Ozdenerol - Spatial Health Inequalities: Adapting GIS Tools and Data Analysis

Spatial Health Inequalities

Adapting GIS Tools and Data Analysis

Spatial Health Inequalities

Adapting GIS Tools and Data Analysis

Esra Ozdenerol

CRC Press

Taylor & Francis Group

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Boca Raton, FL 33487-2742

2017 by Esra Ozdenerol

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Version Date: 20160617

International Standard Book Number-13: 978-1-4987-0150-1 (Hardback)

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This book is dedicated to my two sons, Derin and Deniz; my dad, the Honorable Justice Erdogan Ozdenerol; my mother, Umran Ozdenerol; my sister, Emel Ozbay; my brother-in-law, Alp Ozbay; my two beautiful nieces, Irem and Zeynep Ozbay; and my deceased grandmother, Sidika Erolozden. My family has given me endless support and undivided affection over the years even though there were oceans between us. Thank you for all you have sacrificed during this process.

Contents

It is my great pleasure to write a foreword for this book, written by a talented medical geographer. Since the turn of the century, there have been quite a few books on spatial epidemiology, statistical and geographic information system (GIS) approaches in medical geography, and spatial analysis for health and environment studies. The uniqueness of this book is its focus on spatial health inequalities, which are pervasive in the United States as well as many countries in the world. This book is the first to put together GIS, mapping, and spatial analytical methods to illustrate how these various methods can be used to analyze spatial health inequalities.

Health inequality or disparity has long been a global health problem. Health inequality, as this book states, refers to different health outcomes of individuals due to their differences in socioeconomic status. Low-income, underserved minority groups are more vulnerable to diseases and epidemics and are more likely to lead to adverse health outcomes. In other words, borrowing the concept of resilience in disaster studies, individuals that have higher socioeconomic statuses are generally more resilient to adverse health effects; they generally have better prevention, are more prepared, and bounce back faster than individuals that have lower socioeconomic statuses.

Extending health inequality to spatial health inequality represents a major conceptual as well as practical advance in the study of epidemiology and environmental health. As this book states, health inequality involves both the person and the place. The neighborhoods and the biophysical, political, and cultural environments all play key roles in affecting the health outcomes of individuals. Unequal spatial distribution of resources such as clinics, hospitals, public transportation, fresh food markets, and schools could make the community as a whole more vulnerable and less resilient to adverse health effects, leading to lower community resilience of health. Thus, analysis of health inequalities must also consider its spatial context or larger environment to better understand the problem.

GIS and spatial analytical methods are most apt in studying spatial health inequalities. Moreover, traditional statistical or data mining methods when enhanced with GIS mapping and analysis can help reveal more effectively the spatial patterns of disparity and the factors associated with the patterns. There are many examples in the literature, as well as shown in this book, on how GIS and mapping can demonstrate spatial health inequalities and help in deriving better and more useful hypotheses. For example, my previous studies on mapping Chinas cancer mortalities by county in the early 1970s revealed high concentrations of different types of cancers at different localities. Through an intense data collection and mapping effort on AIDS incidence and mortality in the United States in the 1980s, we were able to confirm a national trend of AIDS spreading to rural America, generating a major discussion of regional disparity that involves the north, the south, the rural, and the urban, in addition to the rich and the poor.

The approach used in this book is clever and useful. This book demonstrates the spatial health inequalities in six most important topics in environmental and public health, including food insecurity, birth health outcomes, infectious diseases, childrens lead poisoning, chronic diseases, and health-care access. These are the topics that the author has done extensive research on. Each chapter addresses a topic. In each chapter, this book will provide a detailed description of the topic from a global perspective, identify relevant data and data sources, discuss key literature on appropriate techniques, and then illustrate with real data with mapping and GIS techniques. It is important to note that while spatial analysis is useful, inappropriate applications of the spatial analytical methods and a lack of understanding of the errors and uncertainties involved in spatial analysis could generate erroneous results and interpretations. This book will discuss the appropriate techniques and bring awareness of the possible errors and uncertainties involved in spatial analysis. Finally, this book has a web-based resource that contains data from the case studies relevant to each health topic. The web page provides links to download data and instructional material to supplement the case studies.

Spatial health inequalities are intertwined with issues in environmental justice and community resilience; they are all closely interrelated. GIS methods are the prime tools to reveal the patterns, identify the factors, assess the progress, and ultimately plan for better health resilience. This book is a timely and valuable addition to the literature. It will be an effective text and resource for those who want to understand the issue of spatial health inequalities and how to analyze the issue with GIS and spatial analysis.