Researching applications of geographical information systems in health: an introduction

Geography: research and teaching in nurse education

This paper outlines how geography might be integrated into nurse education. At one level, researching nurse education geographically could add to the current academic understanding of the many transitional places that make educational experiences and influence outcomes. At another level, as part of a nursing curriculum, teaching geographical concepts and issues to students might provide them with unique insights into core subjects.

A census-based socio-economic status (SES) index as a tool to examine the relationship between mental health services use and deprivation

This paper discusses the development and application of a socio-economic status (SES) index, created to explore the relationship between socio-economic variables and psychiatric service use. The study was conducted in a community-based mental health service (CMHS) in Verona, Northern Italy, utilising service use data from 1996. An ecological SES index was constructed through a factor analysis from 1991 Census data, at census block level. Three factors reflected the following domains: the educational-employment sector (with four components), the relational network (with three components) and the material conditions (with three components). All service users were assigned a SES value, according to their place of residence in 1996. When these data were explored spatially, using ArcView 8.3, an association was observed between socio-economic deprivation and psychiatric service use. The SES index was then successfully validated using occupational status at the individual level. This study confirms the usefulness of developing and validating an ecological census-based SES index, for service planning and resource allocation in an area with a community-based system of mental health care.

Users’ perspectives on epidemiological, GIS and point pattern approaches to analysing environment and health data

Despite examples showing the usefulness of geographical information systems (GIS) and spatial point pattern analysis in health research, there remain barriers to their widespread use within health service settings. This paper explores potential users' views on the relative usefulness of such approaches for analysing spatially referenced environmental health data. Our findings indicate that researchers and practitioners do not always prefer the approach with which they are most familiar. In addition, there is a need for higher levels of understanding of, and confidence in, GIS and point pattern analysis techniques amongst health service professionals. The greatest need is for multi-disciplinary research which uses the most appropriate approach for each investigation, rather than that with which researchers are most familiar.

Mapping high or low mortality places across time in the United States: a research note on a health visualization and analysis project

This research note reports progress in visualizing and analyzing United States mortality data at the county level. The data visualization technique employed here may be applicable to other research situations. We dichotomized the range of mortality rates into high or low mortality counties, mapped them, and explored the clustering of high or low mortality rate counties across both space and time. We find visual evidence that high or low mortality counties spatially cluster together during individual periods of time (5 years). We find further visual evidence that there is a spatial persistence over time (30 years) of these counties with high or low mortality. This evidence leads us to conclude that relatively high or low mortality is anchored over time within a spatial region and population, suggesting that research efforts may be focused on these clusters to assess local causes of high or low mortality rates. Future research will examine the permanence of the resident population (i.e., population mixing), characteristics of the resident population, and characteristics of their place of residence over time.