Spatial Dimensions MidTerm

focuses on the human impact on the environment and the human reaction to environmental changes

a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

Medicine: Healing, for the individual
Public Health: Prevention, for the whole community

-global health: problems, issues, and concerns that transcend national boundary and may best be addressed by cooperative actions

-international health: bilateral foreign aid activities, specific disease control projects etc.
(multinational responses: US Global Health Initiative)

*International health focuses on the health of participating countries with intention to affect non-participating countries, while global health directly states that its goal is to promote health and prevent and treat diseases for all people in all countries across the globe.

1900: pneumonia, tuberculosis, diarrhea (infectious)
1950: heart disease, cancer, stroke (non-communciable)

Shift in the pattern of morbidity and mortality from infectious and communicable diseases to chronic, degenerative diseases.

*every population has health concerns, but the mix of main problems changes over time

A situation in many developing countries, which have not yet fully controlled communicable diseases, and yet are faced with an increasing burden of non-communicable diseases


*struggle to cope with both infectious and chronic conditions associated with increasingly westernized lifestyles

An exposure or characteristic that increases the likelihood of developing a particular disease

*modified risk factors (like behavioral risk factors) can be addressed through individual and public health initiatives

-individual characteristics and behavior
--social networks (family and friends)
---living and working conditions (including access to health services)
----broader social, cultural, political, economic, environmental, and policy conditions)

Factors contributing to the development of a noncommunicable disease that can be altered by modifying one's behavior or environment

*look at image for an example

When there are multiple contributors to a health problem, there are multiple paths to a solution (example: diarrhea)

*casual webb diagram

"medical geography," uses the tools and approaches of geography to tackle health related questions

-focus on the importance of variations across space with an emphasis on concepts such as location, direction, and place
-health geography (social model of health) vs medical geography

Injury-related death rates are 40 percent higher in rural v. urban populations.
Rates of heart disease, cancer, and diabetes exceed those for urban areas.

an approach that recognises improvements in health and wellbeing can only be achieved by directing effort towards addressing the physical, sociocultural and political environments of health that have an impact on individuals and population groups

Space: where things are
Place: cultural meaning of a particular setting

*both inform health geographers
*Questions related to place consider how cultural constructions of a place influence the people who live there
*Spatial Questions consider how and why things are distributed or connected in the way they are

spatial patterns & connections

-not until the 19th century, maps played a major role in the study of health
-Snow mapped the locations of all the deaths that occurred in the days following the beginning of a cholera outbreak in London in 1854.
-proved it was water-borne

-Following WWII health mapping burgeoned as atlases of disease were produced around the world
-John Snow father of medical geography

show a general set of features on the earth's surface for navigation or reference (themeless) (emphasis on location)

Maps that tell stories, typically showing the degree of some attribute or the movement of a geographic phenomenon

unit of distance on a map to a larger distance in the real world

such as "language" or "type of healthcare system" differ in kind but not in degree (label/name)

can order them, but don't know exact distance, cannot be precisely quantified

have specific numeric values, can be added, subtracted, divided, or multiplied

-common to use color schemes
-choropleth map- measure of ratio but at specific ratio
-absolute zero

Data that exist at all points on the earth

-ex: every location on the planet has a temperature at any given time
-geostatistical data
-crime risk
-elevation & annual precipitation

exist in specific locations but not in others. People, roads, hospitals, and airports
-involves a unit
-lattice data/polygon data

-crime rate

over time or space
-which levels of aggregation is used depends on the purpose of the map and can affect the kinds of patterns revealed
-discrete data

*They provide capabilities for multiple aggregate measurements, such as sum, average and counting. Examples of aggregate data include the following: Voter turnout by state or county. Individual voter records are not presented, just the vote totals by candidate for the specific region.

spatially discrete

(discrete data)

1. display the data
2. explore: find spatial patterns
3. analyze: address spatial problems

points/lines/ areas that make up maps

a thematic map that uses points to symbolize the precise location of specific geographic features

just location

use symbols of different sizes to indicate different amounts of something

-attribute & location

often used to symbolize the path and rate of transmission of a disease or for illustrating the diffusion of medical technologies

a map showing heights at regular intervals above sea level by means of contour lines

*good for geostatistical data, use isolines to connect points of equal value in an area

A thematic map that uses tones or colors to represent spatial data as average values per unit area.

