Spatial and Computational Spatial and Computational Models of Risks for Alcohol Models of Risks for Alcohol UsersUsers

Edward J. WegmanEdward J. WegmanUniversity of Cambridge and George Mason University of Cambridge and George Mason UniversityUniversity

Joint work with Yasmin H. Said and William F. Joint work with Yasmin H. Said and William F. WieczorekWieczorek

AgendaAgenda

Spatial Statistics and GISSpatial Statistics and GIS Risk Factors and Social IndicatorsRisk Factors and Social Indicators Erie County, New York Risk Erie County, New York Risk

FactorsFactors Multivariate VisualizationMultivariate Visualization Spatial Analysis using CCMapsSpatial Analysis using CCMaps

Spatial Statistics and GISSpatial Statistics and GIS

Statistical methods are often used in health Statistical methods are often used in health studies including alcohol studies in order to studies including alcohol studies in order to confirm hypotheses about health risks. confirm hypotheses about health risks.

These relatively elementary techniques do not These relatively elementary techniques do not exploit the broader newer methods of exploit the broader newer methods of multivariate data visualization and spatial multivariate data visualization and spatial statistics. statistics.

The ability to manipulate multivariate spatial The ability to manipulate multivariate spatial data offers the possibility of extracting data offers the possibility of extracting additional meaning and suggests not only the additional meaning and suggests not only the possibility of a confirmatory role for statistical possibility of a confirmatory role for statistical methods, but also an exploratory role. methods, but also an exploratory role.

Spatial Statistics and GISSpatial Statistics and GIS

Statistical spatial analysis often begins with Statistical spatial analysis often begins with spatial analysis using a geographic spatial analysis using a geographic information systems (GIS). information systems (GIS).

Such systems allow the analysis of distance Such systems allow the analysis of distance and connectivity including: and connectivity including: – The measures of distances between points and The measures of distances between points and

between points and centroids, analysis of between points and centroids, analysis of adjacency, analysis of networks including roads adjacency, analysis of networks including roads and other transportation systems, and analysis of and other transportation systems, and analysis of buffer areas between otherwise adjacent areas. buffer areas between otherwise adjacent areas.

– Spatial analysis of this sort can give insight into Spatial analysis of this sort can give insight into effective distances which may be substantially effective distances which may be substantially different from apparent Euclidean distances. different from apparent Euclidean distances.

Spatial Analysis and GISSpatial Analysis and GIS

Spatial dependencies define the relationships Spatial dependencies define the relationships among spatially diverse entities, including non-among spatially diverse entities, including non-random patterns in geographic space, clusters, random patterns in geographic space, clusters, dispersion, and spatial autocorrelation. dispersion, and spatial autocorrelation.

Spatial factors are integral to the development of Spatial factors are integral to the development of alcohol simulation models such as those alcohol simulation models such as those presented in the previous talk by Dr. Said. presented in the previous talk by Dr. Said.

Spatial analysis contributes to hypothesis Spatial analysis contributes to hypothesis generation, spatial epidemiology, generation, spatial epidemiology, multi-level/multi-resolution modeling, spatial multi-level/multi-resolution modeling, spatial interaction and travel models, and understanding interaction and travel models, and understanding spatial processes in small areas. spatial processes in small areas.

The latter capability allows the development and The latter capability allows the development and testing of psychosocial models, especially with testing of psychosocial models, especially with respect to spatial interactions among alcohol and respect to spatial interactions among alcohol and drug users. drug users.

Risk Factors and Social Risk Factors and Social IndicatorsIndicators Traditionally, health studies, including alcohol Traditionally, health studies, including alcohol

studies, collect data by surveys which provide studies, collect data by surveys which provide data at the individual level. data at the individual level.

It is not always possible to collect data at the It is not always possible to collect data at the individual level because of cost, privacy, or lack individual level because of cost, privacy, or lack of resources. of resources.

In many situations it is impractical or impossible In many situations it is impractical or impossible to measure a specific outcome such as early to measure a specific outcome such as early drinking, adolescent drug use, or alcohol drinking, adolescent drug use, or alcohol dependence. dependence.

