Projects

Research Premise

Part of our rationale is the belief that health vulnerability is an underappreciated aspect of North American disasters. With this in mind, we focus on spatial patterns of recovery, merging characteristics of the landscape with health outcomes. Topics include post-disaster crime, neighborhood blight, and the reestablishment and quality of services, especially those focused on mothers and children.

To be successful we also believe in a mixed methods approach where geospatial technologies and spatial analyses are combined with local context in the form of geonarratives, which are the spatially tagged stories of ride-along community members who narrate the landscape as we collect our data.

We also strive to advance our spatial understanding of health in contexts not related to disasters. For example, we are working with an endocrinologist to build a Geographic Information System (GIS) supported diabetes clinic in Los Angeles which will use both clinical data and neighborhood context (through patient interviews) to support diagnosis and treatment strategies. This project is an excellent example of actionable GIS, where results can be used in near real time as part of an intervention portfolio. Our other collaborations involve the spatial analysis of infectious and chronic disease associated with urban environments, vectored disease, and most recently, cholera in Haiti.

Current Projects

Dixie Alley - Enterprise, Alabama Tornado Impact on K-12 Policy and Science Curriculum

• 2013
• PI: Jacqueline W. (Mills) Curtis
• Co-PIs: University of South Alabama, Mobile, Alabama - Frances Mujica
• Troy University, Troy, Alabama - Rhonda Bowron, Diane Gossett, Becky Ingram, Barbara Lyons, Charlotte Minnick, Jan Oliver, Isabelle Warren, Jason Wingate

Abstract

The purpose of this study is to identify the impact of tornadoes, and the Enterprise tornado in particular, on K-12 school policy and science curriculum in Alabama, Need for this study is justified by increasing incidence and severity of tornadoes in Alabama and by the destruction and related deaths at Enterprise High School from the Enterprise tornado. Given these circumstances, it is important to understand what educators know about tornadoes, and how their knowledge and experiences shape policy and science curriculum.

Eastside Greenway Project

Background

The eastside of Cleveland and adjacent suburbs are widely diverse with communities of extreme poverty and disinvestment in close proximity to areas with high income and stable real estate values. The area has a remarkable network of existing parks, open spaces and natural areas that include well-loved, maintained and programmed spaces as well as significantly underutilized, undervalued and blighted areas. Currently disconnected and often isolated from one another, these natural areas offer the opportunity to serve as a community transformation catalyst by re-connecting and revitalizing as a regional greenway network.  Linked together as an open space system, the Eastside Greenway can provide recreation, alternative transportation, environmental services, and economic benefits that build community cohesion and improve quality of life. Parks include such historically significant areas as Rockefeller Park with the cultural gardens, University Circle Parks and Gardens, Forest Hills Park, Shaker Lakes and Euclid Creek Reservation. Trails currently run along Euclid Creek, Nine Mile Brook, Dugway Brook, Doan Brook, and Shaker Lakes, however, no formal connections exist between them. 

Currently, several local bikeway, public space, economic and community development initiatives within the project area suggest the time is right for a comprehensive strategy and transformational  public improvement.  The project partners believe that the Eastside Greenway will serve as a catalyst for economic development by leveraging public investment, promoting retail nodes and development opportunities, enhancing aesthetics and safety. It is additionally intended to involve schools with outdoor learning opportunities, skill development and job training. By working directly with the local communities throughout the process, the project will strengthen community cohesiveness and provide a range of social benefits including health, pride and place based identity. Overall, the Eastside Greenway is intended to significantly improve the quality of life of its community members.

Process and Timeline

The project is in the early stages of initial planning with a core group of partners including Cleveland State University, Cleveland Metroparks and LAND studio.   The project will be collaborative in nature and incorporate significant involvement from the local community stake holders, decision makers and residents.  An initial scoping phase of the project is underway and anticipated to be complete by spring of 2013.  Additional funding is being sought to support a Health Impact Assessment (partnership with the County Board of Health) and a physical plan through a Transportation for Livable Communities Grant (partnership with County Planning Commission). Additional funding will be needed to support environmental, community and social equity assessments to ensure interventions achieve the greatest amount of multiple community benefits.  

