PUBH517/CPLN622 Geography & Public Health*
PUBH517/CPLN622
Spring 2010
Tuesdays 6-9pm
Arch Crest Room
(36th Street & Locust Walk)
Instructors:
Douglas Wiebe, PhD (Lead Instructor)
902 Blockley Hall, (215) 746-0149, dwiebe@exchange.upenn.edu
Charles Branas, PhD
936 Blockley Hall, (215) 573-5381, cbranas@upenn.edu
Amy Hillier, PhD
127 Meyerson Hall, (215) 746-2341, ahillier@design.upenn.edu
Office hours:
By appointment
_______________________________________________________________________________
COURSE OBJECTIVES
Geography and physical and social environments have profound effects on public health. Through
this class, students will gain a conceptual understanding of: (1) how geography and health are
related; (2) how the public health toolbox, including geographic information systems (GIS), can be
used to study the places people live, work, and play and how these places either add to or detract
from their health. This class will combine lectures and discussions of readings, presentations
demonstrating how geographic methods can be used to address public health issues, and handson computer or small group activities. Students will learn based on a multidisciplinary framework
that stresses the connections between various fields including public health, epidemiology,
medicine, city planning, and the social sciences.
COURSE REQUIREMENTS
Grades will be based on attendance and participation (15%), homework assignments (four
assignments of 10% each), mid-term exam (15%), and a final project and in-class presentation
(30%).
FINAL PROJECT
Working in teams of two or three, (if possible, pairing public health and MUSA/CPLN students),
conduct a GIS project linking health and the environment. Your project should include a clear
research question, data collection, and data analysis. Each project must involve data collection
and be focused on the implications of geography on health. Deliverables: teams will present their
project (background, methods, data analysis results, conclusions and implications) using
Powerpoint (and/or video) during an in-class presentation during the final two class sessions
(10% of grade), and will submit a written summary (one per team; between 3-5 pages; 20% of
grade). Teams and topics to be considered and decided upon over the first five class sessions.
ArcGIS SOFTWARE
Each student will be given a complimentary copy of ArcGIS software that can be installed on their
personal computer (PC-compatible only, not Mac). The software license is valid for one year.
* Syllabus subject to revision.
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COURSE SCHEDULE
CLASS 1 (1/19): Introduction to Geography and Public Health
Topics: logistics, schedule, assignments, grading guidelines, introduction lecture
Activity: Watch “Unnatural Causes: Is Inequality Making Us Sick? Part 5: Place Matters” (30 min)
Readings:
 Witold Rybczynski, “The Green Case for Cities,” The Atlantic Online, October 2009.
 Malcolm Gladwell, “Mosquito Killer,” The New Yorker, July 2, 2001.
CLASS 2 (1/26): Diffusion and Clustering (Branas)
Topics: measures of diffusion, networks and barriers, population potential, cluster detection
Activity: Suspected Legionnaires’ Disease in Bogalusa
Readings:
 Melinda Meade and Robert Earickson. Disease Diffusion in Space. Chapter 8 in Medical
Geography, 2nd ed., 2000 Guilford Press, pp. 262-305.
 Michael Thun and Thomas Sinks. Understanding cancer clusters. CA Cancer J Clin 2004; 54:
273-280.
 Ian R.H. Rockett. Population and Health: An Introduction to Epidemiology. 2 nd ed.
Population Bulletin 1999; 54(4): 3-40.
CLASS 3 (2/2): Health & the Built Environment (Hillier)
Topics: W.E.B. Du Bois and The Philadelphia Negro; history of public health and planning
collaborations; sprawl; measures of the built environment
Activity: measuring walkability
Readings:
 David Sloane (2006), “From Congestion to Sprawl: Planning and Health in Historical
Context,” Journal of the American Planning Association, Vol. 72(1): 10-18.
 Howard Franklin (2007), “Sprawl and Urban Health,” Article 7 in H. Patricia Hynes and
Russ Lopez, eds., Urban Health: Readings in the Social, Built, and Physical Environments of
U.S. Cities, pp. 141-168.
 J. F. Sallis and K. Glanz (2006). The role of built environments in physical activity, eating,
and obesity in childhood. The Future of Children 16 (1): 89-108.
