Introduction: geospatial health research and GIS

Abstract

While epidemiologists, medical geographers and publichealth practitioners have known for long that humanhealth is not only about the individual body but shouldalso be understood at the population level within particulargeographic contexts, contemporary environmental andsocioeconomic concerns (particularly global environmen-tal change and globalization) have brought unprecedentedattention to the connection between human health andfactors at the landscape and even the global levels. As aresult, in the past two decades, studies of human healthfrom geographic perspectives and research on applyinggeospatial analyses to health problems have experiencedtremendous development (in this essay, we use geospatialhealth research as a general term to refer to this kind ofresearch) (e.g., Gatrell and Elliott 2009; Pearce and Witten2010; Cromley and McLafferty 2011;Kwan2013).Recent landmarks of this development include the positionpaper by Richardson et al. (2013)inScience, articulationof the uncertain geographic context problem (Kwan2012a, 2012b) and the ongoing Spatial UncertaintyProgram launched by the US National Institutes ofHealth (NIH) in 2011.This special issue is a collection of papers contributedby some attendees of a high-level international workshopentitled ‘Fostering International Geospatial HealthResearch Collaborations: Challenges and Opportunities.’The workshop was held at the Chinese University of HongKong (CUHK) during 16–18 June 2014. The organizersincluded the International Association of ChineseProfessionals in Geographic Information Sciences(CPGIS), the Association of American Geographers(AAG), the CUHK, the University of Hong Kong andthe Hong Kong Polytechnic University (HKPU).The overarching goal of the workshop is to provide areview/overview of recent developments in geospatialhealth research and its future directions, as well as to fosterinternational collaboration. During the period of 3 days,scholars from universities, research institutes, governmentalagencies and nongovernmental organizations in NorthAmerica, Europe and Asia gave about 20 invited presenta-tions and participated in an intensive open discussion meet-ing. The nine papers included in this special issue arerepresentative of some major discussions that took placein the workshops.From an application perspective, geospatial healthresearch can be generally classified into two broad areas:studies on disease and well-being of humans (includingphysical, mental, and behavioural aspects), which can begenerally referred to as spatial epidemiology; and studiesabout healthcare services (e.g., quality and access tohealthcare services). In spatial epidemiology, the focuscan be on environmental health (where the environmentcan be physical and socioeconomic) and infectious dis-eases. However, the boundaries between these divisionsare not clear-cut. Underlying these applications, there arealso infrastructure issues and some are fairly unique to thisarea (e.g., data policy problem). The nine papers includedin this special issue cover all these aspects.The first three articles concern foundational challengesin geospatial health research. Michael Goodchild discussesthe dichotomy of space and place and the importance ofthe latter in understanding human perceptions and beha-viours in the context of health research. He argues thatwhile GIS has been useful in health studies (e.g., inanalysing patterns of disease, in tracking human exposuresto the environment and in assessing spatial variations inhealth services and outcomes), its emphasis on spacemakes it difficult to understand human behaviours andperceptions. The paper emphasizes the need for a betterunderstanding of place and the need for a technology thatcan represent, acquire, store and share the rich informationabout place that humans possess.Accurate and precise location information is essentialto geospatial analysis. But making personal health dataavailable to researchers is a sensitive and challengingissue. It is often a significant bottleneck in geospatialhealth research, especially with regard to the replicabilityof research results and collaboration among researchers.