Tag Archive:
GIS and Health

STARS Travel Path: Tracking and Modeling Space-Time Related Risk Factors in Adolescent Violence

" ... learn whether things adolescents do and places they go are associated with whether they will be the victim of violence ... visually mapping a verbal account of activities provides researchers with a powerful tool..."

Map tracking points of a victim’s activity
in the 24 hours preceding a violent assault.

Gunshot injury is the leading cause of death in 10-19 year old African American males and the second leading cause of adolescent death overall. Assaultive injuries appear as the end result of a causative web of factors that include alcohol, firearms, and dangerous urban environments. Yet little is known about the epidemiology of assaultive injury from guns and other weapons among adolescents.

Researchers at the University of Pennsylvania, School of Medicine, have set out to learn whether things adolescents do and places they go are associated with whether they will be the victim of violence. The project, the Space-Time Adolescent Risk Study (STARS) is led by Douglas Wiebe and Charles Branas of the Center for Clinical Epidemiology and Biostatistics and Therese Richmond from the University of Pennsylvania School of Nursing who aim to identify key behavioral and environmental factors that put young people ages 10-19 at risk for being assaulted, thereby spearheading an innovative application of epidemiological space-time modeling.

Azavea was contracted to build the space-time activity tracking software tool to help health care professionals in interviewing adolescent victims of violent crime. STARS Travel Path is a desktop mapping application and database, and is designed to help interviewers guide adolescents injured in an assault through the process of reconstructing the series of events and encounters in the 24-hour time period preceding the assault. Using laptops with GIS data and the STARS application installed, trained interviewers work with each victim to record the victim’s verbal account of his or her activities by placing digital markers indicating the location of each significant activity, on a street map or high-resolution satellite photo.

The interviewer is able to accurately assign times and other information to the markers on a victim’s map – including the assault event – based on factors such as the victim’s mode of transportation to or from each event, speed of movement, interruptions, and other environmental factors. The interviewer also inputs key data on whether the victim was in possession of a gun or took drugs and/or alcohol at any time in the 24 hours prior to the assault. Typically 80-100 points of activity are recorded on each victim’s map. Typically 80-100 points of activity are recorded on each victim’s map. Visually mapping a verbal account of activities provides researchers with a powerful tool that aids in accurately recording complex space/time data.

“Epidemiologic research of this type – that aims to identify risk factors for injury – has typically collected data for only the time at which the injury occurred. We expect that the activities that lead up to an assault are equally important to consider. This application lets us do this by recreating adolescents’ moment-to-moment paths with a high degree of spatial and temporal accuracy. An additional plus is that the mapping interface seems to help keep participants engaged during the interview process.” – Doug Wiebe, University of Pennsylvania Center for Clinical Epidemiology and Biostatistics

The STARS activity mapping application utilizes ESRI’s ArcGIS Engine toolkit to quickly generate and display customized maps, and geocode and record points of activity. The point data and the factors related to each point are then stored in a simple database. Data gathered in the field, on hand-held computers, can be uploaded to a master database linked by X-Y coordinates to environmental data, statistically analyzed. Ultimately, it is hoped that the results of this study will help researchers understand how daily routine, social interactions, use of drugs and alcohol and possession of weapons effects an adolescent individual’s risk of being assaulted with a weapon.

Connect 2-1-1: Enabling Social Services to Be Searched Geographically

"For years, ... people would turn to 911 as a way to get answers, in some cases, overburdening county emergency call systems."

For years, residents seeking heath and human service assistance in the Delaware Valley have faced a maze of options like Medicare, county assistance, Social Security, disability programs, job training, and drug counseling – with no single source for information about them. Without an easy alternative, many people would turn to 911 as a way to get answers, in some cases, overburdening county emergency call systems.

Azavea partnered with the Delaware Valley Association for the Education of Young Children (DVAEYC) and six United Way organizations serving Southeastern Pennsylvania to develop Connect211.org, a web-based application that enables the public and social workers to find and route their way to more than 12,000 organizations and service providers for health, family, education, employment, food, and shelter in the region.

Visitors to the site can easily identify service providers based on where they live and can use the routing function to plan a trip between their homes and the providers they have selected. In addition to driving directions, the system also includes bus, subway, and train routes on the maps. Users can search the database for services at a range of geographic levels including county, township, zip code, neighborhood, and distance from a specific address. Results are listed by address and displayed on a map that enables users to select specific search results, zoom in and out, and pan in any direction. DVAEYC updates the data and service provider information on an ongoing basis to fill in gaps. Connect211.org is free and for Philadelphia residents who lack access to the internet, the Free Library of Philadelphia has provided a Connect211.org link on its computers.

