What if there were a low-cost way for the public to provide accurate scientific data about what’s happening in their community regarding environmental health challenges?
There is, and NLM is helping to lead the way in this growing field.
“Through the Community Health Maps initiative, our goal is to help communities collect and visualize information to support planning and decision making,” said Colette Hochstein, DMD, MLS, of NLM’s Specialized Information Services.
Making Mapping Work
Here’s how two very different states with very different needs are beginning to take advantage of the tools Community Health Maps promotes.
Located between two large bodies of water, the Sunshine State is subject to more natural disasters than most states.
After a disaster, affected communities may need to deal with contaminated water, insect infestation, mold, and more.
When a community doesn’t have many resources, their concerns can be more acute. How can it focus on the most pressing public health needs?
Jan Booher has devoted her career to helping residents cope with environmental issues. “There’s a tremendous amount going on in terms of environmental health and data in Florida,” said Booher, director of the Unitarian Universalist Justice Florida’s Climate Resilience Ministry.
The issues vary.
“We address water quality concerns, flood safety, contaminated water, how to clean up after mold,” said Booher, “and then who do you call for various things like mosquitoes, insect infestation—how do you know what hurricane zone you’re in?”
Data can make a difference.
“In Florida, with the sea level rising, there is a need to share data to get a better picture of what is going on,” she explained, citing the fact that municipal and county governments are getting involved, along with private enterprise.
“We were able to get data about flooding and contaminated sites, about sewage system overflows, or what the storm water drainage system looks like, and the diameters of pipes to overlay what people are reporting,” she said. “People are reporting, for example, they have flooding that prevents them from going to work or prevents them from going to doctors’ appointments or about symptoms during or after flooding. We can overlay that data on where the septic tanks are located or on documented overflows from the sewage system and ask questions about if those are interacting.”
Working with Florida International University and Community Health Maps tools, she has been able to help citizens measure the depth of the water, its salinity, and the presence or absence of coliform bacteria and of E. coli.
“What was wonderful about the National Library of Medicine training was learning how to set up apps and train people how to collect the data,” said Booher. “People may not have graduated from high school, but they can participate.”
Teamwork makes it possible for any interested party to chip in.
“If someone can’t afford a phone, they can partner with someone with a smartphone,” she explained. “Those people did not necessarily do the mapping. What they did was collect data and even participate in deciding what questions were important to answer. So, we now have data sets from the community, collected by the community, which has not commonly been the case historically.”
Combining data sets gives a more complete story.
“Organizers are learning how to do the mapping from the data sets of what we found and combine it with other sets to make sense of what people were experiencing,” said Booher.
The results, she said, are “amazing.”
“Maps have a way of communicating in a dispassionate way that is fact-based,” Booher said.
Booher cites maps showing where mosquitos were found that resulted in a better mosquito spraying program.
“Data gives people a window into low-income communities that they wouldn’t otherwise have,” she said. “People have confidence in data and can use and share it—even people who cannot articulate information and advocate for themselves. This process can give people a voice.”
Booher summed up the work this way: “It’s a scientific project that people can understand.”
In one of the most densely populated states in the US, David Gregorio of the University of Connecticut School of Public Health is in the “very preliminary process” of working with NLM’s community mapping tools. Yet, he said, “They could be quite important to us.”
Energizing and Informing
NLM’s Specialized Information Services’ blog, Community Health Maps, shares best practices and support for people working on visualization and mapping.
The blog is a collaboration of the National Library of Medicine, the Center for Public Service Communications, and Bird’s Eye View. Everything on the site is in the public domain and free of charge for public health leaders to learn about free and low-cost community mapping tools that can be used by people who don’t necessarily have experience with visualization and mapping.
After hosting a Community Health Maps training program last fall at UConn, Gregorio, director of graduate programs and professor of community medicine and health at UConn, is in the “exploratory phase of feasibility” for two projects that will use Community Health Maps tools.
The first project involves youth in Hartford identifying “local environmental hazards in their neighborhoods—places where it stinks, looks bad, or where hazards are in the environment,” he said.
The second project involves the Sudanese community.
“A member of the Sudanese community is interested in using the technology to explore the acculturation of Sudanese immigrants to the Hartford area, looking at migratory patterns from work to home, from work to recreation, and things of that nature, to explore how acculturation expands their community from a localized, ethnically homogenous social space to a more heterogeneous one,” Gregorio said.
But getting the data might not be easy.
They need to establish credibility in the Sudanese community.
“There are concerns about individuals being tagged to locations that they may find troublesome,” he explained. “There is some anxiety about the locational identities of people.”
Gregorio understands this hesitation.
“For example, I can imagine there are places I go that I’m not interested in anyone else knowing. I could be shopping for my wife or playing hooky from work,” said Gregorio. “That’s the kind of conversations that we’re having at the moment. I think this is potentially low risk, but not risk-free. The use of social media is such that people tag where they are and what they’re doing constantly throughout the day, so it’s not a foreign feeling.”
Gregorio also acknowledges age-related differences for people sharing their locations. “It may be inconsequential to someone who’s 20, but for someone who’s 50, it may represent a concern. We’re in the course of discussing this and how to present this and where to engage people,” he said.
Gregorio is open to more ways of using Community Health Maps’ tools.
“For example, we could have people looking at erosion on our beaches or snowfall totals,” he said. “We could identify places that need attention, like whether or not local health departments can discern populations in need of emergency services, like the elderly or disabled, and where they’re likely to be at certain times of day.”
For Gregorio, mapping “relates to the ways people are using their lives.”
More about Mapping
“Community Health Maps tools can help facilitate better understanding and lead to social, health, and environmental change at the community level,” said Hochstein.
John Scott, an expert in disaster risk reduction and reducing health disparities and an NLM contractor, helped develop the NLM community health mapping system. He said, “It was obvious to me that mapping would be a great tool for underserved community-oriented environmental health advocacy groups and public health agencies. It could help them engage with community residents and empower them to collect, maintain, and visualize their own data, rather than relying solely on national or state agencies, or majority-institution partners to provide data to them.”