Public Health GIS News and Informationstacks.cdc.gov/view/cdc/19550/cdc_19550_DS1.pdf · President's Geospatial One-Stop, a White House initiative to spatially enable the delivery

PUBLIC HEALTH GIS NEWS AND INFORMATIONJuly 2002 (No 47)

Dedicated to CDCATSDR scientific excellence and advancement in disease control and prevention using GIS

Selected Contents Events Calendar (pp1-2) News from GIS Users (pp2-7) GIS Outreach(p7) Public Health and GIS Literature (pp7- 12) DHHS and Federal Update (pp12-21)Website(s) of Interest (pp21-22) Final Thoughts (pp22-25)

I Public Health GIS (and related) Events SPECIAL NCHSCDCATSDR GIS LECTURES

September-October 2002 To be announced NCHSCartography and GIS Guest Lecture Series programs areheld at the NCHS Auditorium RM1100 Hyattsville MDThey have been presented continuously since 1988Envision is available to offsite CDCATSDR locationsWeb access is available to all others at sitehttpvideocdcgovramgenenvisionliverm (linkbecomes active approximately 30 minutes prior to theevent and viewing requires RealPlayerinstallation)Cosponsors to the NCHS Cartography andGIS Guest Lecture Series include CDCrsquos Behavioral andSocial Science Working Group (BSSWG) and StatisticalAdvisory Group (SAG) [All NCHS Cartography and GISpresentations are open to the public Contact Editor PublicHealth GIS News and Information]

[Note Calendar events are posted as received for a more completelisting see NCHS GIS website]

Joint ISPRS Commission IV 2002 Symposium theSpatial Data Handling 2002 Symposium and the 95thAnnual Geomatics Conference of the Canadian Instituteof Geomatics (CIG) July 8-12 2002 Ottawa Canada[See httpwwwgeomatics2002 org]

The Secretarys National Leadership Summit onEliminating Racial and Ethnic Disparities in HealthldquoClosing the Health Gap Togetherrdquo US Dept of Healthand Human Services Office of Minority HealthOffice ofPublic Health and Science July 10-12 2002 WashingtonDC [See httpwwwomhrc gov]

National Association of County and City HealthOfficials Annual 2002 ldquoWorking in a Changed World

Strengthening Public Health Preparednessrdquo July 10-132002 New Orleans LA [See http wwwnacchoorg] XXIth International Biometric Conference 2002 July21-26 2002 University of Freiburg Germany [Seehttpwwwibc2002uni-freiburgde]

GML Developers Conference 2002 July 22-262002Vancouver BC [See httpwwwgmldev org]

Council of Geographic Names Authorities AnnualConference July 23-27 2002 Baltimore MD [Seehttpwwwgeocitiescomcogna2002baltimore]

19th Annual HBCU Summer Faculty GIS WorkshopAugust 4-10 2002 Washington DC [See httpwwwcon-edhowardedu]

9th Annual ASHA Summer Institute ldquoHealthy Kids-Healthy Schools-Healthy Communitiesrdquo August 5-72002 Columbus OH [See site httpwwwashaweborgconferenceshtml]

2002 International Conference of the Royal StatisticalSociety September 3-6 2002 University of PlymouthUK [See wwwtechplymacukmathsresearchstatsRSS2002html]

International Conference on Chemical Mixtures 2002Agency for Toxic Substances and Disease RegistrySeptember 10-12 2002 Atlanta GA [See httpwwwergcomiccm]

Inaugural National Conference on Birth Defects

2Developmental Disabilities and Disability and HealthCharting the Course Birth Defects DevelopmentalDisabilities and Disability and Health CDCrsquos NationalCenter on Birth Defects and Developmental Disabilities(NCBDDD) September 17-19 2002 Atlanta GA [Seehttpwwwcdcgovncbdddconferencehtm]

X Congress of Quantitative Methods GeographicalInformation Systems and Remote Sensing September 17-20 2002 Valladolid Spain [See website at URLhttpgramolafyluvaesgeografiaXcongresoindexhtm]

GIScience 2002 Second International Conference onGeographic Information Science September 25-28 2002Boulder CO [See httpwwwgiscience org]

2002 National Asthma Meeting Living Well withAsthma Centers for Disease Control and PreventionOctober 23-25 2002 Atlanta GA [httpwwwcdcgovncehairpollutionasthma2002mtghtm]

40th Annual Conference of the Urban and RegionalInformation Systems Association (URISA) ldquoLookingBack Moving Forwardrdquo October 26-30 2002 ChicagoIl [See httpwwwurisaorg annualhtm]

First Annual TISP (The Infrastructure SecurityPartnership) Congress on Infrastructure Security in theBuilt Environment November 5-7 2002 Washington DC[See httpwwwtisporg]

The 10th ACM International Symposium on Advancesin Geographic Information Systems (ACM-GIS 2002)November 8-9 2002 McLean VA [See website athttpwwwcsfiueduACM_GIS2002]

Brownfields 2002 Investing in the Future InternationalCityCounty Management Association (ICMA)November 13-15 2002 Charlotte NC [See sitehttpicmaorg]

International Conference on QuestionnaireDevelopment Evaluation and Testing Methods (QDET)November 14-17 Charleston SC [See website athttpwwwjpsmumdeduqdetqdet-sethtml]

Ninth Annual Biopharmaceutical Applied StatisticsSymposium December 9-13 2002 Savannah GA [Seehttpviewsvcuedubisbass]

II GIS News (You are encouraged to communicate directly with colleaguesreferenced below on any items note that the use of trade names andcommercial sources that may appear in Public Health GIS News andInformation is for identification only and does not imply endorsementby CDC or ATSDR)

A General News and Training Opportunities1 From John Moeller Federal Geographic DataCommittee (Notice of Standards Development andCall for Participation) All members of the geospatialinformation community are invited to participate in thedevelopment of data content standards and models forNational Spatial Data Infrastructure (NSDI) Frameworkdata (see website httpwwwfgdcgovgeo-one-stop)The standards are being developed as part of thePresidents Geospatial One-Stop a White Houseinitiative to spatially enable the delivery of governmentservices and to improve access and use of geospatialinformation The approved standards will become nationalin scope and applicability The goal is to engagestakeholders from all sectors and use the widest range oftechnical expertise possible There are seven thematicdata layers for NSDI Framework requiring contentstandards and models cadastral geodetic controlhydrography digital orthoimagery transportationelevation and government units This call is directedat all organizations which collect or use geospatial datain any of the Framework themes It provides anopportunity to participate in the standards process and tohelp ensure that the standards and models that aredeveloped meet the communities needs [Contact JulieBinder Maitra FGDC Standards Coordinator atjmaitrausgsgov]

2 From Elaine Quesinberry Census Bureau (SurveyQuality Report) Demonstrating Survey Quality anew report released June 3 2002 summarizes measuresof survey quality for the Census 2000 SupplementarySurvey using the 1990 and 2000 census long forms andother surveys as benchmarks The report includesmeasures of coverage error unit and item nonresponse

3and sampling error The report is available on theAmerican Community Survey web site at httpwwwcensusgovc2sswwwMethodologyReportshtm

The first data from the 2001 SupplementarySurvey (SS01) will be released later this summer Thefirst release will include percent change profiles for 50states the District of Columbia and the nation as well asfor areas of 1 million or more population The data will beavailable on the American FactFinder web site athttpfactfinder censusgov

The Census 2000 Supplementary Survey PublicUse Microdata Sample PUMS data are now availableYou can access the PUMS files on the Internet at sitehttpwwwcensusgovc2sswww ProductsPUMShtmScroll to the bottom of the page to select the Housing orPopulation data and the state [Contact Elaine atelainevquesinberry censusgov source AmericanCommunity Survey Alert Number 5]

3 From Fred Broome Census Bureau (TIGERUpdate) As announced at the June 18 2002 meeting ofthe FGDCrsquos Subcommittee on Cultural and DemographicData (SCDD) the Census Bureau is in the midst of alarge-scale update of TIGER Under this programTIGER boundaries will become current being no morethan one year old at any given time with positionalaccuracy within 5-10 meters and will provide spatialcoordinates for every structure in the USincluding all housing and building structures[Contact Fred Chief Geospatial Research andStandards Staff at fbroomegeocensusgov]

4 From Zhong Liu George Mason University TheHydrology Data Support Team at NSASGSFCDAAC(NASA Goddard) and SIESIP have prepared a web pagefor online visualization and analysis of several global datasets at site httpesipgmueduesipES_gridded_online_analysis_gmuhtml Currently we have the following datasets 1) Observations (1950-1999) from Willmott et alprecipitation air temperatures water budgets andmoisture indices 2) Satellite remote sensing TRMMdaily precipitation (1998-present) TRMM monthlyprecipitation (1998-present) Pathfinder NDVI (1981-2001) and TOMS aerosol indices (1996-present) Weplan to add more products and analyses in the future For

many non-professionals or even professionals it is verydifficult and often frustrated to process earth sciencedata due to many reasons such as data formatsincomplete information etc I personally found these toolsare very useful in my environmental and health studiesand applications [Contact Zhong at zliudaacgsfcnasagov For more information about the GoddardDAAC and its services please visit web sitehttpdaacgsfcnasagov]

B Department of Health and Human Services(httpwwwhhsgov)

President Bush Signs Bioterrorism Response BillSecretary Thompson joined President BushHomeland Security Director Tom Ridge andmembers of Congress in the White House RoseGarden on June 12 for the signing of the PublicHealth Security and Bioterrorism Response Act of2002 The bill has four objectives Enhance thenations ability to prevent and detect bioterroristattacks Strengthen the communications networksthat link health care providers with public healthauthorities Strengthen the ability of the health caresystem to expedite treatments across our countryand Develop better vaccines medicines anddiagnostic tests [See site httpwwwhhsgovnewsnewsletterweekly]

Agency for Toxic Substancesand Disease Registry

(httpwwwatsdrcdcgov)5 ATSDR hosted a June 25 2002 presentationldquoDevelopment of a Public Health Research andDegree Program at Dine College Navajo Nationldquoby Edward R Garrison Dine college Tuesday June 252002 This presentation described how a Tribal College isusing its cooperative agreement funding to develop adegree program which includes the use of GIS inEnvironmental Health [Contact Alan Crawford atapc4cdcgoc]

