Community Health Mapping: A New Year Review

To start the New Year I thought I’d begin with a review of Community Health Mapping (CHM). There are a lot of new project partners, and I thought it would be a good time to give a project overview. CHM is a collaborative effort between the National Library of MedicineCenter for Public Service Communications and Bird’s Eye View. The National Library of Medicine is funding the initiative.

The overall goal is to empower community organizations serving vulnerable or underserved populations with low cost, intuitive mapping technology. Therefore we’ve been working with programs organizations who:

  • Focus on vulnerable populations
  • Frequently use and collect data
  • Need effective, scalable & easy to use mapping tools
  • Lack resources (i.e., for proprietary GIS training & software)

We have identified a suite of tools that allow you to collect custom field data, analyze that data, combine it with other spatial datasets, and generate both static maps and/or dynamic maps on the internet. This allows organizations to collect and work with their own data, and if appropriate, share it with others. CHM involves three components that meet all basic mapping needs:

  • Field Data Collection
  • Desktop Analysis and Cartography
  • Internet Mapping
Community Health Mapping Workflow

Community Health Mapping Workflow

A given project may not require all three, however, collectively these components address the basic needs of all mapping projects.

Field Data Collection:

Rather than focusing on the use of expensive GPS receivers, we recommend the use of smart phones and tablets for these reasons:

  • Most community-based organizations already have them!
  • Many know how to use them
  • They’re intuitive
  • They’re portable
  • They come with an on board GPS receiver (iPhone 5 uses GPS + GLONASS)
  • Have on board cameras
  • Can connect to wireless networks
  • Access to the internet
  • Email is available
  • “There’s an app for that!”
SmartPhones and Tablets vs. Traditional GPS Receivers

SmartPhones and Tablets vs. Traditional GPS Receivers

Of course an important consideration is horizontal accuracy. You can read our blog post on that topic to see if mobile smart devices meet your project needs.

When collecting data you need to be able to develop your own custom data collection form. The top three mobile apps we have found are:

Desktop Analysis and Cartography:

After community field data collection, the next step typically involves bringing the data into a desktop GIS. This is the middle step in the workflow. Here the data can be viewed against basemaps such as Google or OpenStreetMap, and combined with other organizational data. This is also where analyses (proximity, density etc.) can be conducted. Presentation quality maps can also be generated in this step.

The software we found to be the best fit is QGIS. This is an open source desktop GIS software. It has many strengths:

  • It can consume many kinds of data, including all the data that would come out of the field data collection apps.
  • It is both intuitive and robust.
  • It has a large suite of geoprocessing tools for analyzing data.
  • It will run on Windows, Mac, or Linux.
  • It is free to download and install.
  • It is well documented.
  • There is a large user community.
  • New functionality is being continuously added. New stable versions are being released every 4 months!
Baltimore Diabetes Data in QGIS Desktop

Baltimore Diabetes Data in QGIS Desktop

Web Presentation

Often you may want to present an interactive map of your results. Interactive means the map reader can zoom in/out, pan the map and turn layers off and on. For this we recommend CartoDB.

You can sign up for a free account, which gives you 50Mb of storage space. Data can be collected with a smart phone or tablet and brought directly into CartoDB.  It is a very intuitive platform. You can literally drag and drop a spreadsheet onto the CartoDB page and have the data upload to your account.  It will accept the most common geospatial file formats including: spreadsheets and comma delimited text files with addresses or coordinates, KML/KMZ, GPX, and shapefiles.

CartoDB also has great documentation including:

Baltimore Diabetes Data in CartoDB

Baltimore Diabetes Data in CartoDB

In Conclusion

This blog has a lot of resources including reviews of mapping technology and case studies. You might begin by clicking on some of the links in this entry. We are also working on a 6 lab CHM curriculum that interested parties will be able to use to hone their skills. Stay tuned for that!