History of Concerns

The planning partners of the proposed Eastside Greenway project recognize the potential it has to make the communities in the project area better places to live, learn, work and play.  The communities the Greenway encompasses are very diverse economically and racially, and range in their opportunities for healthy living.  Health issues vary across the communities, with the poorest health outcomes (such as high rates of obesity and chronic disease) geographically concentrated in the urban core of the project area (Cleveland and Inner Ring Suburbs).  A recent Cuyahoga County Board of Health study revealed a 24.5 year difference in life expectancy for those living in the Hough Neighborhood in Cleveland and in the City of Lyndhurst, both communities in the project area. It is anticipated that residents of the communities with the least amount of access to opportunities for healthy living would benefit the most from the greenway. 

Health Impact Assessment

The health and hazards mapping project is a collaboration with the Greenway project, and also part of a larger health impact assessment (HIA), a proposed project spearheaded by the Cuyahoga County Board of Health to look at the potential health and equity impacts of building the Eastside Greenway. An HIA is a public engagement and research tool used to predict how a policy, plan, program or project will change health and equity outcomes, and to make recommendations about how positive benefits can be ensured and negative impacts can be mitigated.

Stakeholders To Date

LAND studio                                          Mayfield Village                                                           Port of Cleveland

Cleveland State University                  Village of Bratenahl                                                   Euclid Creek Watershed

Cleveland Metroparks                         City of Mayfield Heights                                             Nature Center at Shaker Lakes

City of Cleveland                                  City of Lyndhurst                                                         Northeast Shores Development Corporation

City of East Cleveland                         Cleveland City Planning Commission                   Lake View Cemetery

City of Shaker Heights                        Cuyahoga County Planning                                      Bike Cleveland

City of South Euclid                             Northeast Ohio Regional Sewer District                Cuyahoga Soil and Water Conservation District

City of Richmond Heights                  University Circle Inc.                                                   Doan Brook Watershed Partnership

City of Euclid                                         Cuyahoga County Board of Health                          GCRTA

City of Pepper Pike                                Cleveland Heights                                                   

City of Beachwood                               University Heights

Spatial Patterns of Post-Wildfire Neighborhood Recovery

• 11/2012 - 06/2013
• University of Colorado Natural Hazards Center
• PI: Jacqueline W. (Mills) Curtis
• Co-PI: Andrew Curtis

Abstract

Until recently, the recovery phase of the emergency management cycle has received relatively little attention from the natural hazards research community in comparison to the other phases of planning, mitigation, and response. However, in the prolonged aftermath of Hurricane Katrina, studies on recovery have become more common as evidence from this disaster suggests that the process is spatially uneven and temporally dynamic. The heterogeneous patterns of recovery and its implications for the well-being of people and places are especially visible at the neighborhood scale. With growing empirical evidence from post-disaster environments such as New Orleans and Joplin, Missouri, studies on neighborhood recovery are becoming a useful endeavor through which to inform emergency management and other city planning policies related to what happens after a disaster, why these outcomes matter,  and how to systematically plan for post-disaster recovery. Despite progress made on understanding neighborhood recovery, these studies have focused primarily on post-hurricane and post-tornado environments. In order to achieve a comprehensive understanding of neighborhood post-disaster recovery, other events (e.g. wildfires) must be included. However, wildfires are also notably underrepresented in natural hazards research. This Quick Response project aims to begin to address both the understudied process (neighborhood recovery) and the understudied event (wildfire). It draws attention to the need for post-wildfire neighborhood recovery studies, particularly in order to understand the implications for health outcomes of impacted residents.