6 International Conference on Chemical Mixtures2002 September 10-12 2002 Atlanta GA The Agencyfor Toxic Substances and Disease Registry (ATSDR) issponsoring this conference that will bring together

4international academic and government researcherspublic health professionals and industry groups toexchange scientific and public health information onchemical mixtures and to address the scientificdevelopments and progress made in the toxicology ofchemical mixtures [See httpwwwergcomiccm]

Centers for Disease Control and Prevention(httpwwwcdcgov)

7 From Lillian Lin NCHSTP-2003 Symposium onStatistical Methods Call for Abstracts Statisticiansepidemiologists and others with an interest in theapplication of statistical methods to public health areinvited to participate in the 9th Biennial Symposium onStatistical Methods sponsored by the Centers forDisease Control and Prevention (CDC) and the Agencyfor Toxic Substances and Disease Registry (ATSDR) tobe held January 28-29 2003 in Atlanta Georgia Thetheme for the Symposium is Study Design and DecisionMaking in Public Health A short course on a relatedtopic will be offered on January 27 2003 in conjunctionwith the Symposium The Symposium will include invitedtalks and contributed papers [To request registration andabstract information and forms or for additionalinformation regarding the scientific content of theSymposium please visit the Symposium web site atwwwcdcgovodadssag]

Centers for Medicare and Medicaid Services(httpwwwhcfagov)

8 The Centers for Medicare amp Medicaid Servicesformerly the Health Care Financing Administration(HCFA renamed CMS 2001) has a new website (seecmshhsgov) CMS runs the Medicare and Medicaidprograms-two national health care programs that benefitabout 75 million Americans And with the HealthResources and Services Administration CMS runs theState Childrens Health Insurance Program(SCHIP) a program that is expected to cover many ofthe approximately 10 million uninsured children in theUnited States CMS also regulates all laboratory testing(except research) performed on humans in the UnitedStates Approximately 158000 laboratory entities fallwithin CMSs regulatory responsibility And CMS withthe Departments of Labor and Treasury helps millions of

Americans get and keep health insurance coverage andhelps eliminate discrimination based on health status forpeople buying health insurance [CMS data and statisticssuch as trends in health and aging may be found at sitehttpwwwhcfagovstatsdefaulthtm]

9 From James Summe Office of ResearchDevelopment amp Information (Mapping SSArsquosGeographic Codes into FIPS Codes- excerptspresentation to the FGDC Subcommittee on Cultural andDemographic Data (SCDD) June 18 2002) Data forCMSrsquo programs are obtained from a variety of sourcesand the geographic codes used for the data varyingdepending on the source Codes used include ZIP FIPSstate and county and SSArsquos state and county CMS usesSSArsquos codes for states and counties to locate andspatially group Medicare beneficiaries and providers linkto contextual and complementary data and employ GISresources Applications also include determination ofprovider reimbursement definition of health plancoverage areas research and policy and programstatistics At issue is most contextual and complementarydata as well as GIS resources are indexed by FIPScodes Mapping from SSA into FIPS codes iscomplicated by the inclusion in SSArsquos state codes ofcodes for countries and continents CMSrsquo extensions toSSArsquos state codes to support identifiers for institutionalproviders and periodic changes in the definitions ofcounties states countries and their equivalents

In the future CMS analysts hope to locatecanonical definitions of counties states and perhapscountries at least since 1990 and ideally back to 1965We hope to find data structure(s) for the codes for theseentities that permit the identification of the entities inexistence on any date from 1965 to the present Wewould like to encode the code sets in a form that could beaccessed on a range of computing platforms from avariety of applications We hope to obtain standardmetadata that are necessary and sufficient to understandand access the codes and their descriptions Themetadata would be most useful to us if they wereaccessible by both humans and computers [Contact Jimat Jsummecmshhsgov appreciation is extended to Jimfor his presentation to SCDD]

5National Institutes of Health

(httpwwwnihgov)10 From Stephen Drigotas Office of Behavioral andSocial Sciences Research (Research on Ethical Issues inHuman Studies) The National Institutes of Health (NIH)invite research grant applications (R01) to investigateethical issues in human subjects research (see web siteat httpgrantsnihgovgrantsguidepa-filesPA-02-103html) The Code of Federal Regulations-Protection ofHuman Subjects (45 CFR Part 46) provides a regulatoryframework that all NIH-supported researchers mustfollow Recent developments in biomedical andbehavioral research however including the rapid growthof new interventions and technologies (eg stem cellsgenetics research) increasing involvement of foreignpopulations in clinical research and concerns aboutfinancial conflicts of interest among researcherschallenge investigators abilities to interpret and apply theregulations Other situations (eg research withvulnerable populations the use of data banks or archivesresearch on stigmatizing diseases or conditions) maypresent difficulties for identifying strategies proceduresandor techniques that will enhanceensure the ethicalinvolvement of human participants in research Thepurpose of this program announcement is to solicitresearch addressing the ethical challenges of involvinghuman participants in research in order to inform andoptimize protections for human participation in research[Contact Stephen at drigotasodnihgov]

C Historically Black Colleges and Universities(HBCUs) and Other Minority Program Activities

[A listing of Historically Black Colleges and Universities (HBCU)may be found at httpwwwsmartnet~popehbcu hbculisthtm ]11 The Secretarys National Leadership Summit onEliminating Racial and Ethnic Disparities in HealthldquoClosing the Health Gap Togetherrdquo US Dept ofHealth and Human Services Office of MinorityHealthOffice of Public Health and Science July 10-122002 Washington DC (see httpwwwomhrcgov)The Office of Minority Health US DHHS is excited tobe sponsoring the first National Leadership SummitThe Summit seeks to draw national attention to theexistence of health disparities and to innovativeapproaches being implemented in our communities and at

the local State National Federal and Tribal levels whichaddress these disparities The mission of the Summit is tostimulate action at all levels to enhance programoutcomes which can lead to the elimination of healthdisparities [See workshop program this edition]

12 From Pamela R Bingham Howard UniversityrsquosNOAA Center for Atmospheric Sciences (Announcingthe 19th Annual HBCU Summer Faculty GISWorkshop) The 19th Annual HBCU Summer FacultyGIS Workshop will be held August 4-10 2002 It will becoordinated by the Howard University ContinuingEducation Urban Environment Institute (see program atwwwcon-edhowardedu) and hosted by the WashingtonGIS Consortium at the National Capital PlanningCommission (wwwncpcgov) in Washington DC TheHBCU Summer Faculty GIS Workshop has been hostedby Howard Universityrsquos Urban Environment Institutesince 1997 For a complete history of the workshopwhich the US Geological Survey initiated in 1983 seeldquoHistorically Black Colleges and Universities as a PublicHealth Resourcerdquo De Cola L Warrick C Public HealthGIS News and Information (44) JAN 2002 11-15

The 2002 opening session features speakers fromthe White House Initiative on HBCUrsquos US Departmentof Education US Congress National Capital PlanningCommission Department of Interior Office of SurfaceMining Department of Commerce National Oceanic andAtmospheric Administration District of ColumbiaGovernment and Howard University GIS training for theworkshop is provided by ESRI In addition to ESRI andWGISNCPC this years sponsors include the Office ofSurface Mining and Bureau of Land Management of theDepartment of Interior Howard Universitys ContinuingEducation and NOAA Center for AtmosphericSciences(NCAS) and the US Army Corps of EngineersEngineer Research and Development CenterTopographic Engineering Center Many of the nationrsquosHBCUrsquos have had faculty and staff trained in GISthrough this program Over 30 federal agencies andprivate companies have participated in the workshops assponsors presenters and exhibitors Sponsorship is opento all interested parties [Contact Pamela GIS WorkshopCoordinator at site pbinghamphysics1howardedu]

613 From Eileen Robertson-Rehberg CornellUniversity Each of the below five papers from theCalifornia Endowment (see httpwwwcalendoworg)focuses on a significant racialethnic population inCalifornia The goal of these papers is to go beyond theepidemiology in order to explain or hypothesize factorsthat give rise to these data and to better understand howhealth impacts the content and context of peoples livesThis series is a five volume set The Health Status ofAmerican Indians in California April 1997 TheHealth Status of African Americans in CaliforniaApril 1997 The Health Status of Asian and PacificIslander Americans in California April 1997 TheHealth Status of Latinos in California April 1997and The Health Status of Whites in California April1997 [Contact Eileen at ear5 cornelledu]

14 From Dabo Brantley NCEH CDC (AmericanIndian And Alaska Native Diabetes Atlas ) TheNational Diabetes Prevention Center Division ofDiabetes Translation CDC sponsored a June 25 2002GIS presentation on the new American Indian andAlaska Native Diabetes Atlas Developed by the NationalIndian Council on Agings Geographic Information System(GIS) mapping team the Atlas is to use GIS to displayanalyze and interpret existing data relevant to the problemof diabetes in American IndianAlaska Native populationswith the intention of stimulating action at the localtriballevel The mapping team demonstrated the capabilities ofthe interactive diabetes atlas utilizing the InternetMapping Service and Scalable Vector GraphicsPresenters included Dave Baldridge ExecutiveDirector National Indian Council on Aging HeatherMann Program Manager National Indian Council onAging Kurt Menke Earth Data Analysis CenterUniversity of New Mexico Mario Garrett DirectorData Analysis Service and JoAnne Pegler TeamLeader National Diabetes Prevention Center Division ofDiabetes Translation Centers for Disease Control andPrevention [Contacts Kurt at kmenkespockunmeduor Mario at dasunmedu]

