Spatial Analysis I

Lex Comber
University of Leicester
ajc36@le.ac.uk

Aims
Basis of Spatial Analysis in Health
Sciences
GIS Operations
Generating area counts
Linking to other data eg demographics

Categories, Classification
Visualisation, including the components of
maps

Spatial Analysis
What kinds of data are analysed in health
sciences using GIS?
Point data: incidence of disease
Area data: some explanatory variable relating to the
characteristics of a particular area
Surfaces: describing some trend

What kinds of analyses are used to investigate

this data?
This depends on the question or hypothesis

Spatial Analysis
In many cases it is to identify either
Explanations (causes, looking back)
OR
Implications (consequences, looking forward)

Example
Impacts of existing or new coal power station on
downstream resident health
Association between socio-economic deprivation and
public health choices (eg smoking) or impacts (eg
infant mortality)

Spatial Analysis
Health data may often be at the individual level
Know something about each case, but maybe not everything
Causes / consequences information may not be available for
each case

Many different types of socio-economic variables are

available for
Areas eg census data
no. of people, age profiles, profession, income, religion, ethnicity,
car ownership, travel to work, etc,
even health status!

Such demographic data is very useful

BUT it only tells us things about the area

Surfaces eg air quality, flood risk, ozone,

Spatial Analysis
We use a GIS to link the individual to the area
and the characteristics associated with the area

Spatial Analysis
We use a GIS to link the individual to the area
and the characteristics associated with the area
Event or Process
- Pollution or Poverty

GIS








Observed condition
- Public Health







Spatial Analysis
- relationships between
process and observed
pattern
- SPATIAL relationships

Spatial Analysis
There are many applications for GIS in
health research:
Examine disease rates over space
Identify disease clusters
Identify variables which cause disease
Examine variation in health and uptake of
health services over space (and time)

Link population, environmental

conditions and health care

Spatial Analysis
Epidemiology is concerned with the
causes and prevention of disease...
Most basic function of GIS is for mapping
the spatial pattern of disease
Q: Where are the incidences of a disease
located and how does this vary?
Lyme Disease
Bacterium (Borrelia burgdorferi)
Vector is ticks

Spatial Analysis
Reported incidence of Lyme Disease

Spatial Analysis
Risk map, 4 categories of risk

Spatial Analysis
Service access is another important
aspect of public health
GIS can be used to determine travel times
to health facilities

Spatial Analysis
Summary
Many applications in public
health
A GIS allows us to

Query

examine what is happening

where
link spatial pattern and process

Locations (eg of disease

incidence) should be
combined with other data in
the GIS to attempt to explain
the location/ spread of the
disease

GIS

GIS Operations
So GIS allows us
to link pattern and process
to identify what happens where

Reminder: including the location or the

geography
More informative answers
More nuanced answers

Illustrate this with a case study

The spatial distribution of EMS cases

GIS Operations
EMS case study
based on some of the practical data to
illustrate the way that GIS can be used
Link observed spatial pattern to underlying
process.

In this case
to examine the relationships (and the spatial
relationships) between critical Emergency
(EMS) cases and population

GIS Operations
1107 serious EMS cases
2076 census areas

GIS Operation
Can use the GIS to generate counts of
EMS in each census area
(you will do something similar in the practical
later!)

Mapping the proportion of EMS cases

against other variables shows the spatial
variation of the phenomenon

GIS Operations

GIS Operations
We can see that there is much variation in
the numbers of EMS cases in each census
area
BUT
Areas with high populations may be
expected to have high counts of EMS
cases

GIS Operations
Normalize and perform a simple statistical
analysis

EMS / Total Population

1,107/ 813,847 1.4 cases per 1000 pop
EMS / Old Population
1,107 / 166,593 6.6 cases per 1000 old people

BUT
Global statistic may hide much local detail
GIS allows us to calculate these statistics in
each census

GIS Operations

GIS Operations

GIS Operations
Can see that the proportion of people and
old people in different areas is not evenly
distributed
amongst the general population
1 or 2 hotspots

amongst the older population

Much more spatial variation

GIS Operations
Integrating health data (in this case points) with area
data (in this case census data)
Allows EMS cases to be related to other variables associated
with those areas
Population, demographics, socio-economic status etc
Allows areas or regions with surprising (high or low) values to be
identified
Clusters

Can be used to direct further investigation relating to

the causes or location specific features (eg environment,
demographics, etc)

GIS Operations
So what kinds of processes have been used
here?
If you think about the data and the outputs can you
guess?