In contrast, information may be easily available In contrast, information may be easily available on factors associated with these phenomena on factors associated with these phenomena such as poverty, immigration status, language such as poverty, immigration status, language facility, and alcohol availability.facility, and alcohol availability.

Risk Factors and Social Risk Factors and Social IndicatorsIndicators Social indicators are numerical data, usually Social indicators are numerical data, usually

archival in nature, that measure the well-being of archival in nature, that measure the well-being of a population. a population.

There are frequently issues of data quality There are frequently issues of data quality including reliability and validity.including reliability and validity. – Is the indicator a stable measure? Is the indicator a stable measure? – Is the indicator actually related to the phenomenon Is the indicator actually related to the phenomenon

of interest?of interest? The advantage of using social indicator data The advantage of using social indicator data

include:include: – The use of substantial amounts of administratively The use of substantial amounts of administratively

available data, available data, – The ability to make data-driven decisions on topics The ability to make data-driven decisions on topics

that are impractical to measure directly, that are impractical to measure directly, – The fact that specific indicators have conceptual and The fact that specific indicators have conceptual and

evidential relationship to difficult to measure evidential relationship to difficult to measure outcomes.outcomes.

Risk Factors and Social Risk Factors and Social IndicatorsIndicators

Disadvantages of using social indicator data Disadvantages of using social indicator data include: include: – The fact that data are collected for purposes other The fact that data are collected for purposes other

than their use as indicator, hence, may not have than their use as indicator, hence, may not have statistical validity, statistical validity,

– That there are few direct indicators (relationships That there are few direct indicators (relationships of indicator to outcome are indirect), of indicator to outcome are indirect),

– That are few indicators at local geographic level That are few indicators at local geographic level (postal code or census tract, most are at county, (postal code or census tract, most are at county, state, or national levels), and state, or national levels), and

– That there are a huge number of indicators from That there are a huge number of indicators from which to select many of which may be overlapping which to select many of which may be overlapping and collinear. and collinear.

Risk Factors and Social Risk Factors and Social IndicatorsIndicators

Social indicators provide an indirect Social indicators provide an indirect method of needs assessment for public method of needs assessment for public health services. health services.

They show relative need for services They show relative need for services and may be used to estimate actual and may be used to estimate actual need for services in some situations. need for services in some situations.

In addition coupled with demographic In addition coupled with demographic information, social indicator analysis information, social indicator analysis allows for tailoring services to allows for tailoring services to population characteristics. population characteristics.

Risk Factors and Social Risk Factors and Social IndicatorsIndicators Indicators can fall into a number of categories Indicators can fall into a number of categories

including neighborhood indicators, family indicators, including neighborhood indicators, family indicators, and individual indicators. and individual indicators.

Neighborhood indicators would include:Neighborhood indicators would include:– Availability of drugs and firearms, community attitudes Availability of drugs and firearms, community attitudes

toward laws and social norms, attitudes favorable to toward laws and social norms, attitudes favorable to drug use, firearms and crime, state of transition and drug use, firearms and crime, state of transition and mobility within the neighborhood, levels of neighborhood mobility within the neighborhood, levels of neighborhood attachment, and community disorganization. attachment, and community disorganization.

Family-level indicators include: Family-level indicators include: – Extreme economic privation, family history of problem Extreme economic privation, family history of problem

behaviors, family management problems, family conflict, behaviors, family management problems, family conflict, and lack of commitment to schools. and lack of commitment to schools.

Individual indicators include: Individual indicators include: – Alienation and rebelliousness, early academic failure, Alienation and rebelliousness, early academic failure,

substance abuse, delinquency, lack of parental substance abuse, delinquency, lack of parental involvement in problem behaviors, and teen pregnancy. involvement in problem behaviors, and teen pregnancy.

Erie County Risk Indicators Erie County Risk Indicators

Wieczorek and Delmerico (2005) assembled a Wieczorek and Delmerico (2005) assembled a database of risk indicators for Erie County, NY database of risk indicators for Erie County, NY using several sources. using several sources.