15 The 8th Annual Summer Public Health ResearchInstitute and Videoconference on Minority Health

was held June 17-21 2002 This years Institute andVideoconference was presented by the University ofNorth Carolina School of Public Health Minority HealthProject and Center for Health Statistics Research theUNC Program on Ethnicity Culture and HealthOutcomes and the Morgan State University DrugAbuse Research Program This annual Institute andVideoconference cover issues and solutions related tocollecting analyzing and interpreting data forracialethnic populations disentangling and assessingrelationships among race ethnicity genetics andsocioeconomic status community-based research andpartnerships between minority-serving universities andresearch universities Funding was provided by the CDCNational Center for HIV STD and TB Prevention incollaboration with the Association of Schools of PublicHealth the CDC National Center for Health Statisticsthe CDC National Center for Infectious Diseases Officeof Minority and Womens Health and the NationalInstitute on Drug Abuse [See web site at wwwminorityunceduinstitute 2002]

D Other Related Agency or Business GIS News16 From Urban and Regional Information SystemsAssociation (URISA)-Revision to the GISCertification Proposal of 2001) The GIS ProfessionalCertification Committee spent the months of Februaryand March 2002 reviewing the public comments madeby GIS professionals since the Certification proposalwas first posted to the web in December 2001 Inaddition to reviewing the hundreds of written commentsposted at the GuestBook members of the committeepresented the proposal and discussed its content at GISprofessional meetings in the states of WashingtonWisconsin and Michigan as well as the Towson StateUniversity GIS Conference in Baltimore The publicinput has been very informative and helpful to theCommittee in attempting to refine the proposal

The committee (see httpwwwurisaorg) foundthat experience is the most important factor in applyingskills to real-world problems and education plays animportant role in providing the knowledge and intellectualmaturity required to approach problems systematicallyand critically In addition the committee stated thatprofessionals must contribute to the advancement of the

7profession by donating their skills in professional efforts tomaintain the fundamental health of the profession ratherthan focusing on individual compensation The committeestated that a typical GIS Certified Professional has thefollowing characteristics a formal degree withseveral specific GIS and GIS-related courses or theequivalent coursework in professional developmentcourses and other educational opportunities atleast four years of experience in a position thatinvolves data compilation teaching etc (feweryears if in GIS analysis design or programming andmore years if in a GIS user position) and a modestrecord of participating in GIS conferencespublications or GIS-related events (such as GISDay)

17 From Mark Reichardt Open GIS Consortium IncOGCs FEMA-sponsored Multi-Hazard MappingInitiative Phase 1 (MMI-1) concluded with a successfuldemonstration on May 9 2002 of a standards-basedframework for discovery access and distribution of multi-hazard map data Until now the diversity and non-interoperability of geographic information systems hashampered data sharing Now the Internet can be used asa medium to locate retrieve and exploit multi-hazard mapdata from many different organizations regardless of theirsoftware vendor One MMI-1 demonstration scenariodepicted development of a land use plan combining multi-source information about land use populationtransportation earthquake susceptibilityhistorical data on faults tsunamis and wildfires Thesecond scenario demonstrated how flood maps and mapsof roads hazard probabilities demographics and historicstorm paths could be rapidly accessed from differentorganizations to aid hurricane response efforts FEMAsonline HazardMaps resource represents one of thetechnologies resulting from the MMI initiative It can beviewed at httpwwwhazardmapsgov Other interestedagencies are invited to participate [Contact Mark at webmreichardtopengisorg]

18 From Milton Ospina ESRI The upcoming SecondAnnual ESRI Education User Conference willhighlight a number of Graduate and Professional programs

at this years conference in San Diego July 5-7 2002Public Health and Medical professionals may beparticularly interested in two sessions whose topicsinclude academic programs institutional implementationcommunity partnerships and risk communication Thereis a GIS Education for Health and Human ServicesSpecial Interest Group meeting scheduled and there willbe 2 sessions (seven papers) on GIS in Health SciencesAdditional information and online registration forEdUC2002 is available at site httpwwwesricomeduc[Contact Milton Higher Education Solutions Managerat mospinaesri com]

III GIS Outreach[Editor All requests for Public Health GIS User Group assistance arewelcomed readers are encouraged to respond directly to colleagues]

F From Ric Skinner Baystate Medical Center I wouldlike to hear from organizations who recognize and arepursuing the role of GIS in preparing for the HealthInsurance Portability and Accountability Act (HIPAA)requirements particularly as they relate to preservingpatient confidentiality and identifyingde-identifyingpatients records I will sum relevant responses [ContactRic Health Geographics amp Spatial Analysis Program atricskinnerbhsorg]

IV Public Health GIS Presentationsand Literature

NCHS Cartography and GIS Guest Lecture Series(to be announced)

CDC Emerging Infectious Diseases and MMWR Emerging Infectious Diseases

Emerging Infectious Diseases is indexed in IndexMedicusMedline Current Contents Exerpta Medicaand other databases Emerging Infectious Diseases ispart of CDCs plan for combating emerging infectiousdiseases one of the main goals of CDCs plan is toenhance communication of public health informationabout emerging diseases so that prevention measurescan be implemented without delay The June 2002ed i t ion i s ava i l ab le a t the webs i t ehttpwwwcdcgovncidodEIDindexhtm and hasseveral potential GIS related articles of interestEpidemiology of Malaria in Western Kenya Drought

8Effects on Saint Louis encephalitis virus FloridaCyclosporiasis and Cryptosporidiosis in Peruvian ChildrenM tuberculosis in Free-Ranging Wildlife DetectingMalaria Epidemics in Western Kenya Water-Supply-Associated Cryptosporidiosis Outbreak article onDrinking-Water-Associated Cryptosporidiosis Outbreaksand Hantavirus Infection with Sinus Bradycardia Taiwan

The July 2002 edition also is available andcontains articles with potential relationships to GIS

applications including Emergence of Usutu virus anAfrican Mosquito-Borne Flavivirus of the JapaneseEncephalitis Virus Group Central Europe Ecologic NicheModeling and Potential Reservoirs for Chagas DiseaseMexico Time-Space Clustering of Human BrucellosisCalifornia 1973-1992 and others The August 2002 iscurrently available at the CDC web site

httpwwwcdcgovncidodEIDupcominghtm

Morbidity and Mortality Weekly Report

Selected articles from CDCrsquos Morbidity and MortalityWeekly Report (MMWR) [Readers may subscribe toMMWR and other CDC reports without cost athttpwwwcdcgovsubscribehtml and access theMMWR online at httpwwwcdcgovmmwr] Vol 51

No 25- Achievements in Public Health Hepatitis BVaccination-United States 1982-2002Vol 51 No 24-Progress Toward Poliomyelitis Eradication-Pakistan andAfghanistan January 2000-April 2002 Cancer DeathRates-Appalachia 1994-1998 Vol 51 No 23- WestNile Virus Activity-United States 2001 (Figure 1) Vol

Figure 2 High lung cancer rates in rural Appalachiahttpwwwcdcgovmmwrpreviewmmwrhtmlmm5124a3htm

51 No 22- Rabies in a Beaver-Florida 2001Vol 51 No21- Occupational Exposures to Air Contaminants at theWorld Trade Center Disaster Site-New York September-October 2001 State-Specific Trends in Self-ReportedBlood Pressure Screening and High Blood Pressure-

United States 1991-1999 Nonfatal Physical Assault-Related Injuries Treated in Hospital EmergencyDepartments-United States 2000Vol 51 No 20- State-Specific Mortality from Stroke and Distribution of Placeof Death-United States 1999 Nonfatal Self-InflictedInjuries Treated in Hospital Emergency Departments-United States 2000 Vol 51 No 19 Trends in CigaretteSmoking Among High School Students-United States1991-2001 Notice to Readers Buckle Up AmericaWeek May 20-27 2002 Vol 51 No 17- Tropical StormAllison Rapid Needs Assessment-Houston Texas June2001 Notice to Readers Interpretation of ProvisionalData Presented in Morbidity and Mortality Weekly ReportTables Notice to Readers Satellite Broadcast- EnhancingEnvironmental Health Services in the 21st CenturyNotice to Readers Applied Epidemiology Vol 51Number RR-5 Progressing Toward TuberculosisElimination in Low-Incidence Areas of the UnitedStates Recommendations of the Advisory Council for

the Elimination of Tuberculosis

Other Literature Special ReportsThe Primary Care Service

Area (PCSA) ProjectSteven B Auerbach MD MPH

Health Resources amp Services AdministrationThe goal of the Primary Care Service Area (PCSA)Project is to provide information about primary careresources and populations within small standardizedareas that reflect patients utilization patterns Thedefinition of PCSA boundaries and the description ofthese areas are contained within a database linked to anInternet-based geographic information system (GIS) toallow federal state and academic users easy access Background The effective delivery of primary careremains one of the most important challenges facing theUS health care system Despite a national consensusthat primary care is an essential component of qualityand cost-effective health care disparities remain inprimary care service availability and utilization Effortsto improve primary care service delivery have beenimpeded by limitations in available information Severalweaknesses stand out Information about primary careresources and utilization are often difficult and expensiveto access Data are frequently outdated by the time it isavailable and updating the information is not alwaysfeasible Most importantly data are usually summarizedto geographic levels (eg counties states) that poorlyreflect utilization patterns As a result per capitameasures of clinician supply are often biased by patienttravel to primary care services across geopoliticalboundaries such as counties States on the other handare too large to be useful measures of primary carewhich is the most localized type of medical serviceCurrent measurement systems also lack standardizationWhile some states have individually developed internalmeasurements for primary care utilization anddistribution they are not part of a national measurementsystem that allows for comparability across states andregions

The PCSA Project The PCSA Projectimproves the deficiencies in the existing primary caredata infrastructure by creating service areas using

10nationwide claims data to reflect actual utilization patternsfor primary care clinical service PCSAs build on thehospital service area approach that has been successfullyemployed by Dr John Wennberg and his Dartmouthassociates to produce the Dartmouth Atlas of HealthCare series A PCSA is the smallest area that representsa discrete service region for primary care utilization Thedevelopment method balances the interest in smalllocalized areas with a minimization of area bordercrossing

PCSAs are defined by aggregating ZIP Codes onthe basis of primary care utilization patterns derived fromMedicare ambulatory claims data PCSA boundaries arethen adjusted in order to establish geographic contiguitySubsequently Medicaid and commercial insuranceprimary care claims in selected states are analyzed toassess the soundness of the PCSA regions forrepresenting primary care utilization of youngerpopulations Primary Care Service Areas are linked in aGIS to data characterizing the regions usingdemographics primary health care resources andutilization measures