We are always looking for new partners and continuously work to support current project partners. If you are interested, or have questions please don’t hesitate to contact John Scott (jscott at cpsc.com) or Kurt Menke (kurt at birdseyeviewgis.com). Most importantly get out and do some mapping in 2016!

 

 

 

Field Data Collection with Fulcrum

Fulcrum was reviewed in our initial survey of field data collection apps in 2012, and almost made the top three. In the last 3 years Fulcrum has improved and has become perhaps the most intuitive and useful data collection app we’ve evaluated period.

It is available for both iOS and Android. It isn’t free, but the subscription fee is affordable. It costs anywhere from $18 – $25 per month. The three pricing plans give you 10 – 30Gb of online storage, which is substantial. Fulcrum offers a free 30 day trial which includes all the functionality. You can use this option to test Fulcrum for your projects. In the following example, I will be using a health care facility data collection form to show how Fulcrum works.

Fulcrum has the most intuitive data collection form builder of any app we’ve seen. When you design a form Fulcrum calls it an ‘app’. Simply drag and drop from the Add Fields section to your ‘app’ to add questions (see figure below). Available data input types include text, numbers, date, single or multiple choice, photos, videos, and audio.  There are no tricks to collecting GPS locations as with iForm. Fulcrum collects locations automatically.

A health care facility data collection form in Fulcrum.

A health care facility data collection form in Fulcrum.

Once a field has been added simply set you parameters. The figure below shows the facility type question being edited. To do this simply click on a field, and fill out the details. It’s so easy a 50 year old can do it!

The health care facility type question parameters.

The health care facility type question parameters.

The companion mobile app can be downloaded for free from the Apple Store or the Google Play Store. Once installed, login and your data collection app(s) will sync with your mobile device. The figure below shows the health care facilities data collection app on an iPhone. Answering the questions is intuitive. Once collected your data will be synced with your cloud account.

Health Care Facilities data collection form on an iPhone

Health Care Facilities data collection form on an iPhone

Once back in the office, login to your account, select your data collection app, and choose Start Export Wizard. You will be taken to the page below. Choose your file format. A complete array of GIS formats is available including: shapefiles, geodatabases, KML, PostGIS and Spatialite.  Choose any other appropriate options and click Next to download your data.

Fulcrum Data Export Options

Fulcrum Data Export Options

I highly recommend that everyone involved in Community Health Mapping evaluate Fulcrum. Along with iForm and ODK Collect is a CHM recommended data collection tool. There is a monthly subscription fee but it is low. It is the easiest and most flexible tool we’ve found. You can use the free 30 day trial period to see if it works for you.

Wildly Successful Community Health Mapping Workshops at MUSC!

Community Health Maps (CHM) conducted it’s largest and most successful workshops ever at the end of September at the Medical University of South Carolina (MUSC). The training at MUSC was divided into three workshops and a presentation. The attendees were a mix of professors, students and researchers, most of whom had little to no experience with GIS. Despite this fact, nearly everyone was able to collect data and make a map. This is a testament to the easy to use nature of the CHM workflow.

It began Monday morning with the first workshop. This was an Intermediate Session for those Community Health Mappers who had been working on projects since the April CHM workshop. We spent two hours covering more advanced topics and answering project specific questions.

Kurt Menke explaining advanced QGIS features.

Kurt Menke explaining advanced QGIS features.

Following that, Kurt Menke presented a CHM project overview at a brown bag lunch session to 30 attendees. Matt Jones closed this session with a 10 minute talk detailing how he used The Community Health Maps workflow this summer to map access to care on Johns Island.

The second workshop was Monday afternoon. It was a two hour session covering field data collection with iForm, and mapping that data online with CartoDB. There were 55 attendees at this session, the vast majority of whom had no GIS experience. In just two hours all 55 attendees were able to collect field data and make a map in CartoDB!

iForm and CartoDB Workshop Attendees

iForm and CartoDB Workshop Attendees

The final workshop on Tuesday was a 5 hour session covering the use of QGIS. The workshop consisted of a custom Charleston based QGIS exercise. Each of the 35 participants worked with a set of Charleston GIS data while learning the basic layout of QGIS. They learned how to add data, style it, and compose a map. The workshop ended with a discussion of each participants goals and project specific questions.

