The importance of understanding the ‘where’ of health issues provides us with a deeper understanding of how diseases spread and the key contributors to widespread health concerns.
Benefitting from the geography of health in this rapidly changing world requires a forward-thinking approach to human safety and a never-before-seen need for interoperability across organisations for community-focused outcomes.
So how can we adjust to the changing landscape of modern health, adapt to new technologies and respond to the world’s current community needs?
As Esri’s Chief Medical Officer and Health Solutions Director, Dr. Este Geraghty brings a unique combination of clinical medicine practice, data-fueled knowledge of public health informatics, and expertise in information technology and geographic analysis.
Ahead of her visit to Australia next week, where she will deliver a keynote presentation at the Precision Public Health Asia Conference, Dr. Geraghty has shared some insight into the changing role of geography in modern health and the importance of geographic analysis in revolutionising insights into community outcomes.
Q: Let’s start by discussing the relationship between health and place and how this has changed over time. Could you please tell us about how geography in the health sector has evolved and the role GIS plays as a feature?
A: Though a foreign idea to some, it’s nothing new that health and place are related. I often refer back to when the Father of Medicine – Hippocrates – wrote a paper linking airs, waters and places to health outcomes in 400BC. Health and place have long been recognised by leaders throughout history, however new technologies are now allowing more and more people to leverage location intelligence for health in transformational ways.
Some of the important health issues currently facing the world are disease propagation and health disparities, both requiring deep insight into the context behind a diagnosis. Conditions around good health and conversely, barriers leading to bad health may include the level of toxic exposures, availability of community resources, and accessibility to health care services. factors that are compounded by the social determinants of health, it is imperative to consider geography. These factors are compounded by the social determinants of health which clearly vary geographically. The importance of understanding the ‘where’ of health issues, provides us with a deeper understanding of how diseases spread and the key contributors to widespread health concerns. Combined with the use of predictive analytics to look into the future, we are able to plan for and efficiently respond to health-related disasters and emergencies.
Q: Can you share a practical example of how integrating spatial insights from across communities has influenced health policies and community development?
A: During my time at the University of California Davis working with the Centre for Regional Change, we were heavily focused on social justice and community action. One project that we worked on – Putting Youth on the Map – showcased how spatial insights can fuel positive changes in the community. By creating an interactive map using location-based analytics, we were able to investigate youth wellbeing and youth vulnerability in a wide range of communities and with this information, understand the circumstances affecting the lives of young people. Pulling in a variety of data sets including foster care situations, poverty levels and teenage pregnancies meant that we could arm the local jurisdictions with data and information to inform decision-makers focused on improving conditions for many of California’s disadvantaged youth.
Q: Has this forward-thinking approach to healthcare been applied to significant issues across the globe like infectious diseases in third world countries?
A: When I first began in my role at Esri, the widespread outbreak of the Ebola virus in West Africa was causing extensive health damages and socioeconomic disruption across the region, becoming a prominent issue for anyone focused on community health. The outbreak turned out to be a turning point in recent history – answering many questions that people had when leveraging geography in a health crisis. Dealing with a rapidly developing crisis required professionals to adapt to new circumstances; making the best possible decisions from not so perfect data in order to save lives. From a geospatial perspective, the crisis proved to be an intriguing case study as we gained insights from mapping existing Ebola treatment units, community accessibility to treatment options, migration in and out of various affected and neighbouring countries, and locations of civil unrest. All of this enhanced the ability of responders to assess disease spread, quarantine needs, responder safety and strategic siting of limited resources.
“Geographic analysis can help communities to better understand the impact of their built environment on health – for good and for bad – to prioritise plans for improvement.”
Q: With the changing landscape of health, how has the importance of interoperability and multi-agency missions evolved?
A: Health will always play a key role in society with health concerns constantly evolving with the patterns of the world around us. Whilst historically, we were seeing high rates of infection, treated with sanitation and vaccination, in recent history we’ve experienced a predominance of chronic diseases requiring more ongoing support and care management from our health systems and furthermore, today we are seeing a rise in what I call ‘social diseases’ like the opioid crisis, homelessness and mental health issues. These social diseases seem to reflect communities of despair in which social and economic opportunities may be declining, leaving many people in crisis. This transition has rightfully increased the attention paid to community health and shifted responsibility of care beyond the healthcare provided by doctors and hospitals. Broader groups of stakeholders are now required to collaborate to address these issues including representation from the criminal justice system, mental health professionals, public health professionals, health care professionals and pharmaceutical companies – to name a few. They all have a role to play in addressing these modern health issues, working together for a healthier outcome for the community. With this growing importance of interagency cooperation and collaboration, it is imperative that we leverage technology software platforms and interoperability to enable information sharing for team outcomes conducted in a seamless, effective manner.
“In future years, I would like to see collaboration and geography as a consideration for every decision.”
Q: What do you think are the most important aspects for decision makers to be focusing on, in order to promote healthier lifestyles within communities?
A: It can be a daunting process to assess gaps in the livability of a community and to assist decision makers in mitigating such issues. Within this process, it is important to understand the value of variability – no one community’s needs are ever the same. For example, one community may need to focus on providing sidewalks and green spaces to encourage residents to get more physical activity, whilst another community may need to prioritise affordable housing in order to decrease homelessness and ensure housing stability. One benefit of a geographic information system is the ability to help governments tailor the right intervention, targeted to the right places – providing the best possible outcome for a community.
Coupled with this, in recent years we have seen an increased focus on sharing government health resources which is pivotal to moving forward with the broader vision of open data. What I would like to see in the years to come is a focus on the strategic use of health data, providing the ability to improve efficiencies, enhance decision-making, support inter and intra departmental sharing of data, and inspire innovation. For this to be effective, thoughtful consideration of the value of data and inclusion of the geographic component, already inherent in most data – is required across the board.
About the author
Dr Este Geraghty
Chief Medical Officer and Health Solutions Director