The unique features of the Primary Care ServiceAreas include service areas that encompass actualpatterns of local primary care use between patients andproviders derived from uniform nationwide Medicareclaims data links between each PCSA and specificprimary care resources like physician workforcemeasures links between each PCSA and populationcharacteristics links between each PCSA and primarycare utilization opportunities for each PCSA to be castinto the larger framework of relevant political sociologicand economic characteristics and a flexible database andsoftware system to allow users to add local informationand adjust PCSA definitions according to specific planningneeds such as rational service area definition

Heres a list of some research projects and policyapplications that could be based on the PCSA databaseIdentification of regions with low levels of primarycare resources Assessment of policies designed toimprove primary care resources Access to primarycare for vulnerable populations Understanding ofrelationship between primary care resourceavailability and health Impact of levels of primarycare resources on the use of preventive care and

Measurement of travel time from given populationto nearest primary care provider etc

Information Access This web site (seehttppcsahrsagov) is the primary means ofdissemination of PCSAs and associated data In additionto viewing PCSAs and their attributes registered userscan examine the underlying ZIP Code assignment datalink the areas to their own data and adjust areadefinitions to specific analytic purposes

An important goal of the PCSA project is todevelop systems for the dissemination of primary care-related data in forms suitable for widely diverse userswith differing needs and computing resources Noviceusers may gain access with a simple Internet browser toan internet-based Geographic Information System basedon ArcIMS that is easy-to-use detail-oriented and multi-user accessible More advanced users may downloadArcView project files and files in ascii and dbf formats

Public users will have access to detailedinformation about the development and potential uses ofPCSAs and the associated data An Excel file with theassignments of ZIP Codes to PCSAs is available to allusers in the Methods Library In order to comply withdata license agreements access to the PCSA attributedata and geographic files is available only to registeredusers

The Role of States State primary care officesand associations have had a critical evaluation role in thePCSA project Nine states have served as official pilotstates (ME NH VT MO KS FL UT MI) althoughmany others have also contributed valuable suggestionsStates are also important end users For some states thePCSA database will be a starting point for organizingtheir own primary care analyses and for others it willsupplement existing sophisticated efforts Over the longterm the projects aim is to incorporate data from statesand other sources to continually improve the quality andgeneralizability of the PCSA information

Updating and Improving the PCSADatabase The development process used in thecreation of the PCSA database was designed to allowfor relatively simple additions to the associated data aswell as updating of the PCSA definitions The projectwill exploit the advantages of Internet dissemination tocontinually update the PCSA data in the coming years

11Planned additions include measures of geographicaccessibility numbers of mid-level providers Census 2000data and incorporation of existing county-based healthcare and population information [Contacts Steve atsauerbachhrsagov David Goodman PrincipalInvestigator Dartmouth Medical School atpcsadartmouthedu and Stephen Mick Co-PrincipalInvestigator Virginia Commonwealth University atmickshscvcued The PCSA project is funded by theBureau of Health Professions and the Bureau of PrimaryHealth Care HRSA]

Other Literature and Meetings

Selected GIS-related presentations at the NorthAmerican Association of Central Cancer Registry(NAACCR) Annual Meeting and Work ShopsToronto Ontario June 8-15 2002 ldquoCancer clusters the myth and the methodrdquo Aldrich TEldquoStatistical methods for detecting global and localclustering of cancerrdquo Aldrich TE Puett R Bolick-AldrichSW Drane JW ldquoPeer county comparisons across threeSoutheastern states for cancer patternsrdquo Aldrich TERamirez S LaRosa RH Sanders LC ldquoAn atlas ofprostate cancer in New York Staterdquo Boscoe FP KielbCL Schymura MJ ldquoIntroduction to GIS a demonstrationusing MapInfo GIS softwarerdquo Boscoe FP ldquoEvaluation ofrisk factors for prostate cancer and their spatialdistribution in the District of ColumbiardquoDavies-Cole JOKofie V Kidane G ldquoReassessment of access to cancercare in Kansas using GIS technologyrdquo Lai SM Van NessC Ranasweera N Keighley J ldquoSpatial analysis of latestage breast cancer in Californiardquo Laurent AA CressRD Wright WE ldquoGeographical science for beginner GISusers in cancer registriesrdquo Rushton G ldquoPreparingMinnesota geocoded data for analysis of canceroccurrence by SESrdquo Schult T Bushhouse S Perkins CldquoInnovative cancer registry products to supportcomprehensive cancer controlrdquo Scruggs NC Aldrich TEBolick-Aldrich SW Sander LC Spitler H (SeeInteractive Map Services at web site httpscangisdhecstatescusextranet includes maps by ElectionDistrict) ldquoGeographic disparities in colorectal cancerstagingrdquo Sherman-Seitz RL Shipley DK Hedberg KldquoDetection of colorectal cancer clusters in District ofColumbia a GIS based approachrdquo Tao X Kofie V

Matanoski GM Lantry D Schwartz ldquoCancer mappingthe EUROHEIS wayrdquo Theriault M-E and ldquoUsinggeographic information systems technology in thecollection analysis and presentation of cancer registrydata introduction to basic practicesrdquo Wiggins L

Journal Articles and Other Submissions

Spatial filtering using a raster geographicinformation system methods for scaling health andenvironmental data Ali M Emch M Donnay JPHealth amp Place 8 (2) 85-92 JUN 2002 AbstractDespite the use of geographic information systems (GIS)in academic research it is still uncommon for publichealth officials to use such tools for addressing healthand environmental issues Complexities inmethodological issues for addressing relationshipsbetween health and environment investigating spatialvariation of disease and addressing spatial demand andsupply of health care service hinder the use of GIS inthe health sector This paper demonstrates simple spatialfiltering methods for analyzing health and environmentaldata using a raster GIS Computing spatial movingaverage rates reduces individual affects and creates acontinuous surface of phenomena Another spatialanalytical method discussed is computation of exposurestatus surfaces eg neighbors influences weighted bydistance decay These methods describe how health andenvironmental data can be scaled in order to betteraddress health problems Spatial filtering methods aredemonstrated using health and population surveillancedata within a GIS that were collected for nearly 210000people in Matlab Bangladesh

Integration of GPS with remote sensing and GISReality and prospect Gao J PhotogrammetricEngineering and Remote Sensing 68 (5)447-453MAY 2002 Abstract The advent of the GlobalPositioning System (GPS) technology has not onlyenhanced the ease and versatility of spatial dataacquisition but has also diversified the approaches bywhich it is integrated with remote sensing andgeographic information systems (GISs) In this paper thenecessity of integrating GPS remote sensing and GIS isdiscussed following their definition The current status ofintegration is reviewed under four proposed models

12linear interactive hierarchical and complex Applicationsof integration are reviewed under three categoriesresources management and environmental monitoringemergency response and mobile mapping This paperreveals that linear integration is the most commonHierarchical integration has found applications in precisionfarming and environmental modeling The complex modeof integration is most valuable in disaster mitigationemergency response and mobile mapping With limitedcases in hierarchical and complex models the fullpotential of integration has not been achieved Theprospects of integration are distributed mobile GISs andlocation-aware multi-media digital personal assistants Asmobile communications technologies improve fullintegration will find more applications in many new fieldsafter removal of the obstacles in integration KeyWordsGeographic Information Systems environmentalapplications aerial triangulation management satellitetechnologies photographs precision accuracy imagery

TitlesEnvironmental risk factors associated with theincidence of visceral leishmaniasis in TeresinaBrazil A case-control study using geographicinformation systems and remote sensing Werneck GCosta CHN Maguire J Am J Epidemiol 155 (11) 416Suppl S JUN 1 2002 Changing area socioeconomicpatterns in US Cancer mortality 1950-1998 partI-all cancers among men Singh GK Miller BAHankey BF Feuer EJ Pickle LW J Natl Cancer Inst2002 JUN 1994(12)904-15 Evaluating siteinvestigation quality using GIS and geostatisticsParsons RL Frost JD J of Geotechnical andGeoenvironmental Engineering 128 (6) 451-461 JUN2002 The urban spread of visceral leishmaniasisClues from spatial analysis Werneck GL Costa CHNWalker AM David JR Wand M Maguire JHEpidemiology 13 (3) 364-367 MAY 2002 Geographicinformation systems in transportation research byThill JC Shaw Sl J of Regional Science 42 (2) 418-421MAY 2002 Exposure simulation for pharmaceuticalsin European surface waters with GREAT-ERSchowanek D Webb S Toxicology Letters 131 (1-2)39-50 MAY 10 2002 When is a map not a map Task

and language in spatial interpretation with digitalmap displays Davies C Applied CognitivePsychology 16 (3) 273-285 APR 2002 ExaminingGIS decision utility for natural hazard riskmodelling Zerger A Environmental Modelling ampSoftware 17 (3) 287-294 2002 Locationallocationrouting for home-delivered mealsprovision Johnson MP Gorr WL Roehrig SFInternational J of Industrial Engineering-theoryApplications And Practice 9 (1) 45-56 MAR 2002Land use change analysis in the Zhujiang Delta ofChina using satellite remote sensing GIS andstochastic modelling Weng QH Journal ofEnvironmental Management 64 (3) 273-284 MAR2002

V Related Census HHS FGDC and Other

Federal Developments The Secretarys National Leadership Summit onEliminating Racial and Ethnic Disparities inHealth ldquoClosing the Health Gap Togetherrdquo USDepartment of Health and Human Services (HHS)Office of Minority HealthOffice of Public Health andScience July 10-12 2002 Washington DCResearchData Plenary Session and Workshops to beheld during the Summit [For full program and registrationsee httpwwwomhrcgov]

