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Using maps and spatial analysis
to inform global health decision making

Peter Speyer
Director of Data Development
@peterspeyer / speyer@uw.edu
UNIVERSITY OF WASHINGTON
Institute for Health Metrics and Evaluation
• Independent research center at the University of Washington

• Core funding by Bill & Melinda Gates Foundation and State of
Washington
• 160 faculty, researchers and staff
• Providing independent, rigorous, and scientific measurement and
evaluations
• “Our goal is to improve the health of the world’s
populations by providing the best information
on population health”
The Global Burden of Disease Study
• A systematic scientific effort
to quantify the comparative magnitude of
health loss due to diseases, injuries, risk factors
• Created 1993, commissioned by the World Bank
• GBD 2010 covers 291 causes, 67 risk factors in 187 countries
for 1990, 2005 and 2010 by age and sex
• GBD country hierarchy 7 super-regions and 21 regions, based
on geographic proximity and epidemiological profiles with
• Almost 600 country, disease and risk factor experts from 80+
countries

3
21 GBD regions

4
Measuring burden of diseases and injuries
Health
Disability Weight

YLDs

YLDs

Deaths
YLLs (Years of Life Lost)
YLDs (Years Lived with Disability)

YLLs

DALYs (Disability-Adjusted Life Years)
Age

Death

Average
life
expectancy
5
GBD process & spatial challenges
Find &
manage data

Analyze data

• Standards

• Missing data

• Coverage

• Missing values

• Representativeness
• Geographies over
time

Get data used
• Interactive
visualizations
• Mapping

• Making data
actionable

6
GBD process & spatial challenges
Find &
manage data

Analyze data

• Standards

• Missing data

• Coverage

• Missing values

• Representativeness
• Geographies over
time

Get data used
• Interactive
visualizations
• Mapping

• Making data
actionable

7
Data inputs
Population based

• Surveys
• Censuses
• Vital registration
• Verbal autopsy
• Disease
registries

Encounter level

• Hospital /
ambulatory /
primary care
records

• Claims data

Other

• Literature
reviews

• Sensor data
• Mortuaries /
burial sites

• Police records

• Surveillance
systems

8
Global Health Data Exchange
(http://www.ghdx.org)

9
10
11
12
13
GBD process & spatial challenges
Find &
manage data

Analyze data

• Standards

• Missing data

• Coverage

• Missing values

• Representativeness
• Geographies over
time

Get data used
• Interactive
visualizations
• Mapping

• Making data
actionable

14
15
GBD covariates and risk factors
• 300+ covariates, e.g. GDP per capita, access to water &
sanitation, education
• Gridded population used for several covariates
(incl. AfriPop, AsiaPop, AmeriPop)
– Population in coastal areas
– Population weighted average elevation, rainfall, temperature
– Population density
– Population at risk for causes like malaria

• Ambient air pollution, ambient ozone pollution (satellite,
surface monitor, TM5 global atmospheric chemistry
transport model)
16
17
• Show GBD Compare map for risk factors
– Ambient air pollution

18
GBD – spatial-temporal regression
• Capture more information than simple covariate models
• Use weighted average of residuals, based on distance in
time, age and space
• Geographic weights based on GBD regional hierarchy
(country/region/super-region)
• Vary weights based on data availability to
increase/decrease smoothing

19
Add graph from COD Viz

20
GBD process & spatial challenges
Find &
manage data

Analyze data

• Standards

• Missing data

• Coverage

• Missing values

• Representativeness
• Geographies over
time

Get data used
• Interactive
visualizations
• Mapping

• Making data
actionable

21
22
23
24
25
26
Small area estimation
• Analyze health patterns outcomes and intervention
coverage for 72 districts in Zambia
• Most data only representative at country/province level
• Modeling approaches
– Pooling data over several years
– Borrowing strength by exploiting spatial correlations
– Using covariates

• Add validation environment
– Identify most appropriate measurement strategy
– Establish minimum sample size for future data collection

27
28
29
30
31
32
33
Remaining tasks and challenges
• Add more spatial covariates

• Conduct burden study at sub-national level
• Identify best practices for managing geographies
(national, subnational) globally over time

• Is there a portal for gridded data?

