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Spatial Analysis and Modeling for Health Applications
KTH, School of Architecture and the Built Environment (ABE), Urban Planning and Environment, Geodesy and Geoinformatics.
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Despite the benefits of applying methods of geographic information science (GIScience), the use of such methods in health service planning and provision remains greatly underutilized. Spread of epidemic diseases is a constant threat to mankind and the globalization of the world increases the risk for global attacks from multi-resistant bacteria or deadly virus strains. Therefore, research is needed to better understand how GIScience could be used in epidemiologic analyses and other health applications.

This thesis is divided into two parts; one for epidemiologic analyses and one for neighbourhood studies. The overall objective of the epidemiologic part of this research is to understand more about the spatial spread of past pandemics and to find out if there are any common patterns. This overall objective is divided into four specific research objectives; 1) to describe the spatial spread of the Russian Influenza in Sweden, 2) to create models of propagation of the Black Death in Sweden, 3) to establish spatiotemporal characteristics common to past pandemics in Sweden and 4) to visualize the spatiotemporal occurrence of salmonella among animal herds in Sweden.

This thesis also discusses some other aspects of health related to place. Are differences in neighbourhood deprivation related to the amount of presence of goods and services? Is the way cities are planned affecting the behaviour within the local population regarding spontaneous walking and physical activity? The specific research objectives for this part are to define how deprivation is related to presence of goods and services in Sweden and to create walkability indices over the city of Stockholm including a quality test of these indices.

Case data reported by physicians were used for the epidemiologic studies. The pandemics discussed covered the entire world, but our data is from Sweden only and as regards the Black Death there was no case data at all. The data for the goods and services analyses are from all of Sweden, whereas the walkability indices are based on data from the city of Stockholm. Various methods have been used to clean, structure and geocode the data, including hand written reports on case data, maps of poor geometric quality, information from databases on climate, demography, diseases, goods and services, income data and more, to make this data feasible for spatial analysis, modeling and visualization. Network analysis was used to model food transports in the 14th century as well as walking in the city of Stockholm today. Proximity analysis was used to assess the spatio-temporal spread of the Russian Influenza. The impact of climatological factors on the propagation of the Asian Influenza was analyzed and geographically weighted mean (GWM) calculations were used to discover common characteristics in the spatio-temporal spread of three past pandemics.

Among the results generated in the epidemiologic study the following should be noted in particular; the local peaking periods of the Asian Influenza were preceded by falling temperature, the total peaking period for the three pandemics (Russian, Asian and A(H1N1)pdm09) was approximately 10 weeks and their weekly GWM followed a path from southwest to northeast (opposite direction for the A(H1N1)pdm09). From the neighborhood studies one can note that compared to the results measured and reported by tested individuals there is a positive (small but significant) association between neighborhood walkability and physical activity outcomes.

The main contribution of this work is that it gives epidemiologists and public health specialists new ideas, not only on how to formulate, model, analyze and visualize different health related research questions but also ideas on how new procedures could be implemented in their daily work. Once the data reporting is organized in a suitable manner there is a multitude of options on how to present important and critical information to officials and policy makers.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2014. , 95 p.
Series
TRITA-SOM, ISSN 1653-6126 ; 2014:03
Keyword [en]
Sweden, spatial analysis, spatial modeling, spatio-temporal spread, epidemiology, pandemic, walkability, health, Russian influenza, Asian influenza, A(H1N1)pdm09, GWM, climate factors
National Category
Environmental Engineering
Identifiers
URN: urn:nbn:se:kth:diva-142835ISBN: 978-91-7595-040-2 (print)OAI: oai:DiVA.org:kth-142835DiVA: diva2:704678
Public defence
2014-03-28, E3, Osquarsbacke 14, KTH, Stockholm, 10:00 (English)
Opponent
Supervisors
Note

QC 20140313

Available from: 2014-03-13 Created: 2014-03-12 Last updated: 2014-03-13Bibliographically approved
List of papers
1. The Russian influenza in Sweden in 1889-90: an example of Geographic Information System analysis
Open this publication in new window or tab >>The Russian influenza in Sweden in 1889-90: an example of Geographic Information System analysis
2008 (English)In: Euro surveillance : bulletin Européen sur les maladies transmissibles = European communicable disease bulletin, ISSN 1560-7917, Vol. 13, no 49Article in journal (Refereed) Published
Abstract [en]

Using data from a study of the 1889-90 Russian flu in Sweden, this article describes how the application of Geographic Information System (GIS) may improve analyses and presentation of surveillance data. In 1890, immediately after the outbreak, all Swedish doctors were asked to provide information about the start and the peak of the epidemic, and the total number of cases in their region and to fill in a questionnaire on the number, sex and age of infected persons in the households they visited. General answers on the epidemic were received from 398 physicians and data on individual patients were available for more than 32,600 persons. These historic data were reanalysed with the use of GIS, in map documents and in animated video sequences, to depict the onset, the intensity and the spread of the disease over time. A stack diagram with the observations grouped into one week intervals was produced to depict the spread in one figure only. To better understand how the influenza was disseminated, Thiessen polygons were created around 70 places reported on by the doctors. Having prepared GIS layers of the population (divided into parishes), estimations could be made for all the Swedish parishes on the number of infected persons for each of the 15 weeks studied. The described models may be useful in current epidemiological investigations, as well.