*can be misleading

Traditional understanding of animation - a
cartographic "movie" with limited control
available.
Could use images or traditional spatial data.
Often, other techniques are better at showing
change over time (e.g. small multiples) because of
change blindness and similar issues.
Showing spatiotemporal dynamics, however, is
tricky in any other way.

-maps have been key to explore diffusion of disease
-data smoothing-removes local variations of features of a GIS

map can also ultimately facilitate analysis of spatial patterns

a way to examine a subset of features of GIS

assumes that a generalized cultural value applies equally well to all members of the culture

*can occur when a researcher or analyst makes an inference about an individual based on aggregate data for a group

*we might observe a strong relationship between income and crime at the county level, with lower-income areas being associated with a higher crime rate

possible inferences:
1) lower-income persons are more likely to commit crime
2) lower-income counties tent to experience higher crime rates

*be careful

Modifiable Areal Unit Problem. The same basic data will map differently when aggregated in different ways.

*geographic manifestation of ecological fallacy in which conclusions based on data aggregated at a particular set of districts may change if one aggregates the same underlying data to a different set of districts
*is a statistical biasing effect when samples in a given area are used to represent information such as density in a given area

Two types of effects:
- Zonation: Major differences in result depending on how the study area is divided up (i.e. neighbourhood/ward), even at the same scale
- Scale: Major analytical differences depending on the size of units used (local variation missing from the big picture)

large volumes of data produced in the digital age, which include all the Web data generated by emails, websites, streaming platforms, and social networking sites. Small data, on the contrary, refers to data small enough for the humans to comprehend both in terms of volume and format

More Info:
*small data is relational and structured whereas big data is non-relational and unstructured
*big data= multiple servers, machine powered, data-scientists, data engineer
*small data= one server, manual or human powered, statistical analyst
*in small data we know where change may happen, but in big data we are uncertain, and there is unknown file types

*main difference is the goal

• Unstructured Data
• Data privacy/security
• Inconsistent, incomplete, unavailable, poor quality or invalid data
• Misused data
• Poor analysis/analytics leading to erroneous correlations/conclusions
• Difficulty in interpretation/inference/general knowledge

the process of analyzing data to extract information not offered by the raw data alone

• Objective: Fit data to a model
• Potential Result: Higher-level meta information that may not be obvious when looking at raw data
• Similar terms: Exploratory data analysis, data-driven discover

raw data--->useful information

Statistics: inference, true relationship between A and B, requires a good sample

AI Machine Learning: prediction <---- entire data (not a sample)
^better for environments such as the world that are constantly changing

"The biggest opportunity for geospatial field in AI is its core asset, which is geospatial data. It is widely acknowledged that 80% of all data that is generated are spatial in nature. So exploiting that data using automation through AI and deep learning comes naturally to creating solutions for rest of the basic sectors." (Geospatial World, 2017)

broader concept, incorporating human intelligence to machines

empowering computer systems with the ability to learn

*One way to train a computer to mimic human reasoning is to use a neural network, which is a series of algorithms that are modeled after the human brain.

subset of ML, similar to information processing patterns in human brain

•Social, political, economic, environmental and institutional factors determining health status are associated with various characteristics linked to geographic locations and show unique spatial patterns
• Outcomes of env/health policy could vary by spatial locations
• Thus, holistic, ecological, and multi-level approach would be needed to guide informed policymaking process, which requires systematic integration of data for various spatial aspects existing at a certain geographical unit.
• GIS/Spatial Analysis is an integrative technology-based tools for collecting, storing, managing, exploring, analyzing, mapping and visualizing information linked to geographic locations

*Applications of spatial analysis are impacting public health both locally and globally. Some examples: Characterizing environmental conditions such as traffic, poverty, climate and water quality. Characterizing accessibility to care, healthy/unhealthy food outlets, and pollution sources.

natural, built, social, institutional (this is also where environmental and health policies can take place)

•no human experts (we must then rely on the machine)
• assistance with human function (driving a car)
•rapidly changing phenomena (diagnosis, fraud detection)
•need for customization/personalization (YOUR news feed, movie/book recommendation)

intended to stop something before it happens

done before someone else can do it

Data that is too large or too complex to be managed using traditional data processing, analysis, and storage techniques

*"Big data" addresses many of the same questions we've had for ages, but what's "new" is that the data collection happens off an existing, computer-mediated process, so the marginal cost of collecting data is essentially zero. This dramatically reduces our need for sampling.

