This document discusses how spatial science and mapping can help allied health professionals understand and address complex healthcare issues. It provides an introduction to concepts in spatial science, health geography, and how mapping can be used to visualize population health data, healthcare facilities, and provider locations. The document emphasizes that health data has an inherent spatial component and that emerging technologies are enhancing our ability to collect, analyze, and visualize spatial health data to better understand issues like population aging and plan healthcare infrastructure.

1. UTS CRICOS 00099F
Spatial Science and Allied Health:
A Mapping Approach to Healthcare Complexities
Hamish Robertson, PhD
Centre for Health Services Management

2. Contents
• Introduction and acknowledgements
• A quick and dirty introduction to spatial science
• Health and medical geography light
• Mapping and allied health professionals
• Population ageing – a growth area for all!
• Big data – health data is spatial data
• Visualising our complex worlds
• Conclusion

3. Introduction
• Colleagues – Nick Nicholas, GIS expert and Amit Dhagat, data
viz/analytics expert
• My background includes multicultural health (5 yrs) SESAHS and ageing
research (more than a decade now) at POWH and after
• Currently with CHSM – health services focus including patient safety
• I met Lisa Pont via UTS digital health strategy and AMR project
• I’ll try and keep this broad, interesting, topical, relevant and not too
boring – but there will be several maps…

4. Spatial Science Q and D
• Deep history and Barbara Tversky (2019) says spatial
cognition was fundamental to human evolution –
geographers (but see also neuro/psych, philosophy,
architecture etc.) generally agree!
• Keith Clarke - spatial cognition, numeracy and then
literacy…
• Modern spatial science is a broad interdisciplinary affair
BUT most technology a result of WW2 and its enduring
consequences
• Computer mapping (GIS), satellites, imagery, missile
systems, the Cold War psychosis, GPS, drones etc.
• Growing digitisation of analogue and electro-mechanical
data systems includes maps and mapping practices

5. From the CIA and Keyhole to Al Gore and Google Earth

6. Geotechnology is one of the three "mega technologies" for the 21st century and promises to
forever change how we conceptualize, utilize and visualize
spatial relationships in scientific research and commercial applications (U.S. Department of Labor)
Modelling
involves analysis of spatial
relationships and patterns
Prescriptive
Modelling
Why So What What if…
Global Positioning
System (location and navigation)
Remote Sensing
(measure and classify)
GPS/GIS/RS
The Spatial Triad
Mapping
involves precise placement
of physical features and
inventories
(Discrete/Graphic)
Descriptive
Mapping
And so we come to the digital
(Nanotechnology) Geotechnology (Biotechnology)
Source: Joseph Berry, 2010
Map Analysis …provides “tools” for investigating spatial patterns and relationships
Geographic Information
Systems (map and analyze)
is
Where What

7. Now Building Information Management (BIM)
• CAD, GIS, LIDAR, RFID etc.
• Integration with EHR
systems to provide
tracking and locational
reporting
• Incident reporting systems
analysis – where as well as
who, what and when
• ‘Smart’ hospitals, smart
beds, AI diagnostics etc.

8. Health and Medical Geography Light
• The environmental concept – health/illness and place are connected, for good
and/or ill
• Hippocrates and On Airs, Places, Waters – basic concepts still with us
• Classical Greek thought (and many other cultures) that is coming around again –
green and blue spaces, nature and health, forest bathing etc.
• Location is intimately connected with health status and opportunity
• Societies build their inequalities in bricks and mortar – and have always done so –
implications going forwards? The role of allied health in mediating effects? Older
people, PWD, homeless etc…
• Space can be seen as objective, analytic and quantifiable while place can be seen as
subjective, experiential and qualitative (plenty of debate about this)
• Ultimately the two are entwined if we are to explain human behaviours using them
– e.g. differential experiences of the same location, place attachment or lack of etc.
• Medical geography came first – doctors, epi etc. (e.g. John Snow) and health
geography emerged in about the 1950’s – more critical of medicine and health
systems generally – linked to growth of critical theory (Foucault etc.)
• Currently a hybrid field (HMG) associated with a broad range of shared interests

9. John Snow’s Cholera Map

10. Social ‘Science’, Social Mapping and Social Taxonomy

12. Mapping and Allied Health Professionals
• You can map clients, professions and analyse for met/unmet
demand/need OR spaces of opportunity for allied health professionals
• Can identify areas with more or fewer resources – socio-economic,
community etc.
• Analyse environmental factors such as green space access or social
factors such as fear of crime
• Map location of contributors to ill health such as pollution, fast food
outlets, alcohol providers etc.
• Can inform and support allied health interventional strategies – e.g.
which locations/communities are optimal for interventional success, or
those already well-resourced and able to get access to needed care
• Policy to practice potential…