Erie County includes the city of Buffalo, New Erie County includes the city of Buffalo, New York. This database provides a data-rich York. This database provides a data-rich snapshot of a relatively small county-level snapshot of a relatively small county-level geographic area. geographic area. – The sources include U.S. Census 2000, New York State The sources include U.S. Census 2000, New York State

Education Department, New York state Department of Education Department, New York state Department of Criminal Justice Services. Criminal Justice Services.

– At the local level, sources include the Center for Health At the local level, sources include the Center for Health and social Research, City of Buffalo Police Department, and social Research, City of Buffalo Police Department, Erie County Board of elections, Erie County Erie County Board of elections, Erie County Department of Health, Erie County Department of Department of Health, Erie County Department of Mental Health, and the Roswell Park Cancer Institute.Mental Health, and the Roswell Park Cancer Institute.

Erie County Risk IndicatorsErie County Risk Indicators

Because all indicators are essentially ratios of the Because all indicators are essentially ratios of the form cases/population (expressed as percent or per form cases/population (expressed as percent or per 10,000), it is important to avoid unreliable indicator 10,000), it is important to avoid unreliable indicator values due to small populations. values due to small populations.

For this reason an arbitrary threshold of population For this reason an arbitrary threshold of population greater than 100 was set. Records for zip codes and greater than 100 was set. Records for zip codes and tracts with populations below 100 have been removed tracts with populations below 100 have been removed from the database. from the database.

Sometimes the source data for calculation of the Sometimes the source data for calculation of the indicators were available at a spatial level other than indicators were available at a spatial level other than census tract or zip code area. census tract or zip code area.

In these cases risk indicators were first calculated at In these cases risk indicators were first calculated at the available level, and then imputed to the zip level. the available level, and then imputed to the zip level. The imputation was performed using population-based The imputation was performed using population-based weighting method.weighting method.

Multivariate AnalysisMultivariate Analysis

Alcohol use and abuse can be thought of Alcohol use and abuse can be thought of in terms of both a cause and an effect. in terms of both a cause and an effect.

Alcohol use and abuse is a cause insofar Alcohol use and abuse is a cause insofar as it leads to as it leads to acute outcomesacute outcomes such as such as DWI/DUI, DWI with fatal crashes, assault, DWI/DUI, DWI with fatal crashes, assault, domestic violence, child abuse, sexual domestic violence, child abuse, sexual assault, murder, suicide as well as assault, murder, suicide as well as chronic outcomeschronic outcomes such as cirrhosis of such as cirrhosis of the liver and other alcohol induced the liver and other alcohol induced diseases.diseases.

Multivariate AnalysisMultivariate Analysis

Some social indicators for these Some social indicators for these outcomes from the Erie County Risk outcomes from the Erie County Risk Indicators Database include: Indicators Database include: – crm.dwi (DWI crime), crm.dwi (DWI crime), – de.traffic (fatal crash deaths), de.traffic (fatal crash deaths), – crm.viol (violent crime), crm.viol (violent crime), – de.trauma (trauma deaths), de.trauma (trauma deaths), – jar.viol (juvenile crime), jar.viol (juvenile crime), – crm.drug (drug-related crimes), crm.drug (drug-related crimes), – de.suicide (suicide deaths), and de.suicide (suicide deaths), and – de.cirrohsis (cirrhosis deaths). de.cirrohsis (cirrhosis deaths).

Multivariate AnalysisMultivariate Analysis

Conversely, alcohol use and abuse can Conversely, alcohol use and abuse can be thought of as being caused by be thought of as being caused by – poverty, poverty, – marital unhappiness, marital unhappiness, – poor education, poor education, – drug and alcohol availability, drug and alcohol availability, – neighborhood factors, neighborhood factors, – parental alcoholism, and parental alcoholism, and – ethnicity issues. ethnicity issues.