Volume: the amount of data
Velocity: the speed of data production
Variety: the different types of data
Value: how relevant the data is
Veracity: the trustworthiness of the data

•social data- human generated (likes, tweets)
•machine data- road cameras, web logs, satellite images
•transactional data- human and machine generate, 911 calls (helps pinpoint location while person calls in)

-texts/numbers
-graphs
-tables
-images
-videos
-clickstreams
-transactions
-others....

• Structured: most traditional data sources; stored in a relational database in a table with rows and columns (e.g. Excel spreadsheet data)(quantitative)
• Semi-structured: not in a relational database, but have some organizational properties that make it easier to analyze (e.g. XML data)
• Unstructured: not organized in a predefined manner or does not have a predefined data model (e.g. word, pdf, text, media logs)(qualitative)

• Sample-based statistical research: sampling and inference is a key

• When it comes to Big Data, we can essentially analyze the entire data set, not just a subset.

• In order to do so, we need to either have the ability to collect or access huge data sets, perform analyses on them using platforms like supercomputers, and identify interesting correlations/patterns among the data.

• Based on (spatial) patterns from the big data, researcher can predict the future trends (no inference necessary

• Genetic/cell data
• Electronic health records (texts, sound, image, video)
• Social media data (e.g. Tweets, Yelp)
• Web search/clicks
• Public service/facilities visits/calls (e.g. 911 calls)
• Personal vital/mobility data • Insurance/claim data
• IoT/sensing/monitoring data (e.g. vehicle trajectory, air quality, weather, movement patterns, etc.)

epidemic/disease outbreak prediction;
individual disease predictions;
increased access to databases on symptoms and new treatments;
real time monitoring of patients

drawing a set of observations randomly from a population distribution. Often, we do not know the nature of the population distribution, so we cannot use standard formulas to generate estimates of one statistic or another.

The description and analysis of geographic variations in disease with respect to demographic, environmental, behavioral, socioeconomic, genetic and infectious risk factors.

considers humans as part of a broader cycle of disease that requires an understanding of how environments influence human health

-natural environment (soil, air, vegetation, and water)
-built environment (human constructed... roads)
-social environment (human behavior and organization that compromise the social structures within which we lived)(for example during the festive season, there is an increase in clothes, sweets, and new fruits, etc.)

people are continually exposed to organisms and substances that can cause disease

-pathogens "living agents"
-geogens "non-living agents"
-physical hazards

*Agent originally referred to an infectious microorganism or pathogen: a virus, bacterium, parasite, or other microbe. Generally, the agent must be present for disease to occur; however, presence of that agent alone is not always sufficient to cause disease.

a disease that is spread from one host to another
(infectious)

*all communicable disease are infectious, but not all infections are communicable (tetnus)

a disease not capable of being spread from one person to another

All communicable disease are infectious, but not all infections are communicable
communicable diseases spread from person to person

example: tetanus is infectious but not communicable

Non-Communicable (non-infectious)
•lung cancer
•malnutrition

Non-Communicable (infectious)
•tetanus

Communicable (infectious)
•malaria
•dengue
•tuberculosis

Communicable ("contagious")
•cholera
•influenza

*All contagious diseases are infectious, but not all infectious diseases are contagious. Contagious diseases are infectious diseases that are easily spread through contact with other people.

the succession of all of events and interactions among the host, parasite and environment that occur in a disease, from initial infection of the plant by a causal agent, through pathogenesis, to over-seasoning, until another infection occurs

disease causing agents

the organism in which the parasite lives in or on.