Wednesday July 10 Assessment 101 The Research That

You Too Can DoThis workshop will provide participants with a basicworking knowledge of why assessments should beconducted of needs and resources within theircommunity what questions to ask and how how to piggyback onto other efforts how to use existing resourcesand how to feed back this information to fundersstakeholders and the community Moderator ldquoHow IsIt That You Assess What You Haverdquo BrianRichmond MPH Academy for EducationalDevelopment Washington DC (Invited) ldquoAssessingNeeds and Resources Within Your Communityrdquo JaniceBowie Johns Hopkins University Baltimore MD(Invited) and ldquoRapid Assessments CrisisResponse Teams Initiativerdquo Dadera Moore Office

13of HIVAIDS Policy US Department of Health andHuman Services (Invited)

How to Access and Use National Data This hands-on workshop will give examples of how toaccess and use national data from the Census CurrentPopulation Survey National Health Interview Survey vitalstatistics and other data sources Instructor Pat Goldenrecently retired from the National Center for HealthStatistics Hyattsville MD (Invited)

Use of Geographic Information Systems (GIS) toReduce Minority Health Disparities

This workshop is designed to instruct public healthprofessionals in the growing uses of GIS to help improvedisease surveillance and prevention among minoritypopulations Attendees will learn 1) how UScommunities are beginning to cost-effectively allocatescarce public health resources to long-standing minorityhealth issues such as environmental lead and rodentexposures and access to care 2) new skills in geocodingand the linkage and use of georeferenced information withcensus geographic and minority population data files and3) new skills in basic easy-to-perform spatial analyticfunctionality common to all GIS software Instructors Frederick R Broome MS Chief Geospatial ResearchUS Census Bureau Geography Division WashingtonDC (Invited) Charles M Croner PhD Editor PublicHealth GIS News and Information Geographer amp SurveyStatistician National Center for Health Statistics Centersfor Disease Control and Prevention Hyattsville MD(Invited) and Jonathan Sperling PhD ManagerGeographic Information amp Analysis US Department ofHousing and Urban Development Office of PolicyDevelopment and Research Washington DC (Invited)

Thursday July 11Evaluation 101 How Do I Evaluate My Project

This session is intended for those who are new toevaluating their projects The session will provideparticipants with a basic working knowledge of whyevaluations should be conducted of their projects how toestablish what change the program interventioneffortshave made how to piggy back onto other efforts how touse existing resources and how to feed back thisinformation to funders stakeholders and the communityModerator Patti Tucker DrPH RN Centers for

Disease Control and Prevention Atlanta GA (Invited)ldquoIncorporating Evaluation Into Service ProgramsLessons Learnedrdquo Brad Boekeloo PhD University ofMaryland College Park (Invited) ldquoHow to MakeEvaluation Work for You and Your Programrdquo Pablo AOlmos-Gallo PhD Mental Health Corporation ofDenver Denver CO (Invited) ldquoHow to Recruit andUtilize Local Evaluatorsrdquo Elvis Fraser PhD Academyfor Educational Development Washington DC (Invited)

Assessment 102 Improving Your Assessment Skills

This session is intended for those who have alreadyconducted a preliminary needs and resource assessmentof their community and would like to improve theirassessment skills REACH 2010 grantees will present abrief description of how they assessed the needs andresources within their community and how theycommunicated this information to policy makersstakeholders and the community Experts in needassessment will provide suggestions on how to improvetheir assessments Presenters Carolyn Jenkins DrPHFAAN Medical University of South Carolina MtPleasant SC (Invited) Sidney Liang CambodianCommunity Health 2010 of Lowell Community LowellMA (Invited) Janine Walker Dyer Center forCommunity Health Education amp Research MetroBoston Haitian REACH 2010 Coalition Dorchester MA(Invited) and David G Schlundt PhD Department ofPsychology Vanderbilt University Nashville TN(Invited) Panel Responders Brad Boekeloo PhDUniversity of Maryland College Park (Invited) Pablo AOlmos-Gallo PhD Mental Health Corporation ofDenver Denver CO (Invited) and Dadera MooreOffice of HIVAIDS Policy US Department of Healthand Human Services (Invited)

Proposed Public Comment Session for theNational Academy of Sciencesrsquo Review of DHHS

Data Collection on Race and Ethnicity In December 2000 the Congress passed the A MinorityHealth and Health Disparities Research and EducationAct of 2000 Title III of that act specifies that theNational Academy of Sciences (NAS) shall conduct acomprehensive study of the Department of Health andHuman Services data collection or reporting systems

14required under any of the programs or activities of theDepartment relating to the collection of race andethnicity including other Federal data collection systems(such as the Social Security Administration) with whichthe Department interacts to collect relevant data on raceand ethnicity This session will provide an opportunity forparticipants of the National Leadership Summit to providecomments to this NAS committee relating to race andethnicity data collection for DHHS data systemsModerators Ed Perrin PhD University of WashingtonSeattle (Invited) and Shelly Ver Ploeg PhD NationalAcademy of Sciences Washington DC (Invited)

Proposed Disparities in Access to Genetic Testing Services A Town Meeting with the

Secretaryrsquos Advisory Committee on Genetic Testing Genetic testing services encompass the evaluation pre-and post-test counseling testing management andtreatment of genetic conditions in the prenatal pediatricand adult populations Disparities in access to healthinsurance and medical care may act as a barrier to thedevelopment and provision of culturally appropriategenetic testing services available to individuals andgroups The Secretarys Advisory Committee on GeneticTesting (SACGT) is currently studying the extent andimpact of healthcare disparities on access to genetictesting services This proposed workshop would providean opportunity for individuals to inform SACGT aboutissues pertaining to the accessibility of genetic testingservices in States and local communities and to share theirperspectives with SACGT on how the problem should beaddressed The town meeting format would also enableparticipants to share perspectives about other issues ingenetic testing Moderators SACGT Members JudithA Lewis PhD RN (Invited) Victor Penchaszadeh MD(Invited) and Vence Bonham Jr JD (Invited)Strengthening Community-Academic Partnerships

for Research Panelists will describe success stories of academicpartnerships which truly involve the communities studiedincluding the informed consent process recruitment ofindividuals into a study data collection analysisinterpretation and dissemination of findings back to thecommunity The Strong Heart Study the Jackson HeartStudy and the Urban Child Research Center will be

highlighted Moderator Sarena D Seifer The Centerfor the Health Professions Seattle WA (Invited)ldquoUrban Child Research Centerrdquo Wornie Reed PhDUrban Child Research Center Cleveland StateUniversity Cleveland OH (Invited) ldquoJackson HeartStudyrdquo Donna Antonine-Lavigne MPH MSEDJackson State University Jackson MS (Invited) andldquoStrong Heart Studyrdquo Jeff Henderson Black HillsCenter for American Indian Health Rapid City SD(Invited)Where Are We Now with the Federal Standards for

Racial and Ethnic Data In October 1997 the Office of Management and Budgetannounced the first revision of the Federal standards forracial and ethnic data in twenty years Multiracialpersons can now report more than one race for Federaldata collection efforts This session will briefly discussthe new standards as well as discuss the issues theOffice of Management and Budget grappled with duringits extensive research and public comment period leadingto its decision New data on the sociodemographics andhealth status of multiracial persons from the Census andnational health surveys will be shared In additioninformation on how the Bureau of the Census and theNational Center for Health Statistics will tabulate dataand study trends over time using the new Federalstandards will be presented Moderator Ed SondikPhD National Center for Health Statistics HyattsvilleMD (Invited) ldquoWhat Did We Learn From Census2000rdquo Claudette Bennett Bureau of the CensusSuitland MD (Invited) ldquoMultiracial Births and DeathsrdquoBrady Hamilton PhD National Center for HealthStatistics Hyattsville MD (Invited) and ldquoHealth Statusof Multiracial Personsrdquo Jacqueline Wilson LucasNational Center for Health Statistics Hyattsville MD(Invited)Do We Know What We Need to Know to Eliminate

Disparities in Health Outcomes Research agendas to address disparities in healthoutcomes will be presented and discussed byrepresentatives from the National Institutes of HealthCenters for Disease Control and Prevention and theMcArthur Research Network on Socioeconomic Statusand Health Moderator ldquoDisease Prevention

15Researchrdquo Walter Williams PhD Centers for DiseaseControl and Prevention Department of Health andHuman Services Atlanta GA (Invited) ldquoBehavioralResearchrdquo Raynard Kington PhD Office of Behavioraland Social Sciences Research National Institutes ofHealth Department of Health and Human ServicesBethesda MD (Invited) ldquoHow the Social EnvironmentImpacts Health Inequitiesrdquo Nancy E Adler MacArthurResearch Network on Socioeconomic Status and HealthSan Francisco CA (Invited) ldquoEnvironmental ResearchrdquoAllen Dearry National Institute of Environmental HealthSciences of Health National Institutes of HealthDepartment of Health and Human Services ResearchTriangle Park NC (Invited) and ldquoRWJ PerspectiverdquoKimberly Lochner ScD The Robert Wood JohnsonFoundation Princeton NJ (Invited)

Do We Know What We Need to Know to EliminateDisparities in Health Care Access and Quality

This session will discuss data gaps and research needs tohelp answer questions of why disparities in health careaccess and quality exist even within similarly insuredpopulations Representatives from the Institute ofMedicine Centers for Medicare and Medicaid ServicesAgency for Healthcare Quality and Research HealthResources and Services Administration and theAcademic Medicine and Managed Care Forum will sharetheir perspectives on this panel Moderator ldquoHealthCare Disparities Researchrdquo Brian Smedley PhD Instituteof Medicine Washington DC (Invited) ldquoAHRQPerspectiverdquo Dr Francis Chesley Agency for HealthcareQuality and Research US Department of Health andHuman Services Rockville MD (Invited) ldquoHRSACollaborativesrdquo Denice Cora-Bramble MD HealthResources and Services Administration Rockville MD(Invited) ldquoCMS Perspectiverdquo Daniel Waldo Centers forMedicare and Medicaid Services US Department ofHealth and Human Services Baltimore MD (Invited)ldquoAcademic Medicine and Managed Care ForumPerspectiverdquo Dennis Oakes Academic Medicine andManaged Care Forum Blue Bell PA (Invited)

