Since at least the 1600s, people have used maps to track and manage diseases and other health effects, and to pinpoint their causes. From plague and cholera to cancer and heart disease, this approach has been a vital tool in the public health toolbox. Maps, combined with data, are powerful because they help people visualize where disease clusters and how it interacts with the physical places in which we live.
In the digital age, technology can be tapped to promote healthy communities in ways that have would have been impossible a decade ago. Geographic information system, or GIS, mapping is lighting new paths forward. In my rural community of Klamath County, Ore., we’ve used GIS mapping to better understand our community’s challenges and the possible solutions. Here are two case studies that illustrate how Klamath County has used GIS mapping in the past, and a third that shows how we’d like to use it in the future:
About six years ago, the leaders of Sky Lakes Medical Center’s wellness center in Klamath Falls, which helps people manage their chronic illnesses, wanted to identify parts of town where people struggled with health. Professor John Ritter, of nearby Oregon Institute of Technology, used anonymized data for 60,000 Sky Lakes patients to create maps that revealed something surprising: Adult residents living along a corridor on the west side of town had a high incidence of obesity, a low incidence of diabetes, and tended to be on the younger side.
We saw the opportunity to help prevent residents from developing diabetes by creating a protected bike lane to give people a healthy and safe way to get around. The maps helped us persuade city and county officials, who approved the plans, and helped us raise money for construction from private foundations and individual donors who funded the project.
The two-mile-long bike lane opened last June. We won’t know its impact on people’s health for several years, but we plan to study it.
In Klamath County, nearly one in four adults smokes. Almost a quarter of 11th graders have ever smoked a cigarette and about 40% have tried other tobacco products or vaping. Because tobacco addiction commonly starts in adolescence, we were concerned by the fact that in 2015, inspections by Klamath County Public Health found 35% of tobacco retailers illegally sold products to minors.
Using public addresses of schools and retailer addresses provided by the public health department, Professor Ritter created a map that showed many of the county’s 80 or so tobacco retailers were within steps of schools.
Klamath County Public Health was able to use that information to support our argument for tobacco sales licenses that retailers must apply for annually. That policy went into effect in January 2018, the same month Oregon officially raised the age of purchase for tobacco and vaping products from 18 to 21. The licenses make it easier for us to enforce tobacco sales laws and educate tobacco retailers if they struggle to comply. This year, the percentage of inspected tobacco retailers who illegally sold products to minors has gone down to 17%. That means we’re keeping tobacco products out of teens’ hands.
A new project Professor Ritter is working on is putting data about the safety of the routes students take to school into an online map the public could access. That involves converting paper maps that show where sidewalks need to be repaired or installed into a digital format, then using a computer to predict the best, shortest path to school for every student.
To make those maps, he’ll need to figure out how to work with schools get student addresses in a way that protects privacy. If he succeeds, his maps will help the city prioritize work on sidewalks and roads along routes to school so students can more easily walk to school, working physical activity into their daily routines.
We’re fortunate that Klamath County is home to the Oregon Institute of Technology, where Professor Ritter teaches. But any community can find the resources to use GIS mapping. Many cities and counties have a GIS office. Your state health department may have GIS capabilities, too. And many private GIS contractors are ready to assist. However you go about it, GIS mapping can be an enormous boon if your community wants to study, understand and begin to solve its unique health challenges.
Jennifer Little directs Klamath County, Oregon’s public health department.
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