Spatial Patterns of Fine-Scale Recovery in the Post-Tornado Landscape of Joplin, Missouri

• 06/2011 - 06/2014
• PI: Andrew Curtis
• Co-PI: Adam B. Cinderich

Abstract

On May 22nd 2011, an EF5 tornado carved a path, up to a mile wide, directly through the heart of Joplin, Missouri killing 158 people, injuring over 1,000 more and is estimated to have caused $2.8 billion US, including the destruction of Joplin High School and St. John's Memorial Hospital. Immediately following, relief efforts began to help the community respond but months and even more than a year later, some are still struggling to fully recover and regain a sense of normalcy. This return to normalcy is understudied and deserves further investigation as understanding the post-disaster landscape provides invaluable information that can shed light on how homes, streets and neighborhoods may or may not recover, thereby allowing emergency managers to better respond to and enact procedures within these environments that are more efficient and equitable. To study the post-disaster environment in Joplin, fine scale data, captured from spatially encoded videos, are collected and coded to examine the visual aspects of building and street changes over time.  The project seeks to combine analytical results with (1) community insights collected simultaneously as a geonarrative during each neighborhood assessment run, (2) crime data, specifically 911-calls as they relate to domestic violence, (3) community health data, specifically as they relate to post-traumatic stress, and (4) property tax assessment and building permit data.

Climate variability/change and the risks for a spectrum of diseases

•  2009 - 2013
• Centers for Disease Control (Subcontract: New York State Department of Health)
• PI: Scott C. Sheridan

Abstract

Climate change affects the environment and increases the frequency and intensity of extreme weather events.  Thus, its public health impact could be substantial.  Many uncertainties remain in understanding the relationship between climate factors and health, however.  Major gaps include the relative paucity of research on morbidity outcomes, lack of a composite index to measure the joint effects of individual meteorological factors, little data on the assessment of the public health burden, and few translational studies to directly apply local research findings into public health practice.  Our proposed study will fill these gaps by evaluating both the independent and joint effects of various meteorological factors on some under-studied outcomes and translating our findings into a climate-health surveillance system and into public communication/education.  Biologically-plausible but under-studied health outcomes, including tick-borne and water/food-borne diseases, adverse birth outcomes, and cold-related diseases will be examined in relation to extreme weather conditions, climate variability, special weather events, and the season-modifying effect of individual climate factors including temperature, humidity, air pressure, and wind in New York State (NYS).  The Spatial Synoptic Classification system, a composite weather index derived from five meteorological variables, will also be used to assess the impact of joint effects on these outcomes as well as other more commonly studied outcomes such as respiratory, cardiovascular, renal and heat-related disease.  Potential confounders such as socio-demographic factors and maternal/infant characteristics will be controlled and the interactive effects between climate factors and air pollutants will be assessed.  We will also try to determine if vulnerable populations such as the elderly, infants, minorities, people living below the poverty level, pregnant women, inner-city residents, or people with pre-existing chronic diseases are disproportionately affected by climate extremes or variability.  For all outcomes except adverse birth outcomes, the case-crossover design or time-series analysis will be used to control for time-varying variables, and a two-stage Bayesian Hierarchical model will be used to assess regional effects as well as state-wide effects after controlling for regional differences (the case-control design will be used to study the birth outcomes).  This study represents a unique effort to assess weather effects on some important but under-studied health endpoints, evaluating the joint effects of climate factors, and integrating local findings and data into the ongoing Environmental Public Health Tracking (EPHT) system and public health education.  This effort will improve our understanding of how climate factors jointly affect health as an air system, identify weather-sensitive diseases and populations, and identify the most hazardous weather factors.  Our multi-disciplinary research team will use data already collected and geo-coded through ongoing NYS projects, readily available environmental and health data sets, and an established EPHT system to ensure the proposed study is feasible, efficient, and sustainable.

The Malpractice of Medicine During the Cambodian Genocide

• National Science Foundation
• PI: James Tyner

Abstract

The provision of health care constitutes a clear expression of societal attitudes toward the value of life. For it is within this context of deciding who is to receive medical treatment and of what treatments are available that one sees most clearly the calculated management of life. In this research I document and analyze the provision of medical care during the Cambodian genocide. Specifically, I propose to reconstruct the planned health system envisioned by the Khmer Rouge between 1975 and 1979. This multidisciplinary project, which combines elements of geography, political science, and public health, constitutes an effort to enlarge our theoretical and empirical understanding of the material geographies of health within genocide. Two key objectives buttress this research: (1) to document the spatial organizational structure of the Khmer Rouge’s planned health system; and (2) to document the specific day-to-day practices of the genocide. Specific tasks include an accounting and analysis of policies and procedures for medical training; policies and procedures for the manufacture and distribution of medicines; and detailed case studies of the ‘practice of medicine.

