Waking up in the hospital after a heart attack, Bill Davenhall, a health-care manager with the geographic information systems software developer Esri, wondered whether the disease that nearly took his life might have been predicted by the pollution he’d been exposed to since birth.
He put his GIS skills to work, mapping his proximity to coal mining pollution growing up in Scranton, Pennsylvania. Then, he added the Midwestern industrial emissions and Los Angeles smog he breathed regularly in later years. When he cross-referenced those pollutants to their known health risks and mortality data, a connection to his heart troubles emerged.
Since then, he has traveled the globe speaking to audiences and advising governments on geo-medicine, an emerging field that uses GIS mapping to correlate environmental conditions to health risks like heart attacks and cancer. Geo-medicine can zoom in on a patient’s life to create a geographically enhanced medical history. Or it can zoom out to give public health officials, city planners and activists detail-rich insights on how to improve the well-being of entire communities.
"It all starts with geographic precision. In the past that had no value except to the billing office,” says Davenhall, whose company offers a free iPhone app to help people map their lifetime environmental exposures.
He's currently working with Loma Linda University Medical Center, 60 miles east of Los Angeles, to geo-code patient address records. “What we are trying to do is show how where you work and play impacts your health,” says Dora Barilla, an assistant professor at Loma Linda University's School of Public Health. She sees real-time address verification as a first step toward improving individual care and overall community health among the 4 million people the teaching hospital serves.
Some doctors are skeptical. They question the value of tracking pollutants that, say, cause lung cancer, when there is currently no preventative screening to catch cases before symptoms appear. Other critics expect it will lead to more lawsuits. Privacy concerns have also been raised.
"There's the stress factor. Do you really want to know?" asks Estella M. Geraghty, an assistant professor of clinical internal medicine at the University of California, Davis.
Geraghty is more interested in practical geo-medicine applications such as mapping a city's food deserts and its diabetes cases. She says some doctors are beginning to come around to the possibilities of GIS.
"Five years ago, most of my colleagues didn’t know what GIS was. Today they think it’s very interesting," though few, she says, are early adopters like herself. Geraghty has used geo-medical technology to study, among other things, the prevalence of diabetes in neighborhoods with few recreational spaces and healthy food options.
The implications for cities are numerous. Had he owned the app his company now gives away, Davenhall says he may have thought twice before accepting a job at his Redlands, California-based firm or arranged to telecommute from someplace where the air is cleaner. (An android version should be ready by year’s end, he says.) Regions with cleaner air could use geo-data to market themselves as good places to live and work, while "dirtier" metro areas may have a harder time attracting private investments and new residents.
Individualized "resource scores," like walkablity scores focused on health services, parks and supermarkets, could eventually migrate from the medical arena to home sales websites, possibly impacting real estate values, muses Davenhall, who says interest in geo-medicine has already "expanded wildly passed anything I had imagined," though there’s lots more work ahead.
"The next phase," he says, "is getting medical schools to teach the value of context."
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