Assignment 1.1

[Chawarat Rotejanaprasert]

For assignment 1.1, please discuss the following questions:

1. What are possible reasons locations in epidemiological research have not been incorporated as much as other components in epidemiological research? How can spatial epidemiology be considered as an interdisciplinary science?
2. Explain why it is widely recognized that the place where an individual lives or works should be considered as a potential disease determinant and give some examples?

[Aung Thura Htoo]

1. There are many established public health studies on the comparison between time and person. However, the comparison between small-scale location study have not been incorporated as much as other components. The reasons are due to the availability and quality of data, lack of advanced software to visualize and analyze spatial data, the complexities of analytical framework, and the privacy and confidentiality issues.
1. Spatial epidemiology can be considered as an interdisciplinary science because it incorporates principles and concepts from other fields to have a better understanding of the distribution and patterns of public health concern across different locations. For example, it incorporates with the fields of statistics, environmental science, social science.
2. The place where we live and work can be regarded as a potential disease determinant because we are exposed to the things that are attached to those places for a significant portion of our life. For example, the places we work might be an area where the pollution is significantly higher than other places, resulting in higher morbidity rate. Additionally, the places we live might be near to vegetation and grasses, leading to higher rate of vector-borne diseases.

[Wannisa Wongkamchan]

Hello Aung, thank you for sharing, I agree that location really shapes people health. It’s clear that environmental factors, like pollution in workplaces, or natural surroundings play a big role in disease risk.

[Cing]

Thank you for sharing your discussion. I can certainly see that the place where we live and work can be regarded as a potential disease determinant. Even office jobs are exposed to eye strain, obesity, cardiovascular disease, back and neck pain, stress, burnout, forward head posture, etc.

[Than Soe Oo]

1. Locations in epidemiological research have not been as heavily emphasized as other components. Traditionally, studies focusing on place or location have received considerably less attention. From a public health perspective, understanding that a health problem is concentrated in specific areas is crucial for the effective distribution of resources for prevention, treatment, or improvement of health outcomes. Several factors contribute to this apparent lack of interest in location, including a shortage of appropriate databases and insufficient software tools. Additionally, spatial analysis techniques and their associated tools can seem overwhelmingly complex. There is a clear need for a glossary to explain common terms in geographical epidemiology, spatial analysis, and Geographic Information Systems (GIS). Spatial epidemiology can be viewed as an interdisciplinary field that connects environmental sciences related to energy, food, and water security, working across various domains such as government and industry. This approach fosters the types of connections that can enhance understanding and collaboration across disciplines.

2. Spatial epidemiology emphasizes the importance of considering where individuals live and work as potential determinants of disease. Health outcomes are shaped by a combination of factors, including personal attributes, physical and social environments, cultural norms, and the availability and use of health services. Variables such as age, sex, and socioeconomic status can vary significantly between locations, and these differences may influence disease risk. In many cases, “place” serves as a substitute for the interaction between genetic factors, lifestyle choices, and environmental conditions. Unfortunately, many public health specialists have overlooked the spatial dimension of disease processes. Health-related data—whether it comes from population studies, environmental exposure assessments, or healthcare utilization—can typically be linked to specific locations, such as street addresses (known as occurrence data) or to broader areas, like communities (referred to as aggregate summaries, such as count data). By analyzing data related to various locations (e.g., home, workplace, hobby sites), researchers can create a clearer connection to biological models. This approach allows for a better understanding of how individual characteristics, such as age, sex, and genetics, contribute to disease risk. As new geographic techniques become more visually appealing and accessible, spatial epidemiology studies are expected to become more prevalent. Improved data and methodologies will enhance our understanding of the complex interactions between the environment and health, ultimately contributing to the pursuit of cleaner and healthier living conditions.

[Aung Thura Htoo]

Hello, thank you for sharing your discussion. I believe that the availability of quality public health data that can be linked to specific locations are still limited in many countries around the world. Even though some software and advanced statistical tests have been developed and accessible, the availability will still be one of the most challenging aspect in spatial analysis.

[Wannisa Wongkamchan]

Hello Than Soe Oo, thank you for sharing, I agree that It is essential to comprehend that a health issue is concentrated in specific areas for allocating resources for prevention, treatment, or enhancing health results. I think that as new geographic tools get better, spatial epidemiology will become even more vital for health care system.

[Wannisa Wongkamchan]

1. Descriptive epidemiology focuses on the triad of people, place, and time. However, in the past, most epidemiology research focused more on individual factors like age, gender, genetics, and behavior, or on how diseases changed over time, rather than historically focusing on place or location. A significant reason for this lack of interest in place was the limitations of suitable databases and insufficient software for effectively managing and analyzing spatial data in the past. But now, with advance technology, spatial epidemiology has many more chances in epidemiological research. Because of this, spatial epidemiology is an interdisciplinary field. It requires knowledge and skills in epidemiology, statistics, geography, and computer science to understand how people, places, and environments are connected, and how they affect health.

2. The place where an individual lives or works should be considered a potential disease determinant because it can indicate the risk of health problems and the onset of diseases. This is because “place” encompasses environmental, social, and economic factors. For example, individuals living or working near nuclear power plants or coal-fired power plants may be exposed to radiation or various toxins, increasing their risk of developing diseases such as cancer. In remote rural areas, individuals may experience malnutrition or nutrient deficiencies due to limited access to diverse and healthy food sources. In urban areas, living in densely populated environments, the social and environmental at the workplace, can contribute to conditions like stress and office syndrome.