Community Mobile STD Screening Partnership (CMSSP) - Geographic Information System based analysis of Gonorrhea in Los Angeles

• 2013-2014
• PI: Andrew Curtis
• Collaborators: Peter Kerndt, University of Southern California and Los Angeles County Department of Public Health (LACDPH)

Abstract

The purpose of this research is twofold: to identify high spatial concentrations of gonorrhea within the District 2 health area of Los Angeles County, and to collect geonarratives of different stakeholders associated with these “hotspot” areas. Using this as a project frame, two research questions will be posed: (1) As District 2 continues to experience high rates of Gonorrhea (at epidemic levels for certain areas), where are the highest concentrations of the disease, and which of these hotspots are temporally stable? (2) What are the unique characteristics of the built environment within these hotspot areas? Answering both questions will illuminate the problems of the area at a geographic scale that can be immediately woven into LACDPH intervention strategies.

Community Health Mapping and Wellness Center Project for Boyle Heights in Los Angeles

• 2013-2014
• PI: Andrew Curtis
• Collaborators: Wei-An Andy Lee, Kreck Medical Center of the University of Southern California

Abstract

This project is designed to understand the diabetes landscape of vulnerable populations in the Boyle Heights area of Los Angeles and to help facilitate intervention and management strategies for a participating diabetes clinic. The objective of this work is to develop a geospatial tool and/or approach that is easy to implement and is transferable amongst other resource challenged clinics serving vulnerable populations. To achieve this, the GIS Health & Hazards Lab is currently (1) Providing a comprehensive summary review of health, social science and planning research previously conducted in Los Angeles, (2) Evaluating the feasibility of using spatial analysis of health and census data for the targeted neighborhood of Boyle Heights, and (3) Piloting the use of mobile mapping to capture the fine scale built environment of patients in Boyle Heights.

Hotspot Analysis of West Nile Virus in Harris County, Texas

• 2013-2014
• PI: Andrew Curtis
• Collaborators: Rudy Brueno, Jr., Harris County Public Health and Environmental Services (Mosquito Control Division); Elyse Heob, CDC & Harris County Health and Environmental Services; Louisa Holmes, University of Southern California

Abstract

The geography associated with many vectored diseases is ideal for investigation within a geographic information science framework.  Arguably, the two most spatially studied vectored diseases within the United States are Lyme Disease and West Nile Virus (WNV). This project considers WNV risk in and around Houston, Texas, for the period from 2002 to present. Using different hotspot analyses, the purpose of this project is to determine where virus risk is greatest, especially in terms of temporal and spatial stability in positive mosquito populations. It also identifies environmental and socioeconomic factors that might help explain mosquito and/or disease presence. Insights gained from these analyses will help prioritize limited control resources. Finally, the micro-geographies of these hotspots are broken apart using novel geospatial technologies previously not applied to vector analysis to understand the determinants of WNV temporal stability.

The Foreclosure, Crime and Health Nexus in Northeastern Ohio

• 2013-2014
• PI: Andrew Curtis
• Collaborators: Eric Jefferis; Northern Ohio Violent Crime Consortium; Akron Police Department; Youngstown Police Department

Abstract

The proposed project fits the BJA strategic plan in terms of reducing violent crime, improving community safety, introducing evidence-based research-driven strategies, with an emphasis on data analysis and collaboration. Spatial video as used in the proposed project is encoded with global position system (GPS) coordinates. This high definition video allows for coding of different built environment aspects (the house, the sidewalk, trash etc), and markings on buildings, such as graffiti, are easily visible. The video can be viewed in free internet based software (which helps in easing the collaboration process between the police department, city government, community groups and Kent State researchers), which shows a location marker that moves on Google high resolution satellite imagery in sync with the video. 

By developing project specific coding systems, these video data can be translated into a geographic information system (GIS) for visualization and analysis, including being combined with other data layers. The collection of fine scale data can be used in longitudinal analysis, to both suggest where intervention should occur, and then as an assessment measure of whether the action was successful. The methodological advances developed by the Kent State team are novel especially with regards the use of geonarratives, which are the simultaneous recording of expert observations (police officers, community members, local clergy etc) during video collection.

