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Objectives. Describe the main data sources available for health-related research in BrazilIntroduce basic demographic methodsDescribe spatial analytical approachesGIS, Remote Sensing, and Spatial Analysis. Questions for Discussion: Data Sources. What are the main data limitations for health-rel
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2. Objectives Describe the main data sources available for health-related research in Brazil
Introduce basic demographic methods
Describe spatial analytical approaches
GIS, Remote Sensing, and Spatial Analysis
3. Questions for Discussion:Data Sources What are the main data limitations for health-related analysis?
What would be needed to fill in the gap(s)?
How could available data be used for evidence-based planning of public health interventions?
4. Questions for Discussion:Data Analysis How would a demographic analysis improve understanding of the 5 diseases focused in this course?
How do the use of spatial tools in public health increase knowledge of disease dynamics?
Is there a balance between local x global analysis?
How can each approach inform policy makers?
Which is most appropriate to evaluate the progress toward achieving the MDG?
5. Data Sources Three types of data:
Events
Cases & deaths
Exposure (“denominators”)
Population
“Clues” on transmission mechanisms
Multidisciplinary: social, economic, demographic, behavior & individual perception/knowledge, ecological, political, biological
6. Data Sources What are we looking for?
Time
Space
Population groups
List of important sources available on the course website
7. Data Sources: Events Administrative data
Outpatient / Hospitalization
Reported cases
Active / Passive
Immunization
Deaths
Control activities
Survey-based data
8. Data Sources: Denominators Population counts
Census
Every 10 years
Civil register system
Under enumeration
Household surveys
Sample
Periodicity & Coverage
Projections
Uncertainty
9. Data Sources: Multidisciplinary Census & household surveys
Agriculture
Environment
Land cover, land change, land use
Climate
Soil, hydrology
Infrastructure
Urban planning & expansion
Social programs (“cash transfers”)
10. RIPSA - http://www.ripsa.org.br RIPSA – Inter-agency Network of Information for Health (Rede Interagencial de Informaçőes para a Saúde)
Joint initiative of the Ministry of Health and the Pan-American Health Organization (PAHO)
Annual publication of summary indicators (available on-line)
11. RIPSA On-line database: http://www.datasus.gov.br/idb
12. Demographic Methods Population (P) numbers can only change by
Births (B) Fertility
Deaths (D) Mortality
Movements in (I) / out (E) Migration
Balancing equation
Pt+1 = Pt + Bt – Dt +It – Et
13. Demographic MethodsMortality Key indicators:
Infant mortality
Child mortality
Life expectancy at birth
14. Demographic MethodsMortality Key tools:
Life tables
Total deaths
By cause of death
Simulated scenarios of cause elimination
Decompose differentials
Inequalities
Modeled mortality schedules
Standards – in the absence of good data
Indirect methods of estimation
15. Demographic MethodsFertility Key indicator: Total Fertility Rate
16. Demographic MethodsFertility Key indicator:
Net Reproduction Rate
Key tools:
Modeled fertility schedules
Standards – in the absence of good data
Indirect methods of estimation
17. Demographic MethodsMigration Migratory flow
Direction
Intensity
Characteristics
Interactive flow mapping
18. Demographic MethodsAge and sex structure
19. Demographic MethodsProjections Projecting “denominators”
Use 3 population components
Assumptions about future patterns
Uncertainty
20. Spatial Tools Visualization
Exploration
Modeling
21. Framework for Spatial Data Analysis spatial analysis essential component of epidemiological analysis:
visualization -> extremely effective for analysis and presentation
exploration -> cluster detection methods (beware of type I error)
modelling -> Bayesian modelling and decision analysis techniquesspatial analysis essential component of epidemiological analysis:
visualization -> extremely effective for analysis and presentation
exploration -> cluster detection methods (beware of type I error)
modelling -> Bayesian modelling and decision analysis techniques
25. Visualization: incidence ratesDengue – Rio de Janeiro
26. Visualization: prevalence rates
29. Patterns? Virgin Mary in a pancake Mermaid in clouds
31. Modeling: predictive model
32. Modeling: spatial diffusion
35. References Anselin, L. 2006. How (Not) to Lie with Spatial Statistics. American Journal of Preventive Medicine 30(2): S3-S6.
Brownstein, J.S., C.A. Cassa, K.D. Mandl. 2006. No place to hide: Re-identifying patients from published maps. New England Journal of Medicine 355(16):1741-2.
Kenneth Hill, Alan D Lopez, Kenji Shibuya, Prabhat Jha, on behalf of the Monitoring of Vital Events (MoVE) writing group. 2007. Interim measures for meeting needs for health sector data: births, deaths, and causes of death. The Lancet 370(9600): 1726-1735.
Werneck, GL et al. 2002. The urban spread of visceral leishmaniasis: clues from spatial analysis. Epidemiology 13(3):364-367.
36. Questions for Discussion:Data Sources What are the main data limitations for health-related analysis?
What would be needed to fill in the gap(s)?
How could available data be used for evidence-based planning of public health interventions?
37. Questions for Discussion:Data Analysis How would a demographic analysis improve understanding of the 5 diseases focused in this course?
How do the use of spatial tools in public health improve the understanding of disease dynamics?
Is there a balance between local x global analysis?
How can each approach inform policy makers?
Which is most appropriate to evaluate the progress toward achieving the MDG?