Brian Altonen, MPH, MS

Brian Altonen’s insight:
The pictures provided here (minus the descriptive text) are from the AMA’s "family health magazine" Hygeia, published in 1944.
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The problem as it existed at this time is discussed in detail in Mark Graczyk’s "HIDDEN HISTORY: Polio outbreaks hit area, 1939 & 1944."
http://thedailynewsonline.com/blogs/mark_my_words/article_03cf064a-e8ce-11e2-8327-001a4bcf887a.html 
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The magazine Hygeia was devoted to health and targeted the average American households (not to be confused with a contemporary journal bearing the same name, published in India). The title Hygeia was in use from 1923 to 1949, after which it was renamed Today’s Health (1950-1976).
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More on the Polio vaccine and its history can be found at the History Channel: http://www.history.com/this-day-in-history/polio-vaccine-trials-begin
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"The Charbor Chronicles". Saturday, April 26, 2014. "On This Day in History – April 26 Polio Vaccine Trials Begin" at http://charbor74.blogspot.com/2014/04/on-this-day-in-history-april-26-polio.html
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Smithsonian National Museum of American History wepage. "Whatever Happened to Polio? " http://amhistory.si.edu/polio/virusvaccine/clinical.htm
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Polio Eradication – Global Status and Progress. UNICEF. at http://www.unicef.org/media/media_18981.html

The current technology exists to monitor child abuse, bullying, adult abuse, or any form of abuse and mistreatment using a basic statistical program.  We do not need a GIS to map many of the conditions that should be monitored by a managed care system, just the right knowledge and manpower.  

Unfortunately, many companies choose to not engage in this very detailed review of the healthcare that our population receives.  This is either because we lack the desire to engage in this work, think we lack the software to accomplish such a brutal endeavour, or believe we haven’t got the manpower we need to accomplish it.  

All of these limits we place upon our self in managed care.  Either we place them upon ourselves, or higher up decisions limit us from reaching these potentials.  Some of the most important social issues in medicine and public health are poorly managed due to this lack of engagement.

In some of my past discussions with student about population health monitoring, I referred to a successful GIS that is already operating and managing several hundred metrics or more per month as our "sixth sense."
Even when nothing appears in the forefront about health matters, viewing the images you are used to seeing every day  can often bring about new attention whenever a new health problem is surfacing, and its appearance on the map suddenly changes.
This is the major reason GIS works better for population health analyses and surveillance than any other method out there that is predominantly word or table based.
On a single page, single screen, one can review several dozen outcomes in just a few seconds.  This rapid processing is what enables us to utilize these methods as a ‘sixth sense" approach to analyzing population health.

Mapping childhood aggressive behavior will probably not resolve the problem or help define its exact cause(s).  

But it may provide us with insights into the social situations or environments that help lead to this growing problem, and/or provide us with the knowledge needed to better understand these events as possible personal behavior induced events.

The relationships between grade level and age, gender, ethnicity, family poverty history, school-derived cultural definitions about certain people, and the nature of ongoing staff-student relationships help shed some light into the social aspects of this problem.

We once believed that the causes for this behavior were very much related to mostly poverty, and crime and gang-related activities.  More recent cases suggest that these social behaviors can occur independent of such causes, tending to be individually derived rather than socially derived.  

 Bullies themselves can be broken down into different groups (http://bullying.about.com/od/Bullies/a/6-Common-Types-Of-Bullies.htm ).

Chances are, many GIS interpretations of bullying and other activities related to violence (spouse or child abuse, drug activity, certain crime events) may in fact show it is not as predictable through spatial analyses as we would like.  However, with spatial analyses we can still see certain large area features being shared by these cases (i.e. mostly within urban settings, or certain SES  and poverty settings). 

For more on this topic . . . . see

Bullying Statistics:

http://nobullying.com/bullying-statistics-2014/

http://www.a4kclub.org/get-the-facts/bullying-statistics

Signs of bullying at school:

http://www.prweb.com/releases/2014/03/prweb11654053.htm

National Association of Nursing opinion on this subject:  http://www.nasn.org/PolicyAdvocacy/PositionPapersandReports/NASNPositionStatementsFullView/tabid/462/ArticleId/638/Bullying-Prevention-in-Schools-Adopted-January-2014

American Psychological Association stance:  http://www.prweb.com/releases/2014/03/prweb11654053.htm

Graphic depiction, caught on tape:  http://www.huffingtonpost.com/2014/01/22/high-school-bullying-video_n_4644787.html

Who is in fact liable?  http://www.nj.com/opinion/index.ssf/2014/03/if_schools_are_liable_for_bullying_parents_can_be_too_editorial.html

But what about kids?

Does the health of homeless people impact you?

At Catholic Online, the article ‘Tuberculosis sweeping through Los Angeles’s population’ attempts to explain this (https://www.catholic.org/news/health/story.php?id=49847).  The authors state:

[begin]

"Tuberculosis is also common among the homeless as they live in overcrowded areas and are constantly moving among hospitals, shelters and the streets. In addition, many have substance abuse or mental health issues that can impede treatment.

"’They go from place to place and the likelihood of passing it along is much greater,’ Paul Gregerson, chief medical officer of the JWCH Institute says. The organization runs a homeless healthcare program on skid row. ‘It makes everybody more susceptible.’

"Tuberculosis is easily transmitted by inhaling droplets from infected patients when they sneeze, cough — or even laugh. TB can be deadly if left untreated. The skid row strain can be treated with all anti-TB medications. Treatment lasts six to nine months.

Most of the TB patients are men. Twenty percent are also HIV-positive, according to the alert. Six of the eight patients who also had HIV have died.

The increase of TB among the homeless population is occurring even as the county is seeing a decline in overall cases."

[end]

The majority of homeless people with Tb are adults.  The majority of Congenital Tb cases in newborn children is coincidentally distributed around many of the same urban settings where homeless is more common.  Both are products of urban settings with dense populations and desirable living space (even on behalf of the homeless).

"One of the four goals of Opening Doors is to finish the job of ending chronic homelessness by 2015.  Working together to implement proven solutions, we can continue to make progress towards our goal."  (Source:  http://usich.gov/population/chronic)

According to Opening Doors . . . 

As long as there are homeless populations, there will be pockets of families and individuals who never receive complete health care.  Typically we hear about Mental Health, HIV, poor nutrition, drug use, the poor management of chronic diseases such as diabetes or epilepsy as primary concerns of community health groups.    

But there is more to this public health issue than normally considered.

http://eurpub.oxfordjournals.org/content/7/4/398.full.pdf?origin=publication_detail

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC80688/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1883152/pdf/bmj00087-0017.pdf

http://www.nationalhomeless.org/factsheets/health.html

http://www.nhchc.org/wp-content/uploads/2011/09/Hln_health_factsheet_Jan10.pdf

My page which includes a review of this topic for Portland, Oregon, is:  

https://brianaltonenmph.com/gis/population-health-surveillance/production-examples/regions-and-health/