13. Dietitians Metro Sydney

14. Podiatrists Sydney Metro

15. Physiotherapists

16. Population Ageing – a growth area for all!
• Health systems are traditionally focused on younger, healthier cohorts
• Aged care and ageing policy have a dubious history – e.g. the
workhouse system, geriatric medicine and nursing
• Moving towards an aged society – not just more ‘old’ people
• A transformational change from demography to society
• Due to peak in 2050 in Australia – allied health and age-related
disease
• Shifting dynamics of chronic disease and disability
• Huge potential for allied health professionals as population ageing
progresses globally…

17. A dementia perspective - building knowledge with/through
geography

18. Building
a spatial
dashboard
for
dementia
in the
European
Union

19. People Aged 75+ and Need for Assistance with Service

20. Comparison of the Three Alzheimer's Scenarios for NSW
0
20000
40000
60000
80000
100000
120000
140000
160000
180000
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027
Scenario 1 Scenario 2 Scenario 3

21. Localisation: 2012 to 2027
0 200 400 600 800 1000
Tweed Heads - South
Port Macquarie - East
Cherrybrook
Umina - Booker Bay - Patonga
Nelson Bay Peninsula
Narrabeen - Collaroy
Berkeley - Warrawong - Windang
Ballina
Tweed Heads
Bateau Bay - Killarney Vale
Mosman
Maroubra
Turramurra
Double Bay - Bellevue Hill
Taree
Top 15 SA2s for AD Prevalence in 2012
0
5
10
15
20
25
30
35
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027
Alzheimer's in the Far West
0
100
200
300
400
500
600
700
800
900
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027
Alzheimer's in Tweed Heads

22. Big Data – Health Data is Spatial Data
• The big data concept is on the rise – digitisation of everything
• Health data catching up – EHRs -> Cerner, Epic etc.
• EHRs and the social determinants (SDOH) of health – interventional
targeting of vulnerable/at risk groups
• Potential role in reducing waste and inefficiencies - localisation
• Has its own problems – quality, quantity, utilisation, storage,
surveillance, ownership (e.g. My Health Record)
• Location, location, location – uneven distribution of health problems
and health services/providers
• Spatial analysis can support intervention while maintaining
privacy/confidentiality – place-based focus

23. There is no ‘end’ to theory – it’s what we do!
He could just read some history and philosophy of science – it really won’t hurt…

24. Data is Made – not natural, never ‘raw’!

25. Big Data Has Social
Implications

26. Disrupting the Norm
• Small data was the norm for a century or so and geography has been in the
forefront of critiquing that paradigm - 1970’s reaction to the quantitative
revolution
• The orthodox small data paradigm is in decline and skilling up for the ‘big
data’ paradigm is gaining momentum – the time to engage is now…
• Like it or not, understanding, engagement and critique are essential
• The demand for visualisation of complexity will only continue to grow – can
hide more than it reveals, open to manipulation
• Some spatial visualisation elements are readily supported by data
visualisation exponents and their software (e.g. Tableau, Qlik, Power BI)
• This scenario will only continue to grow because big data has no intrinsic
problem with location, distance, scale or related complexities (analysis
another issue but change immanent)

27. The Tyranny of Distance
and Big Data – all data
are local!

28. Visualising Our Complex and Dynamic Worlds

29. Hans Rosling – In Memorium - Data Visualiser Extraordinaire

30. Residential Aged Care Facilities in Greater Metropolitan
Sydney

31. Residential Aged Care Providers in NSW – Scalability!

32. Projected AD Prevalence in NSW – No Change Scenario 1

33. Spatial Modelling
Projected AD Scenario 1 by SA2 for Sydney Metro in 2027

34. Scenario 1 Data and Residential Aged Care Facility
Locations for Metropolitan Sydney

35. Modelling Demography, Epidemiology and
Systemic Infrastructure – Ambulance Stations

36. Pharmacies and 2027 Projected AD

37. Estimated Total Cost of Formal Care in Metropolitan
Sydney in 2027 by SA2

38. Spatial Accessibility: RACFs and SA2s (5kms)

39. Spatial Dashboard: AD Prevalence Est. Sydney Metro 2027

40. No. of Pharmacies Less than 5kms by SA2

41. Tableau - Dashboarding Ageing Demography and the Dementias

42. Dashboarding Aged Care Service Providers by Location and Type

43. Heat Mapping Option for Non-Spatial Visual Engagement

44. Conclusion
• Space and place matter in healthcare – acute to community contexts
• Allied health need, demand, supply and opportunity exhibit spatial
patterns now and into the future
• Space might not always be strictly causal but almost always part of the mix
- correlational!
• Digital technologies are mostly spatial now and no sign of decline in this
pattern – GPS in phones, tablets etc.
• Data visualisation is on a rapid growth curve – maps are both visual aides
and analytic tools
• Spatial literacy is entwined with the growth of the big data era
• Health, ageing and disability are data intensive, spatially patterned
environments – join the party!