatly in space), it always has an important
environmental and spatial dimension. The spatial modeling capacities offered by
GIS can help one understand the spatial variation in the incidence of disease,
and its covariation with environmental factors and the health care system.
As mapping is an excellent
means of communication, GIS can be used, as Kabel (1990) suggests, to help
prepare educational materials. In an article on participatory evaluation, M.T.
Fuerstein (1987) describes different methods for monitoring and evaluating
community health projects, including mapping. Fuerstein (1987) suggested that
maps, showing location of houses by number and type, public and private
buildings, water sources, sanitation, bridges, roads, social centres,
neighbourhood boundaries, health centres, etc. give participants a wider view
of where they are living. Maps can help discussion, analysis, decision-making,
management and evaluation.
Meyles and de Bakker (2002) conducted
a study dealing with demand of employers for Geo-information specialists and
the supply of educational institutes. They asserted that there is a need for a
clear definition of a geo-information specialist with according content of the
geo-information curricula. It needed to distinguish education
into to two or three different GIS expert groups.
The situation has changed
dramatically over the past few years. Hardware prices have plummeted, simple
new devices are now available, and a new generation of civilian satellites is
in orbit, circling the world. The Public Health Mapping Programme based within
WHO Communicable Diseases has been developed with the goal of providing greater
access to simple, low-cost geographic information and related data management
and mapping systems to public health administrators at all levels of the health
system (WHO, 2003).
Geographic Information Systems is
also being used to map and explore variation in need for healthy services and
to develop innovative indicators of health care needs (McLafferty, 1998). GIS
has been used for many years to link diverse layers of populati0on and
environmental information to characterize the many dimensions of health care
needs for small areas (Hanchette, 1998; Mohan, 1993). According to McLafferty,
in effect they are restricted to predefined geographical areas such as
countries or zip codes, but in the future such as systems will likely
incorporate GIS-based procedures that allow users to query data for
user-defined areas. GIS has an important role in assessing health care needs
for small areas by facilitating the spatial linking of diverse health, social
and environmental data sets.
As digital information on morbidity,
demographics and utilization becomes more widely available, health needs data
will be incorporated in GIS-based decision support tools that allow communities
and decision-makers to examine questions of health and needs, access and
availability. Measures of geographic access can be either area-based or
distance-based (McLafferty, 1998).
Information
Technology Readiness of the Education System
students has been the constant driving force in geography education. Yet, as
its proponents enjoy the rebirth of geography education, they must also acknowledge
that--while the subject matter of geography education may have remained similar
over time--the modes by which geographic concepts are learned and taught in the
classroom have changed, often significantly. Indeed, while geography education
has returned to the school classroom, it has come back in the context of a
society that expects learning to be accomplished in concert with modern
learning technologies, chiefly the computer. But obstacles are posed by wide
differences in the variety of computer technology available in American
classrooms (Donaldson, 2001).
Among the most exciting
developments in geography education today is the geographic information system
(GIS), a tool that enables students to examine layers of geography in ways that
can reveal fascinating and unique patterns and processes (Donaldson, 1999,
2001; Meyles and de Bakker, 2002; Thurston, 2001). Yet, the world a GIS can
illustrate is being obscured by numerous barriers to its implementation
(Donaldson, 1999, 2001; Meyles and de Bakker, 2002). Successful use of GIS in
classrooms depends not only on the requisite hardware and software
infrastructures, but also on a host of institutional and personal information
networks. This article draws on survey research to identify the most significant
infrastructures in spatial methods used in public health in school and
practice.
Minimal attention has been
directed to the essential components of a faculty development technology
program (Dillon & Walsh, 1992). The literature on social work distance education
has focused primarily on program design, evaluation, and logistics. Basic
skills training allows faculty to understand the potential application of
technology and encourages the use of available resources and tools.
While one aspect of
developing technological expertise involves mastering the technical skills
required to use various software programs, an equally time-intensive task
includes translating those skills to a specific course or curriculum content
(Siegel, 1995). Technology can add new resources to existing course content in
traditional classroom settings. For instance, the Internet enhances the range
of information available to students in addition to providing opportunities for
international communication (Giffords, 1998; Johnson, 1998).
The demand for
increased integration of technology can emanate from students, professional or
organizational expectations, and advances in the application of technology to
social work practice. As students become more familiar with technology, they
may begin to expect online access to reading materials, syllabi, and other
resources. With advances in distance education technology, the profession may
be expected to be responsive to students in remote areas without access to
traditional institutions (Kalke, et al., 1998). As technology becomes more
integrated into professional practice, social workers will need to be skilled
in various aspects of information technology (Giffords, 1998; Gingerich &
Green, 1996; Schervish, 1993).
from students requires that faculty be technologically competent to respond to
this demand. While for some people, and in certain situations, the demand for
technological literacy may be very compelling, for other individuals and in
other situations this demand may not be sufficiently compelling to motivate
learning (Conceicao-Runlee and Padgett, 2000)
but be unable to offer such a time commitment.
