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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 10595

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Dr. Jobst Augustin

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Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany
Interests: spatial analysis; health geography

Special Issue Information

Dear Colleagues,

John Snow's (1813–1858) mapping of the occurrence of cholera in London in 1854 demonstrated the importance of a spatial view on health, having not lost its relevance to this day. However, regional inequalities in morbidity or mortality are still present, in some cases more topical than ever, and of great importance to public health. One example is the spatial dynamic of the COVID-19 pandemic, which, due to its high spatio-temporal dynamics, also required region-specific containment measures. However, existing local socioeconomic inequalities closely related to the regional health status of the population are also relevant for the implementation of public health preventive measures. The spatial analysis of morbidity and mortality requires the application of complex analytical methods; however, not only are the methods of analysis important, but also the communication of the results to the public or decision makers, mostly in the form of maps. For this Special Issue, contributions regarding the topic of public health, mapping and spatial analysis are solicited. Contributions combining a high academic level with a practical focus on spatial analysis and health mapping for the public health sector are desirable. Potential topics include, but are not limited to, the spatial aspects of public health, geostatistical methods for public health, geographic analysis of health inequalities, application of geographic information systems in public health, health mapping, visualization of health data, spatio-temporal aspects of COVID-19, and their relevance to public health.

Dr. Jobst Augustin
Guest Editor

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Keywords

health geography
inequalities
mapping
spatial statistics
geodata

Published Papers (6 papers)

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Research

14 pages, 1554 KiB

Open AccessArticle

Integrating Environmental Data with Medical Data in a Records-Linkage System to Explore Groundwater Nitrogen Levels and Child Health Outcomes

by Christine M. Prissel, Brandon R. Grossardt, Gregory S. Klinger, Jennifer L. St. Sauver and Walter A. Rocca

Int. J. Environ. Res. Public Health 2023, 20(6), 5116; https://doi.org/10.3390/ijerph20065116 - 14 Mar 2023

Viewed by 1473

Abstract

Background: The Rochester Epidemiology Project (REP) medical records-linkage system offers a unique opportunity to integrate medical and residency data with existing environmental data, to estimate individual-level exposures. Our primary aim was to provide an archetype of this integration. Our secondary aim was to explore the association between groundwater inorganic nitrogen concentration and adverse child and adolescent health outcomes. Methods: We conducted a nested case-control study in children, aged seven to eighteen, from six counties of southeastern Minnesota. Groundwater inorganic nitrogen concentration data were interpolated, to estimate exposure across our study region. Residency data were then overlaid, to estimate individual-level exposure for our entire study population (n = 29,270). Clinical classification software sets of diagnostic codes were used to determine the presence of 21 clinical conditions. Regression models were adjusted for age, sex, race, and rurality. Results: The analyses support further investigation of associations between nitrogen concentration and chronic obstructive pulmonary disease and bronchiectasis (OR: 2.38, CI: 1.64–3.46) among boys and girls, thyroid disorders (OR: 1.44, CI: 1.05–1.99) and suicide and intentional self-inflicted injury (OR: 1.37, CI: >1.00–1.87) among girls, and attention deficit conduct and disruptive behavior disorders (OR: 1.34, CI: 1.24–1.46) among boys. Conclusions: Investigators with environmental health research questions should leverage the well-enumerated population and residency data in the REP. Full article

(This article belongs to the Special Issue Public Health, Mapping and Spatial Analysis)

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10 pages, 653 KiB

Open AccessArticle

Spatial Distribution of COVID-19 Hospitalizations and Associated Risk Factors in Health Insurance Data Using Bayesian Spatial Modelling

by Boris Kauhl, Jörg König and Sandra Wolf

Int. J. Environ. Res. Public Health 2023, 20(5), 4375; https://doi.org/10.3390/ijerph20054375 - 28 Feb 2023