Optional Readings:
 W.E.B. Du Bois, The Philadelphia Negro (1899), “Chapter 1, The Scope of this Study,” pp.
1-4, “Chapter 2, The Problem,” pp. 5-9, “Chapter 15, “The Environment of the Negro,” pp.
287-321.Ross C. Brownson, Christine M. Hoehner, Kristen Day, Ann Forsyth, James F. Sallis
(2009). Measuring the Built Environment for Physical Activity: State of the Science
American Journal of Preventive Medicine 36(4S):S99–S123.
* Syllabus subject to revision.
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CLASS 4 (2/9): Health & the Social Environment (Wiebe)
Topics: measuring social exposures, defining neighborhood, social distance
Activity: Google Earth, Six degrees of separation
Reading:
 Robert Sampson (2003), “Neighborhood-level Context and Health: Lessons from
Sociology,” Chapter 6 in Kawachi & Berkman, eds. Neighborhoods and Health, pp. 132146.
CLASS 5 (2/16): Measuring the Environment with Field Data (Hillier)
Topics: reliability and validity of field measures (ecometrics); measuring the food environment;
measuring physical activity
Activity: Developing a new field measure
Readings:
 Stephen Raudenbush (2003), “The Quantitative Assessment of Neighborhood Social
Environments,” Chapter 5 in Kawachi & Berkman, eds. Neighborhoods and Health, pp.
112-131.
 Karen Glanz et al (2007), Nutrition Environment Measure Survey in Stores (NEMS-S)
American Journal of Preventive Medicine 32(4): 282-289.
 T. L. McKenzie, D. A. Cohen, A. Sehgal, S. Williamson, and D. Golinelli (2006). System for
Observing Play and Recreation in Communities (SOPARC): Reliability and feasibility
measures. Journal of Physical Activity and Health 3 (Suppl. 1): S208-22.
HOMEWORK 1: Field Data (due Tuesday 2/23)
Create and test your own field data collection instrument for measuring the built or social
environment as it relates to public health. Be sure to conduct a literature review of
existing measures before you begin. You may either adapt an existing measure or develop
your own from scratch. Your final assignment should include: (1) a brief review of existing
measures and explanation of how yours is different; (2) the instrument; (3) a protocol for
using the instrument (detailed instructions); and (4) a summary of your results from
piloting the instrument. Your instrument should adhere to the principles of good field
measures presented in class.
* Syllabus subject to revision.
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CLASS 6 (2/23): Measuring the Environment with Administrative Data (Branas)
Topics: data dimensions, types of data, data linkage, problems with spatial data
Activity: Internet demonstration of geographic health data available online
Readings:
 Lance A. Waller and Carol A. Gotway. Spatial Data. Chapter 3 In: Applied Spatial Statistics
for Public Health Data. 2004 John Wiley & Sons.
 Charles Branas, Therese Richmond, Dennis Culhane, Douglas Wiebe. Novel linkage of
individual and geographic data to study firearm violence. Homicide Studies 2008; 12(3):
298-320.
 Arline T Geronimus. Invited commentary: using area-based socioeconomic measures –
think conceptually, act cautiously. American Journal of Epidemiology 2006; 164(9): 835840.
HOMEWORK 2: Administrative Data (due Tuesday 3/2)
Select a publicly available online dataset that has geographic identifiers linked to health
information. Download these data, read them into a spreadsheet, database, or statistical
software package. Perform basic operations with these data demonstrating at least one
example of a prevalence calculation for the geographic region or subregion(s) for which
you have data. Finally, create at least one map of the information contained within the
dataset you downloaded – this can be any type of map(s) you choose.
CLASS 7 (3/2): Modeling Movement Through Space (Wiebe)
Topics: migration; indirect exposure modeling; space-time activity patterns
GIS Applications: STARS project
Activity: Interactive demonstration of GPS activity pattern data
Readings:
 Niel E. Klepeis et al. The National Human Activity Pattern Survey (NHAPS): a resource for
assessing exposure to environmental pollutants. J Expo Anal Environ Epidemiol
2001;11(3):231-52.