Special Research Issues for Tribal Governments

Many researchers and funding organizations are notaware that they need to consult with tribal governments

prior to planning and conducting research on AmericanIndians or Alaska Natives This session will discuss thespecial relationship that American Indian tribes havewith the Federal government and how that impacts howresearch is funded and conducted Examples of strongpartnerships to improve vital events data in Michigan andrecruit American Indians for the California HealthInterview Survey will be highlighted In additionmethods for small populations will be discussedModerator Carole Heart Aberdeen Area TribalChairmanrsquos Health Board Aberdeen SD (Invited)ldquoImproving Michigan Vital Events Data for AmericanIndiansrdquo Richard Havertake MPH Inter-Tribal Councilof Michigan Inc Saulte Ste Marie MI (Invited)ldquoLessons Learned from the California Health InterviewSurveyrdquo Delight Satter MPH University of CaliforniaLos Angeles CA (Invited) ldquoMethods for SmallPopulationsrdquo Tam Lutz NW Portland Area IndianHealth Board Portland OR (Invited)

Birthplace Generation and Health What Have We Learned

Studies have documented that rapid acculturation toAmerican values and behaviors could result in negativehealth outcomes for immigrants and their families It isincreasingly realized that newcomers to the UnitedStates bring with them certain culturally protectivefactors from their countries of origin These protectivefactors serve to shield them from many high-risk healthbehaviors For example Latino newcomers tend to livelonger have less heart disease and exhibit lower rates ofbreast cancer among women The ldquoHispanic paradoxrdquodemonstrates that the effects of social economic statuson health indicators is modified by the acculturationstatus of the individual In other words health behaviorsfor Latinos worsen with increased levels ofacculturation regardless of SES While this ldquoparadoxrdquohas not been fully analyzed the ldquoHealthy Migrantrdquoeffect appears to be the result of the socioeconomic andpsychological selectivity of the immigration process Thissession will discuss the latest findings on the health ofimmigrants and their descendants so that healthprofessionals and researchers can identify strategies andinterventions to preserve culturally determined protectivefactors that maintain high levels of wellnessModerator Olivia Carter-Pokras PhD Office of

16Minority Health US Department of Health and HumanServices Rockville MD (Invited) Influence of Nativityon Mortality Among Black New Yorkers MichaelAlderman PhD Albert Einstein College of MedicineBronx NY (Invited) Cancer Among Asian Immigrantsto the United States and Their Descendants GK SinghPhD National Institutes of Health Bethesda MD(Invited) Birthplace Generation and Health AmongLatinos Alexander N Ortega PhD Yale School ofPublic Health New Haven CT (Invited)

Friday July 12Research and Data Plenary Session How toInvolve Communities in Research and Data

In the last ten years traditional population-basedbiomedical research methods have been challenged dueto limited community participation Proponents for changeexplain that community participation as an active partnerin the research process provides numerous benefits toresearch findings and public health intervention outcomesIn addition community participation builds and strengthensthe capacity of community residents to address futurehealth risks through education outreach and trainingIncreased community involvement in the design datacollection analysis and interpretation and in thedissemination phases of research is one approach whichhas been used successfully to improve survey responserates and increase cost effectiveness Furthermoreprevious reports containing recommendations to improveracial and ethnic data have acknowledged the importanceof involving the community in research and data effortsThis panel will examine useful ways of incorporatingcommunities especially racial and ethnic groups into theresearch process to improve data on racial and ethnicgroups

This session will discuss how representatives ofcommunity-based organizations public health agencieshealth care organizations and educational institutions canwork together to ensure that research is conducted whichwill enhance our understanding of issues affecting thecommunity and develop implement and evaluate asappropriate plans of action that will address those issuesin ways that benefit the community Panelists willdescribe success stories involving the communitiesstudied including the informed consent processrecruitment of individuals into a study data collection

analysis interpretation and dissemination of findingsback to the community Success stories using thesemethods to translate research into action to reducedisparities in mental health will also be shared

Moderator ldquoWhy Involve Communities inResearch and Data Effortsrdquo John Ruffin PhD(Invited) Director of the National Center on MinorityHealth and Health Disparities (NCMHD) at NIH willset the stage for this discussion of how to involvecommunities in research and data and will include abrief summary of Departmental efforts to developguidance for community based participatory researchPanelists ldquoOverview of CBPR and Examples from theDetroit Community- Academic Urban ResearchCenterrdquo Barbara Israel DrPH (Invited) is aProfessor in the Department of Health Behavior andHealth Education with the University of Michigan DrIsrael will give an overview of CBPR and provide reallife examples of developing implementing and evaluatingCBPR through their CDC-funded Detroit Community-Academic Urban Research Center Starting with about$300000 annually from CDC they have workedtogether to develop this into a 12 million dollar CBPRenterprise ldquoCBPR and Lay Health Workersrdquo EugeniaEng DrPH (Invited) is a Professor at the Universityof North Carolina School of Public Health She willshare her experience in community based participatoryresearch and the training of health care workers ldquoAnAmerican Indian and Rural Perspective on CommunityBased Participatory Researchrdquo Judy Gobert (Invited)Dean of Math and Science of Salish Kootenai Collegewill share an American Indian and rural perspective oncommunity based participatory research andldquoTranslating Research into Action to Reduce Disparitiesin Mental Healthrdquo Sergio Aguilar-Gaxiola MD PhD(Invited) Professor of Psychology California StateUniversity Fresno CA

Evaluation 102 How Do I Improve My Evaluation

This session is intended for those who have startedevaluating their projects and would like to learn how toimprove their evaluations REACH 2010 grantees willpresent a short description of their project and evaluationapproach and will receive feedback from evaluationexperts Participants will have an opportunity to ask

17questions of their own evaluations Presenters DrAdewale Troutman Principal Investigator for the AtlantaREACH for Wellness Initiative Atlanta GA (Invited)Barbara Ferrer Boston REACH 2010 Breast andCervical Cancer Project Boston MA (Invited) MonaFouad Principal Investigator REACH 2010 andAssociate Professor of Medicine University of Alabamaat Birmingham AL (Invited) and Marcus Plescia MDMPH Dept of Family Medicine Charlotte NC (Invited)Panel Responders Pablo A Olmos-Gallo PhD MentalHealth Corporation of Denver Denver CO (Invited)Pattie Tucker DrPH RN Centers for Disease Controland Prevention Atlanta GA (Invited) Linda Silka PhDUniversity of Massachusetts Lowell MA (Invited) andTom Arcury PhD Wake Forest University School ofMedicine Winston-Salem NC (Invited)

State Plans To Improve Racial And Ethnic Data

Best practices to improve the collection analysisdissemination and use of racial and ethnic data at the statelevel will be presented Moderator William WalkerNew Hampshire Office of Minority Health Concord NH(Invited) ldquoNew England Model PrivatePublicCollaboration Using Data to Eliminate Racial and EthnicHealth Disparitiesrdquo Vania Brown-Small Rhode IslandOffice of Minority Health Providence RI (Invited) ldquoBestPractices in Arkansasrdquo Tara Clark-Hendrix ArkansasDepartment of Health Little Rock AR (Invited) ldquoOhioMinority Health Data Initiativerdquo Dr Frank HoltzhauerOhio Department of Health Columbus OH (Invited)[Conference Contact and Organizer Olivia Carter-Pokras PhD Director Division of Policy and DataHHS Office of Minority Health atocarterosophsdhhsgov]

Federal Geographic Data Committee (FGDC)

[The Federal Geographic Data Committee (FGDC) is an interagencycommittee organized in 1990 under OMB Circular A-16 thatpromotes the coordinated use sharing and dissemination of geospatialdata on a national basis The FGDC is composed of representativesfrom seventeen Cabinet level and independent federal agencies TheFGDC coordinates the development of the National Spatial DataInfrastructure (NSDI) The NSDI encompasses policies standardsand procedures for organizations to cooperatively produce and sharegeographic data The 17 federal agencies that make up the FGDCincluding HHS are developing the NSDI in cooperation with

organizations from state local and tribal governments the academiccommunity and the private sector See httpwwwfgdcgov]Statement of Mark A Forman Associate Directorfor Information Technology and ElectronicGovernment Office of Management and BudgetBefore the Committee on Government ReformSubcommittee on Technology and ProcurementPolicy US House of Representatives- June 72002 (Excerpts) Public Trust A successful E-government strategy must deploy risk-based and cost-effective controls to ensure the securityof the Federal governmentrsquos operations and assetsSecurity is integral to both the E-Government andHomeland Security initiatives Additionally all E-government and homeland security initiatives whereapplicable must comply with security requirements inlaw OMB policy and technical guidelines developed bythe National Institute of Standards and TechnologyThese initiatives must also ensure privacy for personalinformation that is shared with the Federal governmentAchieving a secure homeland must be accomplished ina manner that builds trust preserves liberty andstrengthens our economy The Administrationrsquos e-Authentication project addresses security and privacyconcerns by enabling mutual trust to support widespreaduse of electronic interactions between the public andgovernment and across government by providingcommon avenues to establish ldquoidentityrdquo It will providea secure easy to use and consistent method of provingidentity to the Federal government that is an appropriatematch to the level of risk and business needs of each e-gov initiative In addition project teams will addressprivacy concerns regarding the sharing of personalinformation E-Government depends on confidence bycitizens that the government is handling their personalinformation with care Agencies are working on buildingstrong privacy protections into both E-government andHomeland security initiatives and OMB is focusing ongovernment wide privacy protections by all agencies

Steps to Overcome Information Stovepipes

New agency information technology investments mustspecify standards that enable information exchange andresource sharing while retaining flexibility in the choiceof suppliers and in the design of work processes They

18must also address security needs As you know thePresident has given a high priority to the security ofgovernment assets including government informationsystems and the protection of our nationrsquos criticalinformation assets from cyber threats and physicalattacks We believe that protecting the information andinformation systems that the Federal government dependsupon requires agencies to identify and resolve currentsecurity weaknesses and risks as well as protect againstfuture vulnerabilities and threats OMB will continue tomonitor and measure agency security performancethrough their annual security reports and the budgetprocess

