Public health decision making: the value of geographical information systems (GIS) mapping

Technologies such as geographical information systems (GIS) have emerged during the past two decades as part of the Information Revolution and include functions such as data storage, management, integration, analysis and presentation. GIS have wide and diverse applications in disciplines such as engineering, business/marketing, urban planning and environmental management but remain underused in public health. The thesis reports the findings of a mixed methods study examining the views and perceptions of public health practitioners on the value of GIS mapping in decision-making. A case study design was chosen; the case issue (childhood lead [Pb] exposure) represents an example of the "case" which is defined as 'decision- making in public health'. The exploratory phase of the study combined heterogeneous data to produce a visualisation of lead contamination in Newcastle. The value of GIS in public health was explored in an interview phase. Twenty-two semi-structured interviews were conducted with decision-makers involved either directly or indirectly in public health practice. Interview recordings were transcribed and coded thematically for analysis. Decision-makers tended to be positive about the use of GIS in public health and many volunteered potential opportunities to apply GIS mapping techniques further. Four discourses were highlighted through analyses, namely: data origins (Ontological Discourse), status (Power Discourse), application (Functionality Discourse) and reciprocity (Collaboration Discourse). The power of maps to integrate multiple, disparate datasets was found to be important and respondents felt, overall, that GIS mapping was a democratic means of communication. Complexity frameworks are drawn upon to make sense of the research findings and to illuminate the need for non-reductionist models of decision-making in the public health context. The lessons learnt through this study can be translated to other fields, thereby sharing skills, knowledge and experience to promote collaboration and integrated thinking across the public health landscape