34

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Geospatial Methods

  • 1. Using maps and spatial analysis to inform global health decision making Peter Speyer Director of Data Development @peterspeyer / speyer@uw.edu UNIVERSITY OF WASHINGTON
  • 2. Institute for Health Metrics and Evaluation • Independent research center at the University of Washington • Core funding by Bill & Melinda Gates Foundation and State of Washington • 160 faculty, researchers and staff • Providing independent, rigorous, and scientific measurement and evaluations • “Our goal is to improve the health of the world’s populations by providing the best information on population health”
  • 3. The Global Burden of Disease Study • A systematic scientific effort to quantify the comparative magnitude of health loss due to diseases, injuries, risk factors • Created 1993, commissioned by the World Bank • GBD 2010 covers 291 causes, 67 risk factors in 187 countries for 1990, 2005 and 2010 by age and sex • GBD country hierarchy 7 super-regions and 21 regions, based on geographic proximity and epidemiological profiles with • Almost 600 country, disease and risk factor experts from 80+ countries 3
  • 5. Measuring burden of diseases and injuries Health Disability Weight YLDs YLDs Deaths YLLs (Years of Life Lost) YLDs (Years Lived with Disability) YLLs DALYs (Disability-Adjusted Life Years) Age Death Average life expectancy 5
  • 6. GBD process & spatial challenges Find & manage data Analyze data • Standards • Missing data • Coverage • Missing values • Representativeness • Geographies over time Get data used • Interactive visualizations • Mapping • Making data actionable 6
  • 7. GBD process & spatial challenges Find & manage data Analyze data • Standards • Missing data • Coverage • Missing values • Representativeness • Geographies over time Get data used • Interactive visualizations • Mapping • Making data actionable 7
  • 8. Data inputs Population based • Surveys • Censuses • Vital registration • Verbal autopsy • Disease registries Encounter level • Hospital / ambulatory / primary care records • Claims data Other • Literature reviews • Sensor data • Mortuaries / burial sites • Police records • Surveillance systems 8
  • 9. Global Health Data Exchange (http://www.ghdx.org) 9
  • 10. 10
  • 11. 11
  • 12. 12
  • 13. 13
  • 14. GBD process & spatial challenges Find & manage data Analyze data • Standards • Missing data • Coverage • Missing values • Representativeness • Geographies over time Get data used • Interactive visualizations • Mapping • Making data actionable 14
  • 15. 15
  • 16. GBD covariates and risk factors • 300+ covariates, e.g. GDP per capita, access to water & sanitation, education • Gridded population used for several covariates (incl. AfriPop, AsiaPop, AmeriPop) – Population in coastal areas – Population weighted average elevation, rainfall, temperature – Population density – Population at risk for causes like malaria • Ambient air pollution, ambient ozone pollution (satellite, surface monitor, TM5 global atmospheric chemistry transport model) 16
  • 17. 17
  • 18. • Show GBD Compare map for risk factors – Ambient air pollution 18
  • 19. GBD – spatial-temporal regression • Capture more information than simple covariate models • Use weighted average of residuals, based on distance in time, age and space • Geographic weights based on GBD regional hierarchy (country/region/super-region) • Vary weights based on data availability to increase/decrease smoothing 19
  • 20. Add graph from COD Viz 20
  • 21. GBD process & spatial challenges Find & manage data Analyze data • Standards • Missing data • Coverage • Missing values • Representativeness • Geographies over time Get data used • Interactive visualizations • Mapping • Making data actionable 21
  • 22. 22
  • 23. 23
  • 24. 24
  • 25. 25
  • 26. 26
  • 27. Small area estimation • Analyze health patterns outcomes and intervention coverage for 72 districts in Zambia • Most data only representative at country/province level • Modeling approaches – Pooling data over several years – Borrowing strength by exploiting spatial correlations – Using covariates • Add validation environment – Identify most appropriate measurement strategy – Establish minimum sample size for future data collection 27
  • 28. 28
  • 29. 29
  • 30. 30
  • 31. 31
  • 32. 32
  • 33. 33
  • 34. Remaining tasks and challenges • Add more spatial covariates • Conduct burden study at sub-national level • Identify best practices for managing geographies (national, subnational) globally over time • Is there a portal for gridded data? 34