Cited by 1 | Viewed by 1513

Abstract

The onset of COVID-19 across the world has elevated interest in geographic information systems (GIS) for pandemic management. In Germany, however, most spatial analyses remain at the relatively coarse level of counties. In this study, we explored the spatial distribution of COVID-19 hospitalizations in health insurance data of the AOK Nordost health insurance. Additionally, we explored sociodemographic and pre-existing medical conditions associated with hospitalizations for COVID-19. Our results clearly show strong spatial dynamics of COVID-19 hospitalizations. The main risk factors for hospitalization were male sex, being unemployed, foreign citizenship, and living in a nursing home. The main pre-existing diseases associated with hospitalization were certain infectious and parasitic diseases, diseases of the blood and blood-forming organs, endocrine, nutritional and metabolic diseases, diseases of the nervous system, diseases of the circulatory system, diseases of the respiratory system, diseases of the genitourinary and symptoms, and signs and findings not classified elsewhere. Full article

(This article belongs to the Special Issue Public Health, Mapping and Spatial Analysis)

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21 pages, 2254 KiB

Open AccessArticle

Spatial Accessibility of Primary Care in the Dual Public–Private Health System in Rural Areas, Malaysia

by Jabrullah Ab Hamid, Muhamad Hanafiah Juni, Rosliza Abdul Manaf, Sharifah Norkhadijah Syed Ismail and Poh Ying Lim

Int. J. Environ. Res. Public Health 2023, 20(4), 3147; https://doi.org/10.3390/ijerph20043147 - 10 Feb 2023

Cited by 2 | Viewed by 2228

Abstract

Disparities in access to health services in rural areas represent a global health issue. Various external factors contribute to these disparities and each root requires specific remedial action to alleviate the issue. This study elucidates an approach to assessing the spatial accessibility of primary care, considering Malaysia’s dual public–private system specifically in rural areas, and identifies its associated ecological factors. Spatial accessibility was calculated using the Enhance 2-Step Floating Catchment Area (E2SFCA) method, modified as per local context. Data were secondary sourced from Population and Housing Census data and administrative datasets pertaining to health facilities and road network. The spatial pattern of the E2SFCA scores were depicted using Hot spot Analysis. Hierarchical multiple linear regression and geographical weight regression were performed to identify factors that affect E2SFCA scores. Hot spot areas revolved near the urban agglomeration, largely contributed by the private sector. Distance to urban areas, road density, population density dependency ratios and ethnic composition were among the associated factors. Accurate conceptualization and comprehensive assessment of accessibility are crucial for evidence-based decision making by the policymakers and health authorities in identifying areas that need attention for a more specific and localized planning and development. Full article

(This article belongs to the Special Issue Public Health, Mapping and Spatial Analysis)

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11 pages, 851 KiB

Open AccessArticle

Population-Based, Spatial Analysis of Specialised Ambulatory Palliative Care in Mecklenburg-Western Pomerania, Germany, on the Basis of Reimbursement Data

by Maren Leiz, Kilson Moon, Laura Kerstin Rehner, Ulrike Stentzel, Franziska Radicke, Wolfgang Hoffmann and Neeltje van den Berg

Int. J. Environ. Res. Public Health 2023, 20(3), 2231; https://doi.org/10.3390/ijerph20032231 - 26 Jan 2023

Viewed by 1091

Abstract

In rural areas, healthcare providers, patients and relatives have to cover long distances. For specialised ambulatory palliative care (SAPV), a supply radius of max. 30 km is recommended. The aim of this study was to analyse whether there are regional disparities in the supply of SAPV and whether it is associated with the distance between the SAPV team’s site and the patient’s location. Therefore, anonymised data of the Association of Statutory Health Insurance Physicians of the Federal State of Mecklenburg-Western Pomerania (M-V) were retrospectively analysed for the period of 2014–2017. Identification as a palliative patient was based on palliative-specific items from the ambulatory reimbursement catalogue. In total, 6940 SAPV patients were identified; thereof, 48.9% female. The mean age was 73.3 years. For 28.3% of the identified SAPV patients (n = 1961), the SAPV teams had a travel distance of >30 km. With increasing distance, the average number of treatment days per patient increased. It was found that there are regional disparities in the provision of SAPV services in M-V and that local structures have an important impact on regional supply patterns. The distance between the SAPV team’s site and the patient’s location is not the only determining factor; other causes must be considered. Full article