Fine Scale (disease) Mapping in the Most Challenging Environments - Case Studies in Bangladesh and Haiti

• 2013-2014
• PI: Andrew Curtis
• Collaborators: Jason K Blackburn, Spatial Epidemiology & Ecology Research Laboratory (SEER), Department of Geography, University of Florida; Jocelyn M Widmer, Urban Affairs and Planning, School of Public and International Affairs, Virginia Tech University; J Glenn Morris Jr., Emerging Pathogens Institute, University of Florida

Abstract

Fine-scale and longitudinal geospatial analysis of health risks in challenging urban areas is often limited by the lack of other spatial layers even if case data are available. Underlying population counts, residential context, and associated causative factors such as standing water or trash locations are often missing unless collected through logistically difficult, and often expensive, surveys. The lack of spatial context also hinders the interpretation of results and designing intervention strategies structured around analytical insights. This project offers a ubiquitous spatial data collection approach using a spatial video that can be used to improve analysis and involve participatory collaborations. Case studies have been developed for a coastal community in Haiti, and a slum in Bangladesh where spatial video was used to collect street and building scale information, including standing water, trash accumulation, presence of dogs, cohort specific population characteristics, and other cultural phenomena. These data were digitized into Google Earth and then coded and analyzed in a GIS using kernel density and spatial filtering approaches. The case studies show that previously unavailable fine scale health risk data can be collected for any environment which in turn can improve local area health analysis and intervention. The process is rapid and can be repeated through time to track spatio-temporal dynamics of the communities. Its simplicity can also encourage local participatory collaborations.

Spatial Confidentiality Risk in Maps: New Concerns and Possible Solutions

• 2013-2014
• PI: Andrew Curtis

Abstract

As a GIS lab with multiple public and clinical health partners, it is imperative for us to understand the risks associated with spatial data. This ongoing project continually evaluates confidentiality threats so our partners can be confident in our ability to protect sensitive data.  As GIS use becomes more widespread in the public health, clinical health and associated disciplines, so do concerns that are often raised about the confidentiality vulnerability of spatial data in terms of cartographic display. The simple question is: can I use this map to identify who is sick, or at least reduce a denominator area to unacceptably low levels? This project illustrates the risks of how a map displaying health events (mortality locations) can be reengineered to exact or proximate addresses. The project also considers how the social and physical landscape can increase the degree of risk. The project will also cover a variety of related topics ranging from balancing the importance of spatial public health research, secondary “revealing” data sources, ethics and GIS use, and whether reengineering risk is real or just an academically derived worst case scenario.

Completed Projects

California State University Long Beach
GIS Analysis of Demographic and Economic Data (08/2011 - 08/2012)
Gateway Cities
Southern California Association of Governments (SCAG)
PI: Monaco
Co-PI: Jacqueline W. (Mills) Curtis

University of Southern California
The disproportionate burden of diabetes in East Los Angeles: Using Social Science to identify neighborhood variation (2010 - 2011)
Haynes Foundation
PI: Andrew Curtis

Kent State University & University of Miami
A Spatial Synoptic Classification Approach to Projected Heat Vulnerability in California under Future Climate Change Scenarios (2008 - 2011)
California Air Resources Board
PI: Scott C. Sheridan
Co-PI: L. Kalkstein

Odessa Hydrometeorological Institute & Kent State University
Climatological, epidemiological, and public health justification of a heat wave health warning system for Moldova (2008 - 2010)
US Civilian Research & Development Foundation
PI: R. Corobov and K. Ebi
Co-PI: Scott C. Sheridan

University of Southern California
Evaluating Methods for Preserving Confidentiality During the Release of Records Incorporating Address or other Geodata (2008 - 2010)
Surveillance Epidemiology and End Results - National Cancer Institute
PI: Cockburn
Co-PI: Andrew Curtis

Kent State University
Track 1, GK-12: Inquiry-based approaches to Earth System Science (2005 - 2010)
National Science Foundation (supplemental 2007, supplemental 2008)
PI: M. Munro-Stasiuk
Co-PI: Scott C. Sheridan

