Integrating Approaches to Geographic Variation in Methodologies for Public Health Surveillance

• Author / Creator

  Dover, Douglas C

• Epidemiology is increasingly recognizing the complexity of the underlying mechanisms determining health states. Public health surveillance needs to incorporate this knowledge into their regular reporting and analysis cycles. Aggregate data related to a multitude of health related states and risk factors is produced and publicly shared by public health surveillance. These large stores of aggregate data have the potential to be combined and analyzed to capture much of the underlying complexity. The aim of this thesis is to advance the methods used in public health surveillance for combining and analyzing these disparate sources of aggregate data. Three papers address this aim by focusing on (1) developing a sound methodology using funnel plots for the analysis of aggregate health data, especially addressing the issues of policy relevant analysis and overdispersion, (2) developing a spatial scan statistic capable of identify multiple irregularly shaped clusters in aggregate space-time data, and (3) applying the funnel plot and spatial scan techniques to childhood immunization surveillance in Alberta. These papers conclude that (1) the funnel plot methodology is a robust way of creating policy relevant analysis with understandable visualizations in the presence of overdispersion, (2) the novel MultScan spatial scan performs well at cluster detection, and (3) sophisticated surveillance of childhood immunization can be undertaken accounting for a wide variety of determinants using available aggregate data.

• Subjects / Keywords

  • spatial scan
  • public health
  • funnel plot
  • aggregate data
  • ecologic regression
  • surveillance
  • immunization coverage

• Graduation date

  Fall 2018

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/R38912667

• License

  Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.