The Added Value of Geographical Information Systems in Public and Environmental Health

370 Pages·1995·0.59 MB·English

by  M.J. Lepper

The Added Value of Geographical Information Systems
in Public and Environmental Health
The GeoJournai Library
Volume 24
Series Editor: Wolf Tietze, Helmstedt, Germany
Editorial Board: Paul Claval, France
R. G. Crane, U.S.A.
Yehuda Gradus, Israel
Risto Laulajainen, Sweden
Gerd Luttig, Germany
Walther Manshard, Germany
Osamu Nishikawa, Japan
Peter Tyson, South Africa
The titles published in this series are listed at the end of this volume.
The Added Value
of Geographical
Information Systems
in Public and
Environmental Health
edited by
MARION J.C. DE LEPPER
National Institute for Public Health and Environmental Protection,
Bilthoven, The Netherlands
HENKJ. SCHOLTEN
Department of Regional Economics, Free University & GEODAN bv,
Amsterdam, The Netherlands
and
RICHARD M. STERN
World Health Organization, European Centre for Environment and Health,
Bilthoven, The Netherlands
KLUWER ACADEMIC PUBLISHERS
DORDRECHT / BOSTON / LONDON
Published on behalf of the
World Health Organization Regional Office for Europe
Library of Congress Cataloging-in-Publication Data
The Added value of geographical information systems in public and
environmental health / edited by Marion J.C. de Lepper and Henk J.
Scholten and Richard M. Stern.
p. cm. — (GeoJournal library ; v. 24)
Includes bibliographical references and index.
ISBN 0-7923-1887-0 (hb. : acid free paper)
1. Environmental health—Data processing. 2. Public health—Data
processing. 3. Geographic information systems—Economic aspects.
I. Lepper, Marion J. C. de. II. Scholten, H. J. (Henk J.)
III. Stern, Richard M. IV. Series.
RA566.A33 1994
614.4'2'0285—dc20 93-39559
ISBN 0-7923-1887-0
Published by Kluwer Academic Publishers,
P.O. Box 17, 3300 AA Dordrecht, The Netherlands.
Kluwer Academic Publishers incorporates
the publishing programmes of
D. Reidel, Martinus Nijhoff, Dr W. Junk and MTP Press.
Sold and distributed in the U.S.A. and Canada
by Kluwer Academic Publishers,
101 Philip Drive, NonA^ell, MA 02061, U.S.A.
In all other countries, sold and distributed
by Kluwer Academic Publishers Group,
P.O. Box 322, 3300 AH Dordrecht, The Netherlands.
The views expressed in the publication are those of the contributors and do not necessarily represent
the decisions or the stated policy of the World Health Organization or of Kluwer Academic Publishers
B.V.
Printed on acid-free paper
All Rights Reserved
© 1995 Kluwer Academic Publishers
No part of the material protected by this copyright notice may be reproduced or
utilized in any form or by any means, electronic or mechanical,
including photocopying, recording or by any information storage and
retrieval system, without written permission from the copyright owner.
Printed in the Netherlands
Foreword
Health for all by the year 2000 is the blueprint for change agreed to by the Member
States of the World Health Organization. In Europe, this blueprint is built on 38 regional
targets, many of which have the underlying aim of uncovering new knowledge and of
using existing knowledge more effectively. The targets related to a healthy environment
have the ultimate goals of safeguarding human health against environmental hazards, and
of enhancing the quality of life by providing clean and safe water, air, food, and working
and living conditions. Allied to these goals is the need to reduce the sense of jeopardy
that many people feel about what they perceive as 'the risks of everyday life'.
These goals are an integral part of the European Charter on Environment and Health,
adopted by 29 European Member States and the Commission of the European
Communities in December 1989. The Charter stresses the shared responsibility of
everyone to protect the environment, to be given adequate and accurate information, and
to be involved in decision-making. It outUnes the principles for public policy as well as
what needs to be done to transform them into action. In this, strong information systems
have a vital role to play by helping to monitor the effectiveness of measures taken, of
trends analysed, of priorities set and of decisions made.
In keeping with the letter and spirit of the Charter, Member States need to develop
multisectoral policies that effectively protect the environment from health hazards,
assure community awareness and involvement, and support international efforts to
curtail hazards affecting more than one country. Similarly, the machinery for
implementing such policies must be developed, especially through the monitoring,
assessment and control of a wide range of potential environmental hazards. To do this,
specific agents and their potential effects must be studied to provide information on new
risks and to better quantify old ones, thus providing the necessary input for priority
setting and risk management, and for the development of integrated monitoring systems
for priority substances.
Studies of the health of populations often reveal great unevenness in disease rates in time
and place, which occasionally reach statistical significance. In addition to temporal peaks
that may be related to epidemics, local variations are observed, frequently in the form of
clusters of rare events, or of elevated or depressed rates of incidence (or mortality) in
geographically restricted regions. Such results are often displayed as maps of health
status, which greatly influence public opinion. This book has been developed to
stimulate research and training in this area. In particular, it is directed towards
developing the study of disease or adverse health outcome in individuals and populations