The Administrationrsquos ongoing effort to establishthe Federal enterprise architecture is helping to identifylocate and establish mechanisms to share acrossgovernment the information required to protect theNationrsquorsquos borders and to prepare for mitigate andrespond to terrorist activities Over time every agencyhas developed its own set of business processes andsupporting IT systems These ldquostovepipedrdquo systems werebuilt with the intention of supporting a specific businessunit or function and never contemplated data exchangeswith other systems in the organization E-Government andhomeland security requires us to exchange data acrossorganizations at the federal level as well as with ourpartners in State and local governments and the citizenTo overcome these rigid systems we are using enterprisearchitecture best practices This will enable us to developsimpler more efficient business processes Best practicescombined with information technologies allow us toquickly develop and implement simple and more efficientbusiness processes including processes for homelandsecurity initiatives

FGDC Coordination Meeting Summary Agency

Geospatial Data Use Activities and Expenditures June 4 2002

The following are brief summaries of geospatial activitiesby lead FGDC agency representatives More completereports were provided to attending Office of Managementand Budget (OMB) examiners Janet Irwin OMBspoke of the importance of the FDGC which is receivinghigh profile attention due to the Geospatial One StopInitiative (see Public Health GIS News and Information

(44) JAN 2002) Data is moving towards beingcollected according to FGDC standards OMB andFGDC need to demonstrate the value of spatial datastandards and interoperability There was guidance inthe FY 03 Passback directing agencies to spend moneyon data collected to FGDC standards The OMBexaminers met June 4 2002 to learn more about thevalue of geospatial data at the following agencies

NOAA- All of The National Oceanic andAtmospheric Administrations (NOAA) work ispredicated on the use of geospatial data Satellites andData Ocean and Atmosphere Research OceanService Fisheries Service and Weather Services aresources of coastal mapping information in NOAACategories of marine and coastal spatial data includespatial frameworks meteorological and oceanographicecosystem and human activities NOAAsClearinghouse participation includes NOAAs CoastalServices Center which is one of the FGDCClearinghouses six gateways maintenance of 15 FGDCClearinghouse nodes and metadata training at NOAAsCoastal Services Center NOAA has active leadershipand participation on a number of FGDC subcommitteesand working groups For Geospatial One Stop NOAAis heading up the Geodetic Theme Development and iscontributing to efforts of three other framework layers[Report Howard Diamond]

Census Bureau- All of the Census Bureausinformation is tied to geospatial data The TIGER(Topologically Integrated Geographic Encoding andReferencing) System is at the heart of the CensusBureaus geospatial data support for its statisticalprograms TIGER content Streets lakes streamsrailroads boundaries housing key geographic locations(airports schools etc) ZIP codes and address rangesThe MAF (Master Address Files) is a comprehensivedatabase for each housing unit in the entire UnitedStates Puerto Rico and the associated Island AreasCensus is the Governmental Unit Boundary theme leadfor the Geospatial One Stop [Report FrederickBroome ]

USGS- The US Geological Survey (USGS) hasmany programs with a geospatial component includingCooperative Topographic Mapping Geologic Mapping

Courtesy of Bon Buhler Bureau of Land Management (BLM) Depicts cadastral orlegal rights of land use and ownership information based on early township surveys ofwestern lands into 6 miles square (girder to girder) Spatial data today used in virtuallyall land use decisions by BLM and key component for managing Public Indian andadjoining lands

Land Remote Sensing Energy Minerals HazardsCoastal and Marine Geology Surface Water WaterQuality Ecosystems Fisheries and Aquatic ResourcesInvasive Species and Wildlife and Terrestrial ResourcesUSGS is the Geospatial One Stop Theme lead for threeframework layers orthoimagery elevation and

hydrography Roughly half of the USGS budget is spenton geospatial activities OMB Circular A-16 designatesUSGS as the lead for digital orthoimageryelevationterrestrial hydrography geologic earth covergeographic names watershed boundaries and biological

resources Although the National databases are alreadystandardized the research databases are works inprogress with regard to standardization As the metadatatools become easier to use the more the scientists willbe able to document their data according to FGDCstandards [Report Hedy Rossmeissl]

BLM- The Bureau ofLand Management (BLM) hasused geospatial data since 1785when the West began to besurveyed into 6-mile squaretownships BLM providescadastral data expertise (cadastraldata is the record of our decisionson the land) Approximately 78of BLM business practices usegeospatial data to support missionrelated land and resource decision-making including inventoriespermitting leasing land tenure andplanning Much of the spatial datathe BLM uses is provided by otherfederal state and localorganizations States and localsalso provide input for cadastralstandards BLM fully supports theGeospatial One Stops vision[Report Don Buhler]

N I M A - Prior toSeptember 11 the NationalImagery and Mapping Agency(NIMA) did not have a domesticmission so participation in FGDCactivities is a new role for theagency NIMA provides financialsupport to the Geospatial One Stopand co-chairs the FGDCHomeland Security WorkingGroup On July 11 NIMA will hosta Model Driven Architecture

(MDA) Tutorial Geospatial One Stop Theme leads orpeople involved in standards development may find thisunclassified tutorial helpful [Report Shel Sutton]

DOT- The US Department of Transportation(DOT) creates and maintains transportation specific

20spatial data for highway railroad transit airport facilitiesand airspace and intermodal facilities and producescartographic products aeronautical charts tools andpublications DOT collaborates with State organizationsand gets some spatial information (such as pipeline data)from non-Feds DOT chairs the FGDC GroundTransportation Subcommittee and is the Geospatial OneStop Theme Lead for road rail and air transportationDOT has approximately 20 FTEs working on geospatialactivities DOT has a 6-year cycle for appropriations andduring the next cycle the Department hopes to leveragethe States geospatial data by integrating them with eachother as well as the Geospatial One Stop Portal [ReportCarol Brandt and K Thirmulai]

USDAFSA- The Farm Service Agency (FSA)administers over 40 programs in farm commodity creditconservation environmental and emergency assistanceIts business directly involves the use and maintenance ofmaps and geospatial information FSA is involved inreengineering business processes to eliminate redundantprocesses The FSA is building a GIS training program forFSA employees in the field FSA participates with FGDCactivities regarding Metadata Data StandardsClearinghouse Interoperability Specifications andGeospatial One Stop [Report Shirley Hall]

USDANRCS- The Natural ResourcesConservation Service (NRCS) provides leadership in apartnership effort to help conserve maintain and improveour natural resources Geotechnology tools support manyNRCS programs NRCS has data development activitiesand partnerships related to soils orthoimagery criticalprogram management themes and watershed boundariesThe NRCS collects and generates data at the local levelwith much of the data stored locally The NRCS hasdeveloped a Customer Service Toolkit (CST) gearedtowards customers at the local level [Report ChristineClarke]

USDAUSFS- Roughly 60 of the US ForestService (USFS) budget goes towards collectingmaintaining and using geospatial data and approximately80-90 of USFS business involves geospatial data The2003 USFS Strategic Plan will include more details aboutgeospatial data than past strategic plans Approximately1000 USFS employees are involved with geospatial data

and each district office has several GIS people TheGeospatial Service and Technology Center (GSTC)produce much of the standardized forest-level geospatialproducts for the USFS The GTSC is also responsible forupdating approximately 600 topographic maps per yearUSFS has a Geospatial Executive Board and a GeosptialAdvisory Committee that deal with issues regardinggeospatial investments USFS will have an active FGDCClearinghouse node by FY03 USFS supports theGeospatial One Stop [Report Susan DeLost]

USACE- The US Army Corps of Engineers(USACE) is a decentralized organization with a verylimited mapping mission USACEs only mapping missionis the Inland Waterways USACE participates withFGDC regarding metadata Clearinghouse and datastandards development and coordination USACE issupporting the Geospatial One stop by developingtransportation theme for waterways and is providingfunding to OGC and ANSI [Report Nancy Blyler]

FEMA- The Federal Emergency ManagementAgency (FEMA) works to reduce loss of life andproperty and protect our critical infrastructure from alltypes of hazards A significant amount of resources aredirected toward geospatial data use and activities due tothe geographic nature of hazards and disasters Forexample 50-70 of the Flood Mapping Programsbudget goes toward the creation collection evaluationprocessing production distribution and interpretation ofgeospatial data as well as standards and proceduresdevelopment to support these activities FEMAs NSDIactivities are related to standards development and theMulti-Hazard Mapping Initiative [Report ScottMcAfee]

EPA- The Environmental Protection Agency(EPA) completed a Geospatial Activities Baseline inJune 2001 The baseline describes how Agency businessis supported and documents current data sets hardwareand software applications users and expenditures Thebaseline also identifies stakeholder issues EPAgeospatial data supports Superfund tribal activitiesemergency response water quality and water standardscompliance environmental justice air risk assessmentsperformance measurement and growth The EPA isdeveloping a geospatial blueprint that will describe an

21approach to more effectively organize coordinate andleverage geospatial data activities on an enterprise-levelwithin the EPA The EPA is contributing to the GeospatialOne Stop and has a Clearinghouse node [Report IvanDeLoatch]

NASA- The National Aeronautics and SpaceAdministration (NASA) participates in FGDC throughparticipation on the standards teams Chairing theGeospatial Applications and Interoperability WorkingGroup and fully supporting the Geospatial One StopNASA uses geospatial data in spacecraft and airbornemeasurement programs data distribution and handlingsystems and earth science research composed of bothscience and the applications The latest applicationsstrategy focuses on National Applications throughpartnerships NASA supports the NSDI through theClearinghouse Global Change Master Directory Agency-wide coordination OGC Strategic Membership and ISOTC211 participation Direct contribution to GeospatialOne-Stop will be in the areas of program managementoutreach and portal design [Report Myra Bambacus ]

