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Annual Review of Public Health

Annual Review of Public Health - 4 Mar 2003 15:10 AR...

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Annu. Rev. Public Health 2003. 24:43–56 doi: 10.1146/annurev.publhealth.24.012902.140843 Copyright c 2003 by Annual Reviews. All rights reserved First published online as a Review in Advance on December 2, 2002 P UBLIC H EALTH , GIS, AND S PATIAL A NALYTIC T OOLS Gerard Rushton Department of Geography, The University of Iowa, 316 Jessup Hall, Iowa City, Iowa, 52242-1316; email: [email protected] Key Words spatial analysis, disease maps, exploratory data analysis, geocoding, Monte Carlo simulation Abstract We review literature that uses spatial analytic tools in contexts where Geographic Information Systems (GIS) is the organizing system for health data or where the methods discussed will likely be incorporated in GIS-based analyses in the future. We conclude the review with the point of view that this literature is moving toward the development and use of systems of analysis that integrate the information geo-coding and data base functions of GISystems with the geo-information processing functions of GIScience. The rapidity of this projected development will depend on the perceived needs of the public health community for spatial analysis methods to provide decision support. Recent advances in the analysis of disease maps have been influenced by and benefited from the adoption of new practices for georeferencing health data and new ways of linking such data geographically to potential sources of environmental exposures, the locations of health resources and the geodemographic characteristics of populations. This review focuses on these advances. INTRODUCTION The analytic capabilities of geographic information systems, available in a few cases as fully integrated systems, but more commonly as loosely coupled software systems, have developed rapidly in recent years. Public health is now presented with the opportunity to examine key relationships between the health character- istics of populations and both human and physical environmental characteristics. Some authors suggest that a new discipline of spatial epidemiology now exists, recently described (22, p. v) as being “concerned with describing, quantifying, and explaining geographical variations in disease, especially with respect to variations in environmental exposures at the small-area scale.” Although few implemented examples of such systems currently exist outside of the area of national disease and mortality mapping systems, this is clearly the direction in which spatial ana- lytic tools will be used in the future. Some descriptions of such systems in various stages of implementation can be found in the public health literature (3, 62, 74). This period, too, has seen the beginning of a more critical literature that points out 0163-7525/03/0505-0043$14.00 43 Annu. Rev. Public. Health. 2003.24:43-56. Downloaded from www.annualreviews.org by Stanford University - Main Campus - Robert Crown Law Library on 10/22/11. For personal use only.
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44 RUSHTON the limitations of GIS in answering important public health questions that have a spatial dimension (25, 33).
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