[Aung Thura Htoo]

Hello Wannisa, thank you for sharing your insights on this week’s discussion. Yes, I agree with you that it requires both skills and knowledge in order to comprehend and analyze spatial data in relation to health and disorders. Additionally, like you mentioned, the availability of database and accessible software poses as significant barriers in the past in the field of spatial epidemiology.

[Aye Thinzar Oo]

Thanks for the great points! I agree that while descriptive epidemiology includes person, place, and time, earlier research mostly focused on individual factors and time trends. As you said, the lack of tools and data made it hard to study in detail. However, with advancements in technology and GIS, spatial epidemiology now plays a significantly larger role.

[Cing]

Thank you for sharing your discussion. Regarding databases, to be more specific, historically, they lacked the functions of databases that offer storage, management, integrity, security, data retrieval, etc, for performing spatial epidemiological research. The lack of such technology support acted as a barrier to the continuation of further exploring spatial epidemiology.

[Than Soe Oo]

Thanks for your discussion, Wannisa. You make a very important point. Understanding the geographic concentration of health issues allows for more targeted and efficient allocation of resources, which can significantly improve prevention, treatment, and overall health outcomes. As new geographic tools—such as advanced GIS (Geographic Information Systems), remote sensing, and spatial analysis techniques—continue to develop, spatial epidemiology will indeed become increasingly crucial. These tools provide more precise, real-time data that help identify disease patterns, environmental risk factors, and vulnerable populations. This, in turn, enables healthcare systems to respond more effectively and tailor interventions to the specific needs of different communities. Overall, the enhancement of spatial epidemiology holds great promise for advancing public health strategies and reducing health disparities.

[Aye Thinzar Oo]

Incorporating location into epidemiological studies has historically been difficult due to challenges in gathering and analyzing spatial data. Spatial epidemiology, an interdisciplinary field, requires expertise in epidemiology, geography, statistics, and computer science (particularly GIS) to effectively analyze disease patterns across geographic areas.

The place where an individual lives or works is considered a potential disease determinant because it can reveal spatial patterns and provide insights into disease distribution. Geographical epidemiology uses this information to explore environmental factors, social conditions, and access to healthcare that may influence health outcomes.

[Cing]

Q1 (a). What are possible reasons locations in epidemiological research have not been incorporated as much as other components in epidemiological research?

Answer: The main reason could be the difficulties in correlating with places/locations in epidemiological research because chorographia or geography was not a part of epidemiological research. It is more likely that it was focused on person and time dimensions, for example, gender, age, occupation, socioeconomic level, disease trends based on a specific period, such as weather and climate. Other possible reasons could be a lack of technology support and data acquisition. It would not be convenient to collect data and tag locations on a paper map, and in the end, there would be challenges in performing clustering and correlation geographically. Therefore, locations were not much incorporated in the epidemiological research.

Q1 (b). How can spatial epidemiology be considered as an interdisciplinary science?

In discovering disease distribution patterns and the causative determinants among populations, focusing on locations, epidemiological knowledge is insufficient. Geography plays in understanding information about a place (such as weather, soil, air, and temperature). To infer the correct result from collected data, statistics helps with valid logical reasoning. To develop efficient analysis algorithms and visualization from large datasets, knowledge of computer science is required. Environmental science and public health also help identify environmental risk factors affecting disease patterns. Therefore, spatial epidemiology is inherently interdisciplinary and cannot function as an isolated field.

Q2 (a). Explain why it is widely recognized that the place where an individual lives or works should be considered as a potential disease determinant, and give some examples?

Vector-borne diseases such as malaria and dengue are distributed in spatial patterns. Living in such regions could increase the risk.

People in remote rural areas lack health infrastructure, resulting in poorer health outcomes.

People living near or working in mines, landfills, and industrial complexes have a higher chance of lung cancer.

Therefore, it is widely recognized that the place where an individual lives or works should be considered as a potential disease determinant.

[Alex Zayar Phyo Aung]

1) In health data analysis, location has not been used as much as other factors because of some challenges. Most of the health information systems do not record the exact place of each person rather than data are collected from health facilities or health posts, not from the individual’s home or workplace. Second is unstable or conflict areas, it is often not safe to collect people’s exact location because of confidentiality risks. Third, the importance of location also depends on the type of disease. For example, in maternal health, location may not matter as much but for communicable diseases like malaria where community live or work is very important to understand the disease spread pattern. Spatial epidemiology brings together knowledge from different fields like epidemiology, geography, statistics, and environmental science to deal with these challenges and make better use of location in health studies.
2) Communicable diseases such as malaria or VPDs etc. are closely linked to geographic location. For example, malaria is common in forested areas where mosquitoes breed and it can easily spread to nearby villages. Similarly, outbreaks of VPDs often follow patterns related to population movement and settlement locations. The importance of location in understanding disease has been recognized since the early days of public health like John Snow famously used geolocation to identify the source of a cholera outbreak in London by mapping cases to trace contaminated water sources. This shows that location data should be utilized and mainstreamed across the health information system

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