National Category
Health Sciences
Identifiers
urn:nbn:se:kth:diva-142826 (URN)19081003 (PubMedID)2-s2.0-61749095450 (Scopus ID)
Note

QC 20140312

Available from: 2014-03-12 Created: 2014-03-12 Last updated: 2014-10-17Bibliographically approved
2. Spatial Modeling of the Black Death in Sweden
Open this publication in new window or tab >>Spatial Modeling of the Black Death in Sweden
2013 (English)In: Transactions on GIS, ISSN 1361-1682, E-ISSN 1467-9671, Vol. 17, no 4, 589-611 p.Article in journal (Refereed) Published
Abstract [en]

The purpose of this work is to determine whether spatial modeling can be used to model the spread of the Black Death. The study is limited to models for the propagation of the disease in Sweden in 1350. Geographic data of Swedish water bodies and medieval road networks, historical data on the population in Swedish parishes, including their medieval boundaries, along with historical notes and disease characteristics, were used to build alternative models for spatial distribution. Three different models are presented: one radial, one cost-based and one combining network analysis and radial propagation. Simulations were made to depict different scenarios on the spread of the disease, as well as the drastic changes in the overall population of Sweden, over a couple of hundred years. For purpose of validation the population decrease estimated in each parish is compared with independent historical documents. Results from model scenarios are visualized in maps of propagation, animated video sequences and a web map service. Our analyses clearly demonstrate the power of spatial analysis and geographic information systems to describe, model and visualize epidemiologic processes in space and time.

Keyword
Yersinia-Pestis, Plague, Epidemic, Diseases, System
National Category
History
Identifiers
urn:nbn:se:kth:diva-127763 (URN)10.1111/j.1467-9671.2012.01369.x (DOI)000322598100007 ()2-s2.0-84881454636 (Scopus ID)
Note

QC 20130906

Available from: 2013-09-06 Created: 2013-09-05 Last updated: 2017-12-06Bibliographically approved
3. Spatiotemporal charactyeristics of pandemic influenza
Open this publication in new window or tab >>Spatiotemporal charactyeristics of pandemic influenza
Show others...
(English)Manuscript (preprint) (Other academic)
Keyword
Russian influenza, Asian influenza, A(H1N1)pdm09, spatiotemporal spread, temperature dependence, spatial modelling, GIS
National Category
History
Identifiers
urn:nbn:se:kth:diva-142840 (URN)
Note

QS 2014

Available from: 2014-03-13 Created: 2014-03-12 Last updated: 2014-03-13Bibliographically approved
4. Geographical distribution of salmonella infected pig, cattle and sheep herds in Sweden 1993-2010
Open this publication in new window or tab >>Geographical distribution of salmonella infected pig, cattle and sheep herds in Sweden 1993-2010
2011 (English)In: Acta Veterinaria Scandinavica, ISSN 1751-0147, E-ISSN 1751-0147, Vol. 53, 51- p.Article in journal (Refereed) Published
Abstract [en]

Background: The Swedish salmonella control programme covers the entire production chain, from feed to food. All salmonella serotypes are notifiable. On average, less than 20 cases of salmonella in food-producing animals are reported every year. In some situations, the cases would be expected to cluster geographically. The aim of this study was to illustrate the geographic distribution of the salmonella cases detected in pigs, cattle and sheep. Methods: Data on all herds with pigs, cattle and sheep found to be infected with salmonella during the time period from 1993 to 2010 were obtained from the Swedish Board of Agriculture. Using the ArcGIS software, various maps were produced of infected herds, stratified on animal species as well as salmonella serotype. Based on ocular inspection of all maps, some were collapsed and some used separately. Data were also examined for temporal trends. Results: No geographical clustering was observed for ovine or porcine cases. Cattle herds infected with Salmonella Dublin were mainly located in the southeast region and cattle herds infected with Salmonella Typhimurium in the most southern part of the country. Some seasonal variation was seen in cattle, but available data was not sufficient for further analyses. Conclusions: Analyses of data on salmonella infected herds revealed some spatial and temporal patterns for salmonella in cattle. However, despite using 18 years' of data, the number of infected herds was too low for any useful statistical analyses.