The demand for GIS experts is
growing steadily, along with the increased need for digital geographic data.
However, there is no widely excepted definition of a GIS
expert (e.g. Thurston, 2001), and also no definition what the current contents
of the education to fit the demands should be. The
discussion involving the education curriculum, the
reaction of employers and the possible need for a certification of the
ended.
Geographic Information Systems
Geographic Information
Systems (GIS) are computer systems for capturing, storing, manipulating,
analyzing, displaying, and integrating spatial (that is, geographical, or
locational) and nonspatial (that is, statistical, or attribution) information
(Maguire, 1991). Although professionals in various technical fields (for
example, geology, geography, and urban planning) have been using GIS since the
1960s, these techniques still are little known and used in social work.
meaningful, attention-grabbing maps that visually show important
administrative, policy, and practice issues (Queralt and Witte, 1998)
administrators and practitioners to uncover new insights.
of low service take-up rates, transportation problems, and location of areas of
new demand for services. GIS software
can also help social agencies communicate more effectively to clients the
spectrum of choices available, an issue of increasing importance as the use of
vouchers becomes more prevalent in the delivery of services. In short, GIS
software gives social services agencies a powerful new way to analyze services
in relation to clients and to the communities in which they operate
and Witte, 1998).
Uses and
Benefits of GIS in the Human Services
management and staff a whole new way of looking at data that may reveal
patterns never discovered before (Queralt and Witte, 1998)
and management decisions by providing tools to inventory, through maps, the
agency's clientele, services, or any other information of interest; to assess
the sociodemographic characteristics of the neighborhoods served by the agency;
to assess whether the supply of services in a given community is adequate and
appropriate for the target population and to forecast need or demand for
additional services, given changes in the policy environment, such as the vast
changes now taking place under welfare reform.
One of the major reasons
for this relative neglect is the difficulty of generating accurate, timely, and
inexpensive locational information for human activities. Recently, however, the
use of low-cost GIS software for generating such data has become a realistic
option. Address matching (also known as geocoding (Drummond, 1995), is a very
powerful GIS technology: it can convert any administrative, survey, or business
database with street addresses into a GIS database containing locational information.
The resulting database can then be either displayed as a pin map, aggregated
into regions and displayed as a thematic map, combined with U.S. census
information and other available GIS data, or used as input into the full range
of advanced GIS procedures for spatial analysis (Drummond, 1995).
researchers have been limited in their ability to analyze data to the levels
that correspond to the geographic identifiers that are normally part of
available data sets, such as state, county, city, or zip codes
and Witte, 1998). GIS has opened the
possibility of studying small areas, such as census tracts or blocks, and of
aggregating data to create new units of analysis, such as neighborhoods, school
districts, or mental health catchment areas. This increased flexibility in the
creation of geographic areas for planning and analysis is likely to yield more
accurate answers to research questions and to result in better delivery of
services (Rushton & Frank, 1995).
There is little
documentation in the published literature of the use of GIS in the field of
social work. What little evidence exists at present points to its use for
research-related purposes rather than direct practice or administration
(Coulton, Korbin, Chan, & Su, 1997; Coulton, Korbin, Su, & Chow, 1995).
Professionals in related fields, particularly health, urban and regional
planning, and criminal justice, appear to be using GIS more than in social
work, although at present, few have published articles documenting their use of
GIS.
Love and
Lindquist (1995) used GIS to assess the geographical accessibility of hospitals
to elderly people in Illinois by measuring and displaying the distance old
people traveled from their homes in each of the 10,796 census block groups in
Illinois to the state's 214 hospital facilities. In northwest England,
Hirschfield, Brown, and Bundred (1995) used GIS to plan and develop
community-based health services. With the help of GIS, they mapped the location
of general medical practitioners and local clinics, services provided by each,
and residential location of patients who used these services. Thus, they were
able to identify catchment areas for different services, to assess differences
between the more affluent and poorer areas in the manner in which primary
health care services were delivered, and to determine how far patients needed
to travel to services (both in terms of distance and travel time) and how much
the local transportation system facilitated or hindered their access to
services.