Data:

Outputs:

Did some GIS

Points

Areas

Proportions

GIS Operations
Because we have data
that has an explicit
location, spatial overlays
are possible
Do you remember the Set
Theory?
This is where it comes in
Although you are usually
not aware of it!

Intersect and Union are

very common overlay
procedures

AND
NOT
OR
XOR

GIS Operations
In the above
example we used an
Intersect operation
Counts the number
of EMS points in
each Census area
Stores the value in
the Attribute Table of
the layer that is
created

GIS Operations
Summary
Space and location are crucial components of GIS operations
Combining layers and spatially interrogating one layer using
another allow new information to be generated as a result of
analysis
This is one of the key aspects of GIS that make it different from
standard statistics

In the practical you apply some of these techniques

Overlaying data
Generating area counts
Selecting features based on their distance to other features

GIS Operations
NOTE
I have introduced a small component of a wider study just to
give you an example
This is real data from a real analysis (I have spatially
anonymised the EMS data to protect patient confidentiality)
This work is reported in full in Sasaki et al (2010) seeks to
optimise EMS response times
It uses current EMS data and census data to determine the
relationships between demographic variables and EMS cases.
It combines this model with future projected population changes
It shows how the best places for ambulances (to minimse
response times) changes over between 2010, 2030 and 2050
Allows for more informed spatial planning and health planning

Categories and Classification

Classification is a way of grouping similar
features
In a GIS context it involves
Selecting what is to be included in any class
What goes into the class of high?
Choice of thresholds for each class or group

The number of classes

These aspects are critical

A map is a very powerful way of communicating
a large amount of information in a very efficient
way

Categories and Classification

Consider the following map
What can you tell me about it?

Some hotspots
Generally the same trend

Categories and Classification

What about this map?
It is the same data
The difference: the number of classes

Categories and Classification

Consider the following map
What can you tell me about it?

Some hotspots
Generally the same trend

Categories and Classification

What about this map?
It is the same data
The difference: the number of classes

Categories and Classification

Ok so the number of classes is important
The other major thing to be aware of is
HOW you decide to the boundaries
between classes
There are many ways of dividing up the
distribution of values
Like mean vs mode vs median for averages

Categories and Classification

This is defined by equal interval
Eg in a range of 01
Breaks at 0.2, 0.4, 0.6, 0.8
Class intervals of 0-0.2, 0.2-0.4, etc

Categories and Classification

Classes in this example are
based on 5 quantiles
Breaks at 20th percentile, 40th
percentile, 60th percentile, 80th
percentile
Based on the distribution of
the data values

Categories and Classification

How you present spatial data for visualisation is
important
I could do a whole course on these issues
If you did the MSc in GIS at my university you would!

You need to be aware of how easy it is to make

very different looking maps from the same data
This might be misleading
And often it is!

Visualisation
Finally, I want to talk very briefly about
visualisation
Again this could be part of a whole course on
visualisation

But here I am want to talk about what needs to

be included in a map
And I am hoping that you might know!

What do you think needs to be included in a

map?
Perhaps cartographic convention

Visualisation
1) A Legend
Describes the data
layers and the class
ranges

What is wrong with

this one?
Has the layer data
name - not very user
friendly
6 significant figures!! Is
that precision
important?

Visualisation
2) a scale bar to show the study are size,
the extent of the problem needs units
3) A North arrow to show the orientation fo
the map

Summary
This has covered a lot of ground
All of the content will be applied by you in the practical
session
Key Points
GIS links pattern & process, tells us what happens where
It can identify Explanations (causes looking back) for events or
describe their
Implications (consequences looking forward)
The analytical tools in a GIS relate to geographic measures (eg
distance, area counts etc)
Visualisation is so important
How to Lie with Maps

References
Ambulances in Niigata paper
Sasaki S, Comber AJ, Suzuki H, Brunsdon C. Using
genetic algorithms to optimise current and future
health planning - the example of ambulance
locations. Int J Health Geogr. (2010); 9: 4.
doi:10.1186/1476-072X-9-4
Comber A, Sasaki S, Suzuki H, Brunsdon C, (in
press). A modified grouping genetic algorithm to
select ambulance site locations. Int J Geog Inf Sci

Reviews of use of GIS in Health Sciences

Higgs, G, The role of GIS for health utilization
studies: literature review, Health Serv Outcomes
Res Method (2009) 9:8499

Visualisation
Edward Tufte, (2001). The visual display of
quantitative information. Graphics Press.
Mark Monmonier, (1996). How to Lie with Maps,
University Of Chicago Press