QGIS Workshop Attendees

QGIS Workshop Attendees

In total almost 80 people attended one or more sections of the training! Thanks go out to Dr. Deborah Williamson for hosting the workshops, Dana Burshell for organizing the entire event and assisting during the workshops, and to Sarah Reynolds who was invaluable in providing Mac and QGIS support!

Tableau Public for Data Visualizations

Tableau Public is free software that can help users publish interactive data visualizations to the internet. This software is another great option for data visualization along with GIS Cloud or CartoDB. It has powerful charting and graphing tools, and also allows you to map data and display that data against several online datasets and basemaps.

No plug-ins or programming skills are required, just a browser with JavaScript enabled. Tableau Public uses a simple drag and drop process that anyone can learn. You can work with either the free Tableau Desktop app, or Tableau Online the free cloud based server. Either way you can save your work to the Tableau Public Web servers, which are accessible by everyone on the Internet. One important note about this is that any data you publish is accessible to everyone on the internet.

People see and understand data, reports and dashboards faster with visual analytics technology, which can help uncover key trends, relationships, patterns, and outliers that might otherwise be a challenge to find. Tableau Public can be used to pare down information to its simplest form by stripping away the less important data.

The software can connect to Microsoft Excel, Microsoft Access, and multiple text file formats. It has a limit of 1,000,000 rows of data allowed in any single file. Your organization may use up to 50 megabytes of space.

Tableau Public projects can be shared by emailing a link or by embedding the work in a blog, wiki, or website. Clicking on an emailed link will open a browser page with the view loaded. If embedded onto a page, anyone who visits the page will see the live interactive view.  The following shows the use of Tableau Public in two health related studies.

Public Health Case Studies

To visualize the specific social problem of teen pregnancy over time, Tableau Public was used by the Wisconsin Council on Children and Families to show the decline in births to teen mothers in Wisconsin over recent years. The data depicts racial disparities in teen births in Wisconsin as well as differences in birth rates between older and younger teens. The online link to the data visualizations created with Tableau Public for this study can be found here: http://tblsft.com/public/gallery/teen-pregnancy-declines

The figure below is a screenshot of one of the data visualizations from this study. Data visualizations are interactive. Here the white popup window is showing data from a specific place on the line graph.

Teen Pregnancy Data Visualization

Teen Pregnancy Data Visualization

Such visualizations may help communities address and manage such issues as health problems associated with prematurity and poor academic performance of children of teen parents.

Data can also be mapped by geographic coordinates, city, state, county, and zip code. The visualization below deals with Medicare Costs and combines a map with a chart showing trends in the data.

Tableau Public Desktop - Medicare Cost Data Visualization

Tableau Public Desktop – Medicare Cost Data Visualization

Other data visualization examples created with Tableau Public can be found in the Gallery:

http://www.tableausoftware.com/public/gallery

Other Tableau Public Resources can be found here:

https://public.tableau.com/s/resources

 

 

Community Health Maps Presentation and Training at the Medical University of South Carolina

In May Kurt Menke presented the Community Health Maps project, and conducted a training at the Medical University of South Carolina College of Nursing. The presentation was recorded and is now available online. The presentation was about 45 minutes and includes the powerpoint slides, audio and visual. This is a great way for you to learn more about the project from the comfort of your own office!

Community Health Map Presentation at MUSC

Community Health Map Presentation at MUSC

Teens Map Environmental Health of Their Community (Sea Islands, South Carolina)

By Guest Blogger: Derek Toth – Communities in Schools Charleston

The Teen Health Leadership Program (THLP) is in their eight year of existence at St. John’s High School on Johns Island. The program gathers leaders of the school together and focuses on a health topic they feel is affecting their community and assists the community in understanding this topic through the use of media dissemination.  In the past, topics included Autism, Cancer, Stress, Obesity and Alcohol and Drugs and This year, the students wanted to look at their community as a whole with a topic of Environmental Health.