The National
Cancer Institute has developed an interactive map program that allows users to
construct county-level maps illustrating the geographic distribution of cancer
mortality by age, gender, or race (National Cancer Institute, 1992). Wain
(1993) discussed how to use GIS in locality profiling. By mapping the location
of problems of concern in specific localities (for example, health care
problems such as high levels of infant mortality), one can develop a service
strategy that is sensitive to the needs of the community. Similarly, she
suggested, if one is concerned about the possible effects of a particular
environmental hazard, such as an expressway, one can create, with the help of
GIS, a map showing a butter zone around the hazardous area and then study the
health experiences of people living in this area, compared with others living
elsewhere. Armstrong, Rushton, and Lolonis (1991) used GIS to study the
geographic distribution of low-birth weight babies in Iowa and its relationship
to factors such as the distance from the mother's home to the closest doctor,
to the closest hospital with obstetric services, and to the closest hospital
with more than 50 births per year.
time and effort, the first step in this process is to make sure that the data
to be mapped is up-to-date, accurate, and complete. Prior to placing records on
a map, referred to as "pin-mapping" or "geo-coding," it is
wise to spend time cleaning up and updating records.
next step is to save them in a database format compatible with the GIS software
package to be used. Having put records in the appropriate database format for
the GIS software chosen, the user is ready to create maps for each geographic
area served by the agency. These maps will serve as "containers" in
which pin-mapped records are kept.
Geographic Information System Use in Public
Health
The systems link data generated from surveillance and public
health information systems where their common reference points are geographic
locations such as regional health areas, enumeration areas or postal codes. GIS
tools enable health workers to examine health effects and environmental
determinants by layering on a series of maps: population demographics,
boundaries and environmental factors such as soil, water, air and agricultural
information
Health professionals in local/regional, and
provincial/territorial public health offices need direct access via the
Internet to user-friendly and cost-effective GIS, spatial data and metadata. We
have worked with public health regions to develop a GIS Infrastructure that
supports the spatial information needs of regional public health programs in
their evidence-based planning and decision-management practices. The GIS tools
and training are designed according to the needs of a broader range of health
workers including those having limited GIS skills and experience.
style='mso-ansi-language:EN-GB'>METHODS AND PROCEDURE
style='mso-bidi-font-family:Arial;color:windowtext;mso-ansi-language:EN-GB'>This
chapter shall discuss the research methods available for the study and what is
applicable for it to use. Likewise, the chapter shall present how the research
will be implemented and how to come up with pertinent findings.
Method of Research to be Used
use the descriptive research method which uses observation and surveys. In this
method, it is possible that the study would be cheap and quick. It could also
suggest unanticipated hypotheses. Nonetheless, it would be very hard to rule out
alternative explanations and especially infer causations. This descriptive type
of research will utilize observations in the study. To illustrate the
descriptive type of research, Creswell (1994) will guide the researcher when he
stated: Descriptive method of research is to gather information about the
present existing condition. The purpose of employing this method is to describe
the nature of a situation, as it exists at the time of the study and to explore
the cause/s of particular phenomena. The researcher opted to use this kind of
research considering the desire of the researcher to obtain first hand data
from the respondents so as to formulate rational and sound conclusions and
recommendations for the study.
described in this document is based fundamentally on
mso-ansi-language:EN-GB'>quantitativestyle='font-family:Arial;mso-ansi-language:EN-GB'> research methods. This
permits a flexible and iterative approach. During data gathering the choice and
design of methods are constantly modified, based on ongoing analysis. This
allows investigation of important new issues and questions as they arise, and
allows the investigators to drop unproductive areas of research from the
original research plan.
basically intends to investigate the
in what is taught in Schools of Public Health using GIS (geographic information
systems) and what employers, particularly in the Public Health sector both
private and public expect these students to be able to do using spatial
analysis in GIS. Specifically, this study shall discuss the state and
local public health offices, public health research firms, and GIS educators in
order to determine if their employees coming out of these schools possess
the necessary skills or are they being taught on the job to use GIS.
of data will come from a researcher-made questionnaire and interviews conducted
by the researcher among employees and personnel in the public health sector,
students who have taken GIS courses in public health and educators in GIS.
sources of data will come from published articles from Health and Information
Technology Journals, books and related studies on Public Health, GIS curriculum
and instruction and GIS application in the public health setting.
style='mso-ansi-language:EN-GB'>
style='mso-ansi-language:EN-GB'>For this research design, the researcher will
gather data, collate published studies from different local and foreign
universities and articles from social science journals; and make a content
analysis of the collected documentary and verbal material.
the information, make a conclusion based on the null hypotheses posited and
provide insightful recommendations on the dealing with GIS in the public health
sector.
style='mso-ansi-language:EN-GB;font-weight:normal'>Respondents of the Study
style='mso-ansi-language:EN-GB;font-weight:normal'>The general population for
this study will be composed of selected personnel in the public health sector,
GIS students and GIS instructors numbering to 60 respondents. The researcher
shall also provide interviews for public health managers whose function is
directly related to the organisation and implementation of the GIS employed in
the organization.