based on the availability of geographic linkage between medical information in the
health records, usually collected in routine surveys and compilations of public health
statistics, and the address of the individual concerned, and information on spatial
variations of potential exposures or environmental hazards. The study of such small area
health statistics at large scale enables us to learn about variations in health status on a
subregional, national or subnational level. It also indicates to governments the need for
questioning, at the very least, the origin of such variations, especially when they imply a
locally reduced standard of public health. As geographically coded information becomes
available at a smaller and smaller scale, as is now the practice in many European
countries, especially with the inclusion of local postal codes in addresses in hospital
discharge records, local authorities, national governments, the public and the press are
becoming aware of the degree of variation in health risk at small scale. When a high
degree of risk is found among a population with close geographic association to what
could be a potential source of environmental risk, public concern becomes acute.
In response, public authorities turn to the scientific community for advice. In particular,
the scientific community is asked for an estimate of the probability that a locally high
health risk is not due to chance, but is the reflection of a local increase in risk. The
methods necessary for such studies in analytical environmental epidemiology are
complex; they also demand high standards of scientific rigour and are in a state of rapid
development.
This book is the first attempt to bring together the experience of environmental
epidemiologists, statisticians and map-makers in a single volume. It is also one of the
first outcomes of the WHO European programme on environment and health information
systems. This programme, which has been generously supported by the German Ministry
of Environment, Nature Conservation and Nuclear Safety, the Italian Ministry of
Environment and the Department of Health in London will be carried out by a large
number of participating institutions in Europe, assisted by several WHO collaborating
centres and coordinated by the newly established European Centre for Environment and
Health with offices in Copenhagen, Bilthoven, Rome and Nancy.
The wide use of this book is expected to improve the ability of the European Region to
identify areas of environmental concern and to help improve public and environmental
health planning policy.
Jo E. Asvall
WHO Regional Director for Europe
Acknowledgements
This volume would not have been possible without the technical and adminstrative
support of the National Institute of Public Health and Environmental Protection (RIVM),
Bilthoven, the Netherlands. The editors are also indebted to colleagues from the RIVM
and from Geodan BV in Amsterdam for their scientific contributions. We wish to thank
Han van Veldhuizen and Andre van der Veen for their work in preparing camera-ready
copy for the manuscript, and to express our gratitude to both Alice Uppelschoten and
Carmen Molina for all their efforts in facilitating the production of the book.
Marion J.C. de Lepper
Henk J. Scholten
Richard M. Stern
September 1994
Contents
Foreword v
Acknowledgements vii
List of figures xvii
List of tables ixx
List of maps xx
Editorial introduction xxiii
PART I: NEED OF INFORMATION IN PUBLIC AND ENVIRONMENTAL HEALTH
1 Environment and health data in Europe as a tool for risk management:
needs, uses and strategies - Richard M. Stern
1.1 Introduction 3
1.2 Information needs 6
1.3 Studying risks to the environment and to health and their geographical
variation 7
1.4 The need for high resolution and global environmental data: indicators 10
1.5 Strategies for identifying priority data 11
1.6 Conclusions 23
2 Indicators of public health and environmental quality - Erik Lebret
2.1 Introduction 25
2.2 Concepts of health and environment 25
2.3 Combining health and environmental quality indicators in a GIS 35
2.4 General considerations and criteria for health and environment data in a GIS 36
2.5 Indirect indicators for environmental health 37
2.6 Conclusions 37
3 Meta-information systems for environment and health - Jan A. Bakkes
3.1 What is a meta-information system? 41
3.2 The added value of meta-information systems 43
3.3 The CIMI formula 43
3.4 Recommendations 46
3.5 Conclusion 49
PART II: THE COMPONENTS OF GEOGRAPHICAL INFORMATION SYSTEMS
4 An introduction to geographical information systems -
Henk J. Scholten, Marion J. C. de Lepper
4.1 Defining geographical information systems 53
4.2 Types of spatial information systems 55
4.3 The objectives of geographical information systems 56
4.4 Technical aspects of geographical information systems 58
4.5 Type of user and kind of need 62
4.6 Conclusions 66
5 The integration of information in geographical information systems -
Arthur U.CJ. van Beurden, Marion J.C. de Lepper
5.1 Introduction 71
5.2 Spatial and descriptive information in GIS 72
5.3 Information integration 74
5.4 Conclusions 84
6 Organizational aspects of geographical information systems -
David W. Heath
6.1 Data organization 87
6.2 GIS development and management 93
6.3 Direct user access 95
6.4 Dissemination 96
7 Data aspects of geographical information systems -
J. Maes, M.H. Comaert
7.1 The CORINE Programme 99
7.2 The European Environment Agency and its information and observation
network 100
7.3 The CORINE Information System 101
7.4 Some generic GIS lessons learned 105
7.5 Examples of GIS use in the framework of the CORINE Information System 107
7.6 Conclusions 109