University of Southern California
Collection and Dissemination Mechanism for Spatial Data Collected in a Post-Earthquake Environment (08/2008 - 08/2009)
Earthquake Engineering Research Institute (EERI) - Federal Emergency Management Agency (FEMA)
PI: Andrew Curtis
Co-PI: Jacqueline W. (Mills) Curtis

University of Southern California
Census-based Pediatric Vulnerability Assessment (08/2008 - 08/2009)
Children's Hospital of Los Angeles - U.S. Department of Health and Human Services
PI: Andrew Curtis
Co-PI: Jacqueline W. (Mills) Curtis

Kent State University
Monitoring Agricultural Sewage Sludge, Ohio (2008 - 2009)
Department of Agriculture (Subcontract: University of Toledo)
PI: M. Munro-Stasiuk
Co-PI: Scott C. Sheridan

Louisiana State University
GOHSEP Critical Infrastructure (08/2007 - 08/2008)
Governor's Office of Homeland Security and Emergency Management (GOHSEP)
PI: Jacqueline W. (Mills) Curtis

University of Southern California
SGER: Spatial Patterns of Post-Wildfire Neighborhood Recovery (10/2007 - 03/2008)
National Science Foundation (NSF)
PI: Andrew Curtis
Co-PI: Jacqueline W. (Mills) Curtis

Kent State University
Monitoring biosolids in Ohio (2006 - 2008)
U.S. Department of Agriculture (Subcontract: University of Toledo)
PI: M. Munro-Stasiuk
Co-PI: Scott C. Sheridan

Louisiana State University
Modeling the natural distribution and forecasting disease spread of pathogens with known potential for use as biowarfare agents (2005 - 2006)
US Army Medical & Research Command
PI: Hugh-Jones
Co-PI: Andrew Curtis

University of Otago (New Zealand) & Kent State University
Climatic influences on the spatial and temporal variability of aerosols over North America (2004 - 2006)
National Science Foundation (NSF)
PI: H. Power
Co-PI: Scott C. Sheridan

Kent State University
Municipal response and public perception of heat-health watch-warning systems: An evaluation of effectiveness (2003 - 2005)
Environmental Protection Agency (EPA)
PI: Scott C. Sheridan

Kent State University
Wind speeds and vehicle stability related to hurricane evacuation (01/2003 - 12/2004)
Palm Beach County (FL) Emergency Management Division
PI: Thomas Schmidlin

Kent State University & University of Delaware
Development of Heat Watch Warning Systems: Implementation and Intervention (2000 - 2004)
National Atmospheric and Oceanic Administration (NOAA)
Subcontract PI: Scott C. Sheridan
Co-PI: L. Kalkstein

Kent State University
Stability of a heavy ambulance in hurricane winds (01/2003 - 09/2003)
Lee County (FL) Division of Emergency Management
PI: Thomas Schmidlin

Kent State University
Tornado shelter options and shelter-seeking behavior among mobile home residents in the United States (09/1999 - 01/2001)
National Science Foundation (NSF)
PI: Thomas Schmidlin

Kent State University
Tornado shelter availability in mobile home parks in the United States (06/2000 - 12/2000)
Research Experiences for Undergraduates (REU) - National Science Foundation (NSF)
PI: Thomas Schmidlin

Kent State University & Boyce Thompson Institute
Motor vehicles in tornadic winds (01/1999)
Natural Hazards Research and Applications Information Center
PI: Thomas Schmidlin
Co-PI: Paul King

Kent State University & Boyce Thompson Institute
Risk factors and mortality in the 23 February 1998 Florida tornadoes (02/1998)
Natural Hazards Research and Applications Information Center
PI: Thomas Schmidlin
Co-PI: Paul King

Kent State University
Risk factors and mortality in the 1 March 1997 Arkansas tornadoes (03/1997)
Natural Hazards Research and Applications Information Center
PI: Thomas Schmidlin
Co-PI: Paul King

Kent State University
Risk factors and tornado mortality in Bangladesh (06/1996)
Natural Hazards Research and Applications Information Center
PI: Thomas Schmidlin