Instruments to be Used
To determine
the effects of GIS education in the public health sector, the researcher will
prepare a questionnaire and a set of guide questions for the interview that
will be asked to the intended respondents. The respondents
will grade each statement in the survey-questionnaire using a Likert scale with
a five-response scale wherein respondents will be given five response choices.
The equivalent weights for the answers will be:
– 5.00 Strongly
Agree
3.50 – 4.00
2.50 – 3.49
1.50 – 2.49 Disagree
0.00 – 1.49 Strongly Disagree
mso-ansi-language:EN-GB'>
EN-GB'>
font-family:Arial;mso-ansi-language:EN-GB'>Validation of the Instrument
For
validation purposes, the researcher will initially submit a sample of the set
of survey questionnaires and after approval; the survey will be conducted to
five respondents. After the questions
were answered, the researcher will ask the respondents for any suggestions or
any necessary corrections to ensure further improvement and validity of the
instrument. The researcher will again
examine the content of the interview questions to find out the reliability of
the instrument. The researchers will
exclude irrelevant questions and will change words that would be deemed
difficult by the respondents, to much simpler terms.
font-family:Arial;mso-ansi-language:EN-GB'>Administration of the Instrument
The
researcher will exclude the five respondents who will be initially used for
the0 validation of the instrument. The
researcher will also tally, score and tabulate all the responses in the
provided interview questions. Moreover, the interview shall be using a
structured interview. It shall consist of a list of specific questions and the
interviewer will not deviate from the list or inject any extra remarks into the
interview process. The interviewer may encourage the interviewee to clarify
vague statements or to further elaborate on brief comments. Otherwise, the
interviewer will be objective and not influence the interviewee's statements.
The interviewer will not share his/her own beliefs and opinions. The structured
interview will mostly be a "question and answer" session.
Statistical
Treatment of the Data
style='font-family:Arial;mso-ansi-language:EN-GB'>When all the survey
questionnaire will have been collected, the researcher will use statistics to
analyse all the data.
The
statistical formulae to be used in the survey questionnaire will be the
following:
mso-ansi-language:EN-GB'>
mso-fareast-font-family:Arial;mso-ansi-language:EN-GB'>1.
Percentage
– to determine the magnitude of the responses to the questionnaire.
style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:Arial;mso-ansi-language:
EN-GB'> n
style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:Arial;mso-ansi-language:
EN-GB'>% = -------- x 100 ;
style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:Arial;mso-ansi-language:
EN-GB'> N
number of respondents
mso-ansi-language:EN-GB'>
mso-ansi-language:EN-GB'>
mso-ansi-language:EN-GB'>
mso-ansi-language:EN-GB'>
mso-fareast-font-family:Arial;mso-ansi-language:EN-GB'>2.
Weighted
Mean
mso-ansi-language:EN-GB'>
style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:Arial;mso-ansi-language:
EN-GB'> f1x1
+ f2x2 + f3x3
+ f4x4 + f5x5
style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:Arial;mso-ansi-language:
EN-GB'>x = ---------------------------------------------
style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:Arial;mso-ansi-language:
EN-GB'> xt
style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:Arial;mso-ansi-language:
EN-GB'>
style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:Arial;mso-ansi-language:
EN-GB'>where: f – weight given
to each response
style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:Arial;mso-ansi-language:
EN-GB'> x – number
of responses
xt
– total number of responses
style='mso-ansi-language:EN-GB'>The researcher will be assisted by the SPSS in
coming up with the statistical analysis for this study.
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Appendix 1
Definition of Terms
System (GIS): It is a system that uses computers to enter, store, manage, analyze and
present spatial data. The system brings together databases and graphics to make
products, such as maps, data tables and charts.
use of routinely collected, non-identifiable health data to guide public health
action.
managed, analyzed and used.
Metadata: is
descriptive information about each data set stored in the Spatial Data
Warehouse. Metadata describes how and when and by whom a particular set of data
was collected, updated and formatted. Metadata is essential for understanding
information stored in data warehouses.
Public health: the
science and practice of protecting and improving the health of a community
through: population health assessment; health
surveillance; health promotion; disease and injury prevention and; health
protection
Public health professionals: people who provide programs and services, or work in an institution,
that emphasize the prevention of disease and the health needs of the population
as a whole. Working together, public health professionals maintain and improve
the health of all people through collective or social actions.
Spatial data: is data
that has geographical reference to a specific location on Earth. Spatial data
is stored in the Spatial Data Warehouse including examples such as hospital
locations, regional health area boundaries and more. Spatial data serves to
link information to diseases, health risks and health determinants for
visualization and analysis.
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