Dr. John Ritter: Mapping for Wellness

Dr. John Ritter
Dr. John Ritter
interview by Sheila G. Miller

Dr. John Ritter is a GIS professor in the geomatics department of the Oregon Institute of Technology in Klamath Falls. He partnered with Sky Lakes Medical Center’s wellness center to identify high incidences of health problems in Klamath Falls through GIS mapping. As a result, the team has found areas in the community to target for health interventions. The project could easily spread to other communities and help people get and stay healthy.

What’s the goal?
What we wanted to do was to see if disease incidence could be related to things like walkability and/or demographics. And if that were the case, and we found that there were identifiable pockets of disease, that’d be a great bonus for trying to do remediation efforts.
What did you find?

We did find that we could rate our areas in terms of walkability and we did find that there was a slight anti-correlation between walkability, and heart disease—the more walkable places were, they tended to have less heart disease and vice versa. We found, again, a slight anti-correlation between average income and heart disease: the higher the income, the less the heart disease and vice versa. And one of the interesting things we found was regarding cholesterol—we found that there is an anti-correlation between cholesterol and the percentage of Hispanics in the population. That is, the greater Hispanic percent of the population, the lower the cholesterol.

How did the project come together?

We got 60,000 patient records from Sky Lakes Medical Center in several disease categories—diabetes, hypertension, obesity, stroke, heart disease, smoking. We de-identified them, and each record was identified by category. Then using GIS we put a pinpoint on a map for that particular disease incident. When it was all done, to protect privacy, we aggregated the information like a census block group, which tends to have a few hundred people in it so you can’t tell who is who. Lo and behold, we really did find patterns of disease. One of the outcomes is that, in an area that was of high obesity, it happens to be where it would be desirable to have a protected bike lane. So you could put in this protected bike lane and you would provide people in that area another avenue for which to invite them to get more movement and more exercise, possibly warding off future evolutions of what obesity might tend toward.

How have you used the information to better Klamath Falls?

A few months ago, there was a meeting for what was called a trails master plan—city hall was packed and there was a lot of interest in trying to make a comprehensive plan for how to connect trails and create walkability around town. I presented for a few minutes there and showed a map that showed where, if the city did something constructive, it could actually impact the presence of disease and probably impact the presence of disease. It provided data that backs up and confirms anecdotal evidence.

The next thing coming along is actually to present to city council the fact that we would like to put in a protected bike lane along a certain avenue, and to show basically the same map that shows that exactly where it’s proposed is where it’s needed. This could have real health implications.

What comes next?
Some of the results we’ve come up with don’t have answers as to why—it just is. We’re talking with people in OIT’s population health management degree, they’re all excited about going into areas with surveys and trying to understand more deeply why we have this abundance or deficit of disease.

This is applicable everywhere, and with hospital medical agencies trying as best they can to change the mantra from treating sick people to attending well people and trying to preserve their wellness, this is a great step forward.

The other thing we want to do is do this longitudinally. These data sets were taken from 2012, so it would be neat to do in a few years after the wellness program has been in place for awhile. It would show whether changes are actually being made and we’ve been able to move the needle at all.

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