National Category
Zoology
Identifiers
urn:nbn:se:kth:diva-47982 (URN)10.1186/1751-0147-53-51 (DOI)000296273500001 ()2-s2.0-84855260755 (Scopus ID)
Note

QC 20111116

Available from: 2011-11-16 Created: 2011-11-15 Last updated: 2017-12-08Bibliographically approved
5. Differences in neighborhood accessibility to health-related resources: A nationwide comparison between deprived and affluent neighborhoods in Sweden
Open this publication in new window or tab >>Differences in neighborhood accessibility to health-related resources: A nationwide comparison between deprived and affluent neighborhoods in Sweden
Show others...
2011 (English)In: Health and Place, ISSN 1353-8292, E-ISSN 1873-2054, Vol. 17, no 1, 132-139 p.Article in journal (Refereed) Published
Abstract [en]

This nationwide Swedish study used geocoded data from all businesses in Sweden to examine the distribution of 12 main categories of goods, services, and resources in 6986 neighborhoods, categorized as low, moderate, and high neighborhood deprivation. The main findings were that high- and moderate-deprivation neighborhoods had a significantly higher prevalence of all types of goods, services, and resources than low-deprivation neighborhoods. These findings do not support previous research that hypothesizes that poorer health among people in deprived neighborhoods is explained by a lack of health-promoting resources, although a higher presence of health-damaging resources may play a role. (C) 2010 Elsevier Ltd. All rights reserved.

Keyword
Accessibility, Deprivation, Neighborhood
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:kth:diva-39196 (URN)10.1016/j.healthplace.2010.09.005 (DOI)000288776500016 ()2-s2.0-78751574043 (Scopus ID)
Funder
Swedish Research Council, K2005-27X-15428-01ASwedish Research Council, 2008-3110Swedish Research Council, 2008-2638Formas, 2006-4255-6596-99Formas, 2007-1352
Note

QC 20110908

Available from: 2011-09-08 Created: 2011-09-08 Last updated: 2017-12-08Bibliographically approved
6. Neighborhood walkability, physical activity, and walking behavior: The Swedish Neighborhood and Physical Activity (SNAP) study
Open this publication in new window or tab >>Neighborhood walkability, physical activity, and walking behavior: The Swedish Neighborhood and Physical Activity (SNAP) study
Show others...
2011 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 72, no 8, 1266-1273 p.Article in journal (Refereed) Published
Abstract [en]

More knowledge concerning the association between physical activity and objectively measured attributes of the built environment is needed. Previous studies on the association between objectively measured neighborhood walkability, physical activity, and walking have been conducted in the U.S. or Australia and research findings are available from only one country in Europe - Belgium. The first aim of this Swedish study of 2269 adults was to examine the associations between neighborhood walkability and walking for active transportation or leisure, and moderate-to-vigorous physical activity (MVPA) and whether these hypothesized associations are moderated by age, gender, income, marital status and neighborhood-level socioeconomic status. The second aim was to determine how much of the total variance of the walking and physical activity outcomes can be attributed to neighborhood-level differences. Neighborhood walkability was objectively measured by GIS methods. An index consisting of residential density, street connectivity, and land use mix was constructed to define 32 highly and less walkable neighborhoods in Stockholm City. MVPA was measured objectively during 7 days with an accelerometer and walking was assessed using the validated International Physical Activity Questionnaire (IPAQ). Multilevel linear as well as logistic models (mixed-effects, mixed-distribution models) were used in the analysis. The statistically significant and "adjusted" results for individuals living in highly walkable neighborhoods, as compared to those living in less walkable neighborhoods, were: (1) 77% and 28% higher odds for walking for active transportation and walking for leisure, respectively, (2) 50 min more walking for active transportation/week, and (3) 3.1 min more MVPA/day. The proportion of the total variance at the neighborhood level was low and ranged between 0.0% and 2.1% in the adjusted models. The findings of the present study stress that future policies concerning the built environment must be based on context-specific evidence, particularly in the light of the fact that neighborhood redevelopments are time-consuming and expensive.

Keyword
Neighborhoods, Physical activity, Sweden, Walking
National Category
Medical and Health Sciences Social Sciences Natural Sciences
Identifiers
urn:nbn:se:kth:diva-34353 (URN)10.1016/j.socscimed.2011.03.004 (DOI)000290699700006 ()2-s2.0-79954745819 (Scopus ID)
Funder
Formas
Note

QC 20110818

Available from: 2011-08-18 Created: 2011-06-07 Last updated: 2017-12-08Bibliographically approved

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