While the application uses Microsoft .Net framework, Microsoft SQL Server, ESRI’s ArcIMS, ArcSDE and ArcWeb Services, a few years have passed since we originally developed it and the technology has evolved, so we are currently working with DVAEYC and the United Way to build a Phase II for Connect211.org that will leverage more contemporary technology.

GIS and Trauma Center Siting

"The difference between life and death for severely injured people depends upon the amount of time it takes to get them to a trauma center hospital."

The difference between life and death for severely injured people depends upon the amount of time it takes to get them to a trauma center hospital. The siting of trauma center hospitals, however, is more complex than just maps of land area coverage showing ringed bands around each hospital. Surrounding helicopter and ambulance locations and speeds, the number and location of trauma centers in a region, and the spatial relationships between these facilities also need to be considered. To be viable, the hospital must serve a large enough population of severely injured people to maintain the skills of its healthcare providers and offer high quality care.

A team of researchers from the University of Pennsylvania and Johns Hopkins University set out to develop a mathematical model to assist with trauma center siting while taking these important considerations into account, and to make that model accessible through the Internet. They have developed the Trauma Resource Allocation Model for Ambulances and Hospitals (TRAMAH), a mathematical optimization model that uses population and access to existing trauma centers based on geographic relationships to ambulances and helicopters to simulate the effects of newly sited trauma centers.

Azavea partnered with the researchers and the Cartographic Modeling Lab to develop an interactive website enabling visitors to specify timeframe (access within 45 or 60 minutes) and transportation mode (ambulance, helicopter, or both), and identify the locations of current hospitals and trauma centers and their accessibility. The application provides a map and coverage information based on percentages of population and land covered by the existing system.

This website, which leverages ESRI’s ArcIMS and ArcSDE technologies, is now accessible to the public at http://tramah.cml.upenn.edu.

Many other factors may need to be taken into consideration in siting trauma centers, and the TRAMAH system will be best used alongside, rather than instead of, the specialized knowledge of trauma systems planners. It does, however, demonstrate the very real value that GIS can add when dealing with limited resources that must be allocated over extensive geographic areas.

A “Traumatic” Puzzle

The American Trauma Society’s TRAMAH website uses algorithms developed in collaboration with the University of Pennsylvania and Johns Hopkins University to understand and map access to trauma center hospitals across the country.

Visit the application and compare the three states with Azavea offices (Pennsylvania, Vermont, and Washington.

1. In which state does the largest percentage of the population have access to trauma care by ambulance within 45 minutes?

2. Which state has the smallest percentage of land coverage within 45 minutes?

3. Explore the US map. Three states have 100% of their population with access via helicopter or ambulance within 60 minutes. Name two of them.

Be the first to send an email with all three correct answers to info@azavea.com and we will send you a $20 gift card to Barnes & Noble!

Nourishing MANNA

"These[Azavea-created] maps serve as a visual tool for MANNA to demonstrate the extent of their services and impact on the Greater Philadelphia Region."

Azavea is committed to working on socially redeeming projects that ask intriguing social questions. As part of this commitment, Azavea employees are able to spend their personal research time (approximately 10% of their time) on pro bono projects. Through these projects, we strengthen our ties to the community and share our geographic analytical expertise with new audiences. One of our recent pro bono projects involved cartographic representation of the reach and services of local nonprofit, MANNA.

Founded in January 1990 by members of the First Presbyterian Church, MANNA is the only non-profit, non-sectarian organization in Philadelphia, which provides freshly cooked, home-delivered meals prepared exclusively for the nutritional needs of people living with HIV/AIDS and has recently expanded their services to homebound people living with cancer. MANNA delivers more than 2,000 meals each day to clients living in Chester, Delaware, Montgomery, and Philadelphia counties as well as the New Jersey counties of Burlington, Camden, Gloucester, Salem, and Delaware’s New Castle County. Azavea used MANNA’s database of customers, volunteers and supporters to create a series of maps highlighting the number of meals they serve, the number of people they assist and the geographic range of their services. These maps serve as a visual tool for MANNA to demonstrate the extent of their services and impact on the Greater Philadelphia region. Initially they were used to show volunteers and supporters the immense reach of the organization, but they have also been used in grant applications and public presentations.