Web Site(s) of Interest for this Editionhttpwwwsdigov Interagency Working Group onSustainable Development Indicators (the SDIGroup) In the SDI Group people from a number ofFederal Agencies work together to create indicators ofsustainable development for the United States On thissite is a downloadable version of our first reportSustainable Development in the United States AnExperimental Set of Indicators In the future we plan topost an updated version with further thoughts on theframework for indicators a revision of the set of 40 andcomments on indicator projects at the community andcorporate level There are also many links to otherGovernment and non-Government sites related toindicators The US Interagency Working Group onSustainable Development Indicators welcomes publicparticipation in the discussion and selection of indicatorsfor sustainable development

httpwwwhazardmapsgovatlasphp FEMAsMutihazard Mapping Initiative The vision of FEMAsMutihazard Mapping Initiative is to maintain a living atlas

of hazards data and map services for advisory purposessupplied from a network of hazard and base mapproviders The initiative is an implementation of Section203(k) of the Disaster Mitigation Act of 2000 whichcalls for the creation of Multihazard Advisory Maps ormaps on which hazard data concerning each type ofnatural disaster is identified simultaneously for thepurpose of showing areas of hazard overlap httpwwwoceansatlasorgindexjsp United NationsAtlas of the Oceans The UN Atlas of the Oceans isan Internet portal providing information relevant to thesustainable development of the oceans It is designed forpolicy-makers who need to become familiar with oceanissues and for scientists students and resourcemanagers who need access to databases andapproaches to sustainability The UN Atlas can alsoprovide the ocean industry and stakeholders withpertinent information on ocean matters

httpwwwurbanuiuceduce02eventsstandardsstandardshtml GIS Standards Workshop at University ofIllinois August 5-8 Champaign IL

httpwwwspesissitReporthtm Regarding the measlesoutbreak in Campania Italy in the period January-April2002 data from the sentinel pediatric surveillance showan incidence of approximately 1600 cases per 100000population which corresponds to more than 15000 casesin children less than 15 years of age The highestincidence is in the age group 5-9 years followed by 10-14 years These data refer only to Campania and arebased on the observation of 41000 children less than 15years of age (that is 4 percent of the regional total of thesame age group) The epidemic is attributable to a poorvaccination coverage (the most recent estimate refers tothe 1998 birth cohort and is 53 percent for those 24months of age) For readers who are interested in seeingthe monthly incidence data with an excellent mapping byregion select the month of interest for disease (mallatia)put in morbillo for measles The data on the websiteare very well presented and readable even for those ofus who do not read Italian As clearly stated in theabove summary the ongoing outbreak is related to lowvaccination coverages with a resultant large cohort of

22susceptibles a situation in which a resultant outbreak isnot unexpected The measures taken to start immunizationat 6 months of age with follow-up dose after 12 months of

age are prudent

Final ThoughtsMinority Health Disparities and GIScience

The timing is now to bring full attention to the many uses of GIScience to help address minority health disparities Thepower of GIS technology allows geospatial data to be of prime importance to help study the differential burden ofdisease among our minority populations The fact that health disparities are so pervasive among minorities and

especially for African American orBlack Americans makes this concerna high public health and nationalpriority GIScience and technologywith the capacity to detect spatial andspace-time inequalities has animportant contributing role to play inthe growing national effort toeliminate human health disparitiesFirst we must comprehend thedimensions and extent of this humancrisis in America

The recent 8th AnnualSummer Public Health ResearchInstitute and Videoconference onMinority Health June 17-21 2002( s e e wwwminorityunceduinstitute2002agendahtm) clearlyconveyed the message of disparitiesFor example in his opening talk

ldquoRacial and Ethnic Disparities in Health An Overview of National Data and NIH Future Directions inBehavioral and Social Causal Factorsrdquo Raynard Kington National Institutes of Health (NIH) demonstrated thatin spite of the great improvements in the health of the American people over the past hundred years there remainpersistent and large differences in health status acrossracial and ethnic populations National trends show thatcompared with all other groups Black populationdifferentials persist in key measures of life expectancyat birth infant mortality coronary heart disease andage-adjusted death rates Additionally infant mortalityrates when controlling for education of mother arehighest for black females even when comparing mosteducated black females with the least educated of othergroups

The picture is as bleak in other areas Kington reported Black and Hispanic populations have highestpercentages of related children below 150 percent of poverty the percentage of Black male smokers is highest and

ldquoHealth care disparity is the most significantCivil Rights issue America must facerdquo Joseph LGraves Jr Professor of Evolutionary Biology ArizonaState University West 8th Annual Summer Public

Percent of households that are headed by femalesUnited States and Region IV States by race 2000

BlackAfrican AmericanTotal population

United S

Region

Kentuck

Mississip

North Caro

South C

arolina

Tennes

Alabam

Georgia

Source Census 2000 Summary File 1 US Bureau of the Census

No spouse present

respondent-assessed health status is highest in the categories of ldquofairrdquo or ldquopoorrdquo among Blacks Among those withouthealth insurance under age 65 Hispanics and Blacks are the most vulnerable reaching 35 and 20 percent respectivelyAlthough rates of health insurance coverage for their children are better the differentials still persist and are a majorissue

Minority disparities exist for other areas of public health care such as differentials in diagnostic tests therapeuticand specialty care referrals routine medical procedures and other treatments The issue of environmentaldiscrimination was raised in that the percentof population living in EPA non-attainment airquality counties was highest for Hispanicsand Blacks respectively Obesity whileprevalent among all groups is especially highamong Mexican Americans and Blacks ForBlacks risk factors have been identifiedwhich help explain about 13rd of thedifference with other groups includingsmoking systolic blood pressure diabetescholesterol body mass alcohol familyincome and education Much work remainsto be done here

There exist less visible dimensions ofdisparity Readers will recall the recentHarvard University study (JAMA March 132002) on racial disparities on quality of careBlack Medicare HMO patients were foundto receive lower quality medical care thantheir white counterparts The most striking difference was found in psychiatric care though blacks also received poorer

diabetes-related eye care fewer beta-blockersand a lower rate of breast cancer screeningAnd the list goes on

Other presentations in the 8th AnnualSummer Public Health Research Institute andVideoconference on Minority Healthaddressed a variety of related issues ofdisparity These included SES EthnicityCulture Toward Understanding theSources Of Disparity in Academic andMental Health Outcomes Recentdevelopments in improving racial amp ethnicdata Perinatal Health Of MexicanAmericanLatino Women ImplicationsFor Research and Health ServiceDelivery Assessing the Health of AsianAmerican Youth A MultidisciplinaryApproach Tobacco Control in AmericanIndian communities and others

Percent of population below the federal poverty level United States and Region IV States by race 2000

United S

Region

Kentuck

Mississip

North Caro

South C

arolina

Tennes

seeAla

Florida

Georgia

Source Census 2000 Supplementary Survey US Bureau of the Census

Percents are based on income in the past 12 months

I = 90 confidence interval

Other important national forums and initiatives are occurring The Department of Health and Human Services(HHS) will host The Secretarys National Leadership Summit on Eliminating Racial and Ethnic Disparitiesin Health ldquoClosing the Health Gap Togetherrdquo July 10-12 2002 (see Section V this edition) The program includesa GIS workshop designed to convey the role of geospatial information and how these tools can be used to help reduceminority health disparities Other federal initiatives include HHSrsquo Eliminating Disparities Goal for Healthy People 2002National Goals and Objectives for Disease Prevention and Health Promotion National Academy of Science Study ofHHS Collection of Race and Ethnicity Data 2001-2003 NIH Research Plan to Eliminate Health Disparities and others

GIS tools have much to offer in the scientific study of disparity Georeferencing of disease events and humancondition has a rich history in geography epidemiology and related public health sciences We are not new to healthdisparity and inequity in disease etiologies environmental exposures access to care disease predisposition and relatedmeasures But several things are different than in the past One there is a growing urgency to recognize minority healthdisparities as a public health and national priority The data presented at these national forums on health disparity clearlyilluminate the persistent divide in our society on key conditions quality of care and other parameters of wellbeing Twowe now have more computing and supercomputing power to better study and analyze existing health disparities in timeand space Perhaps more than ever we are positioned as a scientific community to better decipher associations andoutcomes that drive these disparities of minority health GIS has a role to play and one possibly bigger than we everenvisioned We need to make minoritydisparities in public health a national GISpriority

The empowerment of minorityscientists to bring GIScience to bear uponthis effort is important Few programsnationally exist with this express purposeThere is one that merits our attention andcan serve as a role model for similarlycreative initiatives The 19th AnnualHBCU Summer Faculty GIS Workshopwill be held August 4-10 2002 It will becoordinated by the Howard UniversityContinuing Education Urban EnvironmentInstitute (see program at wwwcon-edhowardedu) and hosted by theWashington GIS Consortium at theNational Capital Planning Commission(wwwncpcgov) in Washington DCSince its beginnings in 1983 this workshop has trained many faculty at many of our Historically Black Collegesand Universities Their accomplishments using GIS technology with their students and in their communities attests tothe success of this effort (see Special Report Public Health GIS News and Information (44) JAN 2002) Agenciesare especially welcome to help sponsor and assure the continuation and excellence of this program (see p 6 this report)

Addressing minority disparities in public health is a shared responsibility of all scientists We can make it adefining moment for GIS in public health [Appreciation is extended to Richard J Klein Lead Statistician Healthy People 2010Office of Analysis Epidemiology and Health Promotion NCHS for graphics in this section]

Recipient of the ldquo2002 NCHS Directors Award for Equal Employment Opportunityand Civil Rights Program Activitiesrdquo

Charles M Croner PhD Editor Public Health GIS News and Information Office of Research and MethodologyNational Center for Health Statistics at cmc2cdcgov While this report is in the public domain the content should notbe altered or changed This is the 47th edition with continuous reporting since 1994

Our GIS home page contains current GIS events archived reports and other links httpwwwcdcgovnchsgishtm

I Public Health GIS (and related) Events

II GIS News

A General News and Training Opportunities

B Department of Health and Human Services

C Historically Black Colleges and Universities (HBCU) and Other Minority Program Activities

D Other Related Agency or Business GIS News

III GIS Outreach

IV Public Health GIS Presentations and Literature

CDC Emerging Infectious Diseases


Other Literature Special Reports



Titles

V Related Census HHS FGDC and Other Federal Developments

The Secretarys National Leadership Summit


Web Site(s) of Interest for this Edition

Final Thoughts Minority Health Disparities and GIScience