The THLP students wanted to see what makes their Sea Island community different.  The Sea Islands are composed of John’s Island, Wadmalaw Island, Seabrook Island and Kiawah Island outside of Charleston, South Carolina.  Students primarily come from John’s and Wadmalaw Islands. These islands are extremely different for many reasons. The students wanted to be able to translate these differences in a new form for the Teen Health Leadership Program. The students were presented with an opportunity to use the Community Health Mapping tools discussed on this blog, and some training made available from the National Library of Medicine. With GIS, the students can pin point differences within the islands for their community to see.

(This January Kurt Menke conducted a Community Health Map training at the Medical University of South Carolina College of Nursing.  Two teachers with Communities in Schools Charleston attended and the next afternoon Kurt Menke went to St. John’s High School and showed the students how to map their campus with their iPhones.) 

Derek Toth teaching his students to map their campus

Derek Toth teaching his students to map their campus

The students used smart phones, along with an app named iForm, to map points of interest with GPS. They collected well water locations, ground and city water sources, as well as, places in the community to purchase food. The food resources they mapped included farmers markets, produce stands, grocery stores and local farms. The students were able to indicate these points on a map. Google maps was used to create the final map.

With the final map they were able to determine that people on Wadmalaw Island have less access to food and water than those on St. John’s Island. For example, Wadmalaw Island is limited in places to buy produce or groceries, and has limited access to the farms that John’s Island has. Residents of Wadmalaw Island are on well water, and obtain their produce at the local grocery store on Johns Island, as opposed to driving to one of the many local farms.

Teen Health Leadership Program Seal Islands Access to Food and Water

Teen Health Leadership Program Seal Islands Access to Food and Water

The final  map was inserted into the Environmental Health project for the community to have a unique perspective of their Sea Island Community. Overall, the students felt that using their smart phones to map their community was easy to learn and fun. They were able to grasp the information quickly and seemed pleased with their results. The group feels it reached it’s goal of accomplishing a fresh look at the Sea Islands and felt it added to their presentation on Environmental Health.

Using CartoDB for Beautiful Online Maps

CartoDB is an online cloud based platform for storing and visualizing spatial data. It is the perfect tool for the third part of the workflow (outlined in the Introduction). You can sign up for a free account, which gives you 50Mb of storage space. Data can be collected with a smart phone or tablet with iForm, and brought directly into CartoDB.  It is a very intuitive platform. You can literally drag and drop a spreadsheet onto the CartoDB page and have the data upload to your account.  It will accept the most common geospatial file formats including: spreadsheets and comma delimited text files with addresses or coordinates, KML/KMZ, GPX, and shapefiles. Below is an example of a spreadsheet of Baltimore Dialysis Centers in CartoDB. This shows the spreadsheet in Data View .

CartoDB Data View

CartoDB Data View

After telling CartoDB which columns contain the latitude and longitude values, the data can be viewed in Map View (below). Here the default Positron basemap is being used. There are a variety of basemaps to choose from including imagery, Stamen maps and Nokia maps.

CartoDB Map View

CartoDB Map View

Once multiple data layers have been uploaded you can create a visualization. Below is a map focusing on Balitmore Diabetes. It includes Baltimore neighborhoods classified by the number of diabetics, food deserts and dialysis centers.  CartoDB provides wizards and other tools for styling your data. The dynamic map can be accessed here: http://cdb.io/1G4xP7j

CartoDB Visualization

CartoDB Visualization

Visualizations can be shared via hyperlinks and embedded into webpages.  CartoDB also has great documentation including:

Sign up for a free account and take it for a spin. On a related note Community Health Maps is almost done with a complete curriculum for community health mapping. It consists of six labs. The final lab shows you how to work with CartoDB from setting up an account to sharing a visualization. Stay tuned!