States Use Data Visualization Tools to Address Health Concerns

September 29, 2022 | Emma Talkington, Dan Tauriello, Emma Carlson

Geographic Information Systems (GIS) and other data visualization tools have become integral parts of public health decision-making workflows and provide crucial support to topic areas such as environmental health, the COVID-19 pandemic response, and chronic disease investigation and prevention. GIS can visualize almost any data with a location component. When thinking specifically about environmental health, this flexibility allows for more efficient locating and tailoring of responses to both short- and long-term environmental hazards.

Since the start of the COVID-19 pandemic, the utility of these tools has been even further recognized and leveraged by public health agencies around the nation. Geospatial services and data have also been “democratized” and brought into the public eye through websites and applications that are freely available and make use of data from new sources and partnerships. This newfound visibility of GIS underscores a need for improved geospatial infrastructure and staff expertise.

In 2021, ASTHO began convening a group of GIS professionals in state and territorial health agencies (S/THAs) to discuss innovative applications of GIS technology to their work. This GIS Innovations Community of Practice (GIS CoP) works to build a collective evidence base for GIS and geospatial technology use in public and environmental health practice. By discussing challenges, sharing promising practices, and gaining a greater understanding of these technologies, the GIS CoP supports S/THA GIS professionals as they leverage these tools for mapping, surveillance, health communication, and decision-making, with a specific focus on environmental health applications.

Health Agencies Utilize GIS to Improve Public Health

Many states utilize GIS tools to create interactive maps and platforms to raise awareness about specific public health issues and connect communities with resources and information.

The Montana Department of Public Health and Human Services (MT DPHHS) houses several interactive maps and story maps on their website, which provide information on relevant public health issues and available resources to help address those issues. Story maps are tools for effectively housing multiple maps and including context and rationale for the data used to build the maps. MT DPHHS’s Joy in Healthy Living story map provides “easy access to healthy lifestyle strategies for youth and adults.”

The Arizona Department of Health Services (ADHS) regularly uses GIS tools to gather information from providers about where the public can find COVID-19 testing and vaccination sites. Using these data, ADHS developed two maps to help the public find COVID-19 testing and vaccine sites.

GIS tools can also help S/THAs take targeted action to protect against environmental health threats. In 2019 and 2020, there were regional outbreaks of Eastern equine encephalitis (EEE), a rare mosquito-borne disease, in Indiana. During these outbreaks, the Indiana Department of Health (IDOH) utilized GIS tools to help guide response efforts. CDC reports that EEE infections are uncommon, with only a small number of cases reported yearly in the United States.

IDOH mapped EEE cases in humans, horses, and mosquitoes using GIS tools, which helped to identify the location of mosquitoes carrying the virus. In conversation with ASTHO, IDOH shared that it treated suspected high-risk areas with aerial application of pesticides, while avoiding “areas where pesticide application was undesirable, such as USDA-certified organic farms.” Following these targeted spraying efforts, Indiana has not identified new EEE infections.

The Connecticut Department of Public Health’s Childhood Lead Poisoning Prevention Program (CT CLPPP) uses GIS tools to assist with the identification, surveillance, and prevention of lead poisoning in children. The program also uses GIS tools to help prioritize the replacement of lead service lines, which, according to EPA, can be an important contributor to lead in drinking water.

In both instances, CT CLPPP uses the Social Vulnerability Index, a tool created by CDC and the Agency for Toxic Substances and Disease Registry, to target lead poisoning prevention efforts for those communities in most need. In the future, the program hopes to automate geocoding of lead poisoning cases to provide real-time situational awareness to agency management and supplement local health departments’ awareness of new cases and potential exposure sources (e.g., lead-based paint, drinking water).

Engaging Leadership and Staff to Promote the Use of GIS Tools

When developing and utilizing GIS tools, it is important to engage leadership who can help ensure continued implementation of these tools and promote them more widely. Other staff who may not be aware of the power and utility of GIS, both within and outside the health agency, are also important to engage. S/THA staff from ADHS, CT CLPPP, IDOH, and MT DPHHS shared best practices based on their own experiences of working with their leadership, as well as other colleagues in the health department, to develop GIS tools and advocate for their use to aid in public health decision-making.

	Arizona	Apply spatial thinking to problems, which helps demonstrate the utility of GIS tools to leadership. Many programs still use spreadsheets, but ADHS is working on showing the power of visualizing data using maps. Operations dashboards have been a favorite with ADHS’s leadership because of their interactivity and ability to quickly filter data to get answers. Additionally, ADHS moved away from PDF maps to quickly publishing interactive maps during the COVID-19 pandemic. It amazed leadership how quick and easy it was to develop a map and app they could share with partners and stakeholders.
	Connecticut	Create basic reference data sets to use in various projects and initiatives. CT CLPPP created a repository of useful Connecticut-focused datasets, including basic datasets on roads, housing, poverty, and other topics, to help inform various environmental health branch programs and potentially other health agency activities and interventions. Make educational materials available for health agency leadership and staff to explore. CT CLPPP saves reference information from various authoritative GIS-focused sources, including tutorials on regression and hot spot analyses, allowing staff to learn about the power of GIS on their own time.
	Indiana	Identify opportunities for leadership to communicate GIS-related successes. IDOH’s chief medical officer gave the keynote address at the state’s 2021 GIS Day on how GIS has helped decision-making during the pandemic response. Some of IDOH’s biggest projects have been developing public apps for finding testing, vaccination, and treatment sites; building the first version of the state’s case dashboard; real-time mapping of personal protective equipment deliveries; and using spatial case and vulnerability metrics to identify locations in greatest need of targeted response.
	Montana	Write GIS activities into new grant workplans. MT DPHHS writes GIS-related products and outcomes into several grant applications as activities to complete for surveillance, epidemiology, and communication. MT DPHHS also makes GIS a key aspect of their Data Modernization Initiative workplan, which is a key priority for health agency leadership and other stakeholders. Meet regularly with leadership about available GIS resources, promote the use of training dollars for GIS trainings, and advocate for adding dedicated GIS staff roles within the health agency. This has allowed for dedicated time to spend on GIS training as well as growing capabilities and analysis capacity. Regularly include the State GIS Coordinator (or a similar position) in meetings with leadership. MT DPHHS has found that having the State GIS Coordinator present at meetings allows them to advocate, from their perspective, on how the health agency could partner with other agencies via GIS, which includes efforts in data governance development and maintenance.

Looking Forward

ASTHO will continue to convene the GIS CoP to help S/THAs build capacity to apply GIS tools to public health practice. Looking forward, ASTHO hopes to recruit additional interested S/THA staff to the GIS CoP and continue highlighting innovative applications of GIS to public health decision-making and interventions.

Special thanks to the Arizona Department of Health Services, the Connecticut Department of Public Health, the Indiana Department of Health, and the Montana Department of Public Health and Human Services for providing input used in this blog post. Additionally, a special thanks to Nicholas Porter and Zeeshawn Chughtai for their support in developing this post.