Multivariate AnalysisMultivariate Analysis

Some social indicators in the Erie County Risk Some social indicators in the Erie County Risk Indicators Database include: Indicators Database include: – fam.pov (family poverty), fam.pov (family poverty), – med.income (median income), med.income (median income), – unem (unemployment), unem (unemployment), – divorce (divorce rates), divorce (divorce rates), – nv.married (never married), nv.married (never married), – edu.g8 (education below 8th grade level), edu.g8 (education below 8th grade level), – edu.col.d (educated beyond college), edu.col.d (educated beyond college), – dropout (dropout rates), dropout (dropout rates), – alc.all (all alcohol outlets), alc.all (all alcohol outlets), – alc.off (off license outlets), alc.off (off license outlets), – tobacco (tobacco outlets), tobacco (tobacco outlets), – vacant (neighborhood vacancies), vacant (neighborhood vacancies), – vote.gen (general voting registrations) and vote.gen (general voting registrations) and – poor.eng (poor household English usage rates). poor.eng (poor household English usage rates).

Multivariate AnalysisMultivariate Analysis

An indicator of overall alcohol An indicator of overall alcohol problems for Erie County is the rate of problems for Erie County is the rate of admissions to treatment for alcoholism admissions to treatment for alcoholism and substance abuse. and substance abuse.

The appropriate indicator is The appropriate indicator is oasas.18ov, which is the rate per oasas.18ov, which is the rate per 10,000 by zip code for individuals over 10,000 by zip code for individuals over the age of 18.the age of 18.

Multivariate AnalysisMultivariate Analysis

Spatial Analysis Using Spatial Analysis Using CCMapsCCMaps

Spatial Analysis Using Spatial Analysis Using CCMapsCCMaps

Spatial Analysis Using Spatial Analysis Using CCMapsCCMaps

Spatial Analysis Using Spatial Analysis Using CCMapsCCMaps

Spatial Analysis Using Spatial Analysis Using CCMapsCCMaps

AcknowledgementsAcknowledgements

The work of Dr. Wegman is supported in part by the U.S. Army The work of Dr. Wegman is supported in part by the U.S. Army Research Office under contract W911NF-04-1-0447. Research Office under contract W911NF-04-1-0447.

The work of Dr. Said is supported in part by grant number The work of Dr. Said is supported in part by grant number F32AA015876 from the National Institute on Alcohol Abuse and F32AA015876 from the National Institute on Alcohol Abuse and Alcoholism. Alcoholism.

The work of Dr. Wieczorek is supported in part by grant number The work of Dr. Wieczorek is supported in part by grant number R01AA016161 from the National Institute on Alcohol Abuse and R01AA016161 from the National Institute on Alcohol Abuse and Alcoholism and by a contract from Western New York United Alcoholism and by a contract from Western New York United Against Alcohol and Drug Abuse/Erie County Department of Against Alcohol and Drug Abuse/Erie County Department of Mental Health. Mental Health.

The content is solely the responsibility of the authors and does The content is solely the responsibility of the authors and does not necessarily represent the official views of the National not necessarily represent the official views of the National Institute on Alcohol Abuse and Alcoholism or the National Institute on Alcohol Abuse and Alcoholism or the National Institutes of Health. Institutes of Health.

Drs. Wegman and Said were Visiting Fellows at the Isaac Newton Drs. Wegman and Said were Visiting Fellows at the Isaac Newton Institute for Mathematical Sciences at the University of Institute for Mathematical Sciences at the University of Cambridge in Cambridge, England. We are indebted for the Cambridge in Cambridge, England. We are indebted for the support provided by the Newton Institute, which has made the support provided by the Newton Institute, which has made the successful completion of this work possible.successful completion of this work possible.

Contact InformationContact Information

Edward J. WegmanEdward J. Wegman– ewegman@gmail.comewegman@gmail.com– (703) 993-1691(703) 993-1691

Yasmin H. SaidYasmin H. Said– ysaid99@hotmail.comysaid99@hotmail.com– (301) 538-7478(301) 538-7478

William F. WieczorekWilliam F. Wieczorek– wieczowf@buffalostate.eduwieczowf@buffalostate.edu– (716) 878-6137(716) 878-6137