University City

December 14, 2012

Geography plus public health equals discovery

On the last day of August 1854, a cholera epidemic emerged with such sudden ferocity in London’s Soho district that it claimed 500 lives in its first 10 days.

On the last day of August 1854, a cholera epidemic emerged with such sudden ferocity in London’s Soho district that it claimed 500 lives in its first 10 days.

As many of the townspeople fled in droves, unsure how the disease was spreading so quickly, physician John Snow was rushing past them in the opposite direction.

Determined to find the source of the disease, Snow knocked on doors, asking residents questions about their habits and recording his results on a map of Soho. What he learned – that high concentrations of cholera were occurring near the Broad Street water pump – helped trace the source of the disease to contaminated water.

Snow’s discovery saved hundreds of lives and secured him the title of the father of epidemiology – the study of the patterns and trends of diseases and health conditions in populations.

Flash forward 158 years later, and Dr. Russell Kirby is carrying on Snow’s work.

This month, Kirby, a professor at the University of South Florida’s College of Public Health, invited members of UNC Charlotte’s geography and public health departments to a discussion on the benefits the two disciplines can create when combined.

“If you’re interested in understanding the disease process and how to prevent it, the first thing is to figure out where it is most common,” said Kirby, who holds advanced degrees in geography and epidemiology.

Back in Snow’s day, there were no computers or census reports to glean data. He relied on the shoe-leather method of going door-to-door and writing information by hand.

Today geographic information systems – programs that create computerized mapping of data – can do a lot of the monotonous work for researchers.

“The array of special analytical tools today is remarkable compared to what it was even five years ago,” said Kirby, who in the 1980s worked as a researcher for the Center for Health Statistics, when tracking by ZIP code was considered the latest innovation.

The topics to analyze are endless. Researchers can compile data about where food-borne illnesses have struck or Lyme disease has surged. They can record the characteristics of a region with a higher-than-normal prevalence of low birth rates or a higher proportion of breast cancer. It’s all information that can lead to advancements in health.

“These are all things where place doesn’t give us all the answers, but it gives us some ideas where to look,” said Kirby, who hopes that, one day, an advanced degree combining the fields of geographic information systems and public health will be offered at universities. Right now, he’s working to create a 12-credit GIS/public health certificate at USF for students next year.

Arming public health experts with GIS knowledge could someday solve some of society’s most puzzling health issues. It wasn’t long ago, for example, that doctors were grappling for a way to reduce instances of spina bifida, a common birth defect.

“We knew for years that certain populations had a higher prevalence than others, and we thought it might to some extent be bound up in culture and diet,” said Kirby.

When experts began mapping and collecting data from mothers of children with spina bifida, they quickly found a correlation between the disorder and a folic acid deficiency.

“We knew from the maps,” said Kirby. “Folic acid and spina bifida correlated exactly. I wouldn’t say the map gave us all the answers, but it was an ‘aha’ moment.”

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