An organism that transmits disease by conveying pathogens from one host to another

acts as sources of infections and be animate (monkey) or inanimate (water body)

refers to the ways in which regions impart patterns to disease distributions via factors such as vegetation, geology, and climate

-elevation & precipitation

-Heat waves and stress can cause death
-Respiratory ailments, expansion of tropical diseases
-Drowning, disease, and sanitation problems (flooding)
-water temperature

*malaria- spreading in Amazons where forests are being removed for cattle land, improving breeding conditions for mosquito vector
*lyme disease

1. biological & technological feasibility
2. social conditions must favor eradication (economic/political)

1979
-vaccination main factor of success
-and spatial pattern

*no animal reservoir or vector
*distinctive symptoms made it easy to recognize
*people only at risk
*vaccine very effective & easy to administer
*herd immunity
*ring vaccination

The resistance of a group to an attack by a disease to which a large proportion of the members of the group are immune

used when a new case of disease is reported, All people who have been in contact with/live close to the patient are vaccinated

integrated approach

-would not be possible without serious study of both space and place

1.ecological approach
2.social approach
3. spatial approach

-viral disease and highly infectious
-several common symptoms- fever, fatigue, headache, and vomiting

-ecological and social aspects:
*virus can persist asymptomatically in humans and the environment
*length of campaign=waning political and donor interest
*war and instability
*social resistance to polio vaccination

The way of identifying, explaining, and predicting the human and physical patterns and the connections of various locations.

to create social environments that facilitate and enhance behavior change

*Social determinants of health such as poverty, unequal access to health care, lack of education, stigma, and racism are underlying, contributing factors of health inequities.

Culture may shape important behaviors (with respect to diet, activity patterns, water use, sexual practices, etc.) that predispose individuals to acquire certain diseases. Secondly, though culture, people actively change the nature of their environment. Culture is a mechanism of adaptation to environmental threats, such as diseases, which act as agents of natural selection in the evolution. of both human biology and culture.

Climate epidemiology plays an important role in informing policy related to climate change and its threats to public health. Climate epidemiology leverages deep, integrated collaborations between epidemiologists and climate scientists to understand the current and potential future impacts of climate-related exposures on human health.

Urbanization leads to many challenges for global health and the epidemiology of infectious diseases. New megacities can be incubators for new epidemics, and zoonotic diseases can spread in a more rapid manner and become worldwide threats.
*overcrowding & overextended infrastructure in urban environment crucial to spread of disease

Caused by pathogenic microorganisms, such as bacteria, viruses, parasites or fungi; the diseases can be spread, directly or indirectly, from one person to another.

all people are at risk of acquiring serious infectious diseases

-in low-income areas, infectious disease are responsible for a large proportion of deaths, especially child deaths

-however we now see that every country is vulnerable (COVID, regardless of wealth

timeline of exposure to infected people to recovery or death

symptoms of illness

how often exposed people become infected

reproduction of an infectious agent inside a human host

how often sick people are severely ill or die

how often infected people become symptomatic

-agent type
-primary symptom
-mode of transmission
-diffusion type
-a typical classification (combination)
ex: diarrheal disease, respiratory disease, vector-borne disease, STDs, NTDs

1: human to human
-direct (person to person)
-fecal oral
-vertical= mother-to-child transmission
air-borne, water-borne

2: animal to human
-vector-borne (insect/animal-to-human)

The ways in which phenomena, such as technological innovations, cultural trends, or even outbreaks of disease, travel over space.

the spread of a phenomenon across space, passed through interactions between one person and his/her neighbors

the introduction of a phenomenon to a new location, completely outside the current range of that phenomenon

the spread of a phenomenon along hierarchical settlement patterns. More likely to move into large cities before small villages

ex: spread of MERS to South Korea
-spread mainly through hospitals in big urban spaces

can evolve rapidly, making them a challenging target for drug and vaccine manufactures

emerges when antibiotics kill the most susceptible bacteria in a population. The remaining individuals, with higher levels of resistance to the antibiotic, are able to breed rapidly, thereby increasing the proportion of antibiotic-resistant bacteria in the population

-overuse or misuse of antibiotics?

tuberculosis

• A major problem with TB is that the course of treatment is extremely long and people often stop drug regimens before they are complete.
• This has led to the development of many drug-resistant strains of TB.
• In treating drug-resistant strains, several different drugs are often administered.
• Also, many places have adopted directly observed therapy (DOTS) to make sure that people complete the drug regimen