(This article belongs to the Special Issue Public Health, Mapping and Spatial Analysis)

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10 pages, 723 KiB

Open AccessArticle

Contamination Landscapes: Spatio-Temporal Record and Analysis of Pathogens in Clinical Settings

by Christoph Höser and Thomas Kistemann

Int. J. Environ. Res. Public Health 2023, 20(3), 1809; https://doi.org/10.3390/ijerph20031809 - 18 Jan 2023

Viewed by 877

Abstract

Nosocomial outbreaks require quick epidemiological clarification of possible chains of infection, since the pathogen usually has a head start that has to be caught up. Identification of people and areas at risk is crucial for efficient confinement. This paper describes a concept which can be applied to healthcare settings. The application skips the time-consuming and imperfect reconstruction of direct and indirect contacts. Indoor mobility of people and devices are instead measured precisely, and the mobility history is used to construct a spatio-temporal ‘landscape of infection’. This landscape allows for the calculation of a modelled ‘contamination landscape’ (CL) adding location-based prolongation of infectivity. In that way, the risk per person can be derived in case of an outbreak. The CL concept is extremely flexible and can be adapted to various pathogen-specific settings. The combination of advanced measurements and specific modelling results in an instant list of possible recipients who need to be examined directly. The modelled, pathogen-specific parameters can be adjusted to get as close as possible to the results of mass screenings. Full article

(This article belongs to the Special Issue Public Health, Mapping and Spatial Analysis)

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13 pages, 1041 KiB

Open AccessArticle

Associations between a Subjective Living Environment and Quality of Life among People with Arterial Hypertension—Results from the Hamburg City Health Study

by Jobst Augustin, Ramona Bei der Kellen, Christian-Alexander Behrendt, Christina Magnussen, Claudia Terschüren, Leonie Ascone, Simone Kühn, Sandra Wolf, Matthias Augustin and Valerie Andrees

Int. J. Environ. Res. Public Health 2023, 20(1), 180; https://doi.org/10.3390/ijerph20010180 - 22 Dec 2022

Cited by 1 | Viewed by 2068

Abstract

Hypertension is a global public health concern and an important contributor to cardiovascular disease. It remains disputed how important life circumstances are for the etiology of hypertension. Thus, the aim of this study is to assess the spatial variation of hypertension within an urban population and to investigate the association with the quality of life of city dwellers and their subjective evaluation of their residential district, as well as their home environment, using the example of Hamburg, Germany. In this cross-sectional study, the first 10,000 participants from the Hamburg City Health Study (HCHS) were analysed. Only participants who had resided at the current address for a minimum of five years were considered. In the descriptive analysis, participants with and without arterial hypertension were compared considering various parameters. The subjective quality of the living environment was obtained using an appropriate subjective living environment index. Quality of life was mapped using the EuroQol Group quality of life questionnaire (EQ-5D) score and the two (mental and physical health) scores of the Short Form Health Questionnaire SF-8. The Gini-coefficient was used to quantify the regional economic variation within Hamburg. Linear and logistic regression analyses were performed. Regional levels were 68 city district clusters in Hamburg. The analysis included n = 8192 participants living at least five years in Hamburg at the time of participation in the HCHS. There was a spatial variation in the prevalence of arterial hypertension within Hamburg. Prevalence rates between city district clusters ranged from 50.0% to 88.5%. The results showed that city district clusters with a worse subjective perception of the living environment were partly associated with an increased prevalence of arterial hypertension. Furthermore, a negative association was observed between arterial hypertension prevalence and the sociodemographic status of participants in the city district clusters. Thus, participants with a high level of education suffered less frequently from arterial hypertension than participants with a rather low level of education. The subjective living environment index and quality of life were significantly related to the occurrence of arterial hypertension; however, more extensive and detailed studies are necessary to derive possible clinical implications. Full article

(This article belongs to the Special Issue Public Health, Mapping and Spatial Analysis)

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