 Wiebe DJ, Branas CC. Daily activities and violence in community landscapes. In (Wachter
S, ed.) How place matters. University of Pennsylvania Press (in press).
MIDTERM EXAM: One hour, in class, closed book to test understanding of class content to
date.
HOMEWORK 3: Movement Through Space (due Tuesday 3/16)
Keep a diary of 3-7 consecutive days of your activities. Analyze your data, and submit a
summary (3 pages maximum) of your activities and an assessment of the health
implications of your activities over the course of your diary days.
* Syllabus subject to revision.
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SPRING BREAK (3/9): No class
CLASS 8 (3/16): Network and Discrete Location (Branas)
Topics: facility siting, location science models, access to healthcare, decision support
Activity: Using Excel Solver to optimally locate ambulances
Readings:
 Mark S. Daskin. Introduction to location theory and models. Chapter 1 In: Network and
Discrete Location. Models, Algorithms, and Applications. 1995 Wiley & Sons, NY, pp. 1-18.
 Charles ReVelle. Siting ambulances and fire companies. New tools for planners. American
Planning Association Journal 1991; 57(4): 471-484.
 Charles Branas, Charles ReVelle. TRAMAH to the Rescue. Operations Research /
Management Science Today 1999; 26(3):38-40.
CLASS 9 (3/23): Community Participatory Methods (Hillier)
Activity: Guest speaker Nicole Thomas, Philadelphia Area Research Community Coalition (PARCC)
Readings:
 Carolyn C. Cannuscio, Eve E. Weiss, Hannah Fruchtman, Jeannette Schroeder, Janet
Weiner, and David A. Asch (2009), “Visual epidemiology: Photographs as tools for probing
street-level etiologies,” Social Science & Medicine 69: 553-564.
 Barbara Israel et al (2005), Community-Based Participatory Research: Lessons Learned
from the Centers for Children’s Environmental Health and Disease Prevention Research,
Environmental Health Perspectives 113(10): 1463-1471.
 Suzanne B. Cashman et al (2008). “The Power and the Promise: Working with
Communities to Analyze Data, Interpret Findings, and Get to Outcomes.” American
Journal of Public Health 98(8): 1407-1417.
Optional Reading:
 Witnesses to Hunger website www.witnessestohunger.org
HOMEWORK 4: Photo-Voice and CBPR (due Tuesday 3/30)
Take photographs highlighting elements of the built and social environment from one
block in your neighborhood or another neighborhood of interest that you believe impact
health. Create a presentation that incorporates no more than 10 photos and your voice
describing your different perspectives.
* Syllabus subject to revision.
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CLASS 10 (3/30): Modeling the Environment with GIS (Hillier)
Topics: network analysis, measuring distances between points, inverse distance weighting (IDW),
kernel densities, “hot spot”/point pattern analysis
Reading:
 Hillier, Amy, Cole, Brian, Smith, Tony E., Yancey, Antronette, Williams, Jerome, Grier,
Sonya and McCarthy, William (2009), Clustering of Unhealthy Outdoor Advertisements
Around Child-serving Institutions: A Comparison of Three Cities. Health & Place 15: 935945.
CLASS 11 (4/6): Modeling the Environment with GIS (Hillier)
Topics: map algebra (raster GIS), cartograms, animation
Readings:
 C. Dana Tomlin (2009), “Using Map Algebra to Model Urban Heat,” in Tomlin and Culhane,
eds., Philly.Dot.Map: The Shapes of Philadelphia.
 Cartograms http://hetv.org/resources/cartograms.htm
CLASS 12 (4/13): Modeling the Environment with Spatial Statistics (Wiebe)
Topics: spatial autocorrelation, spatial weights matrix, spatial regression
Activity: Spatial regression with GeoDa.
Reading:
 Selected exercises from:
Luc Anselin (2005), Exploring Spatial Data with GeoDa: A Workbook (revised). Center for
Spatially Integrated Social Statistics; University of Illinois – Urbana-Champaign.
CLASS 13 (4/22): Final project presentations
CLASS 14 (4/27): Final project presentations
* Syllabus subject to revision.
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