A Prescription for Data on City Health

15
May
2013

Watch or listen to the news in any city and you'll be fed a stream of numbers: traffic times, weather forecasts, sports scores and financial reports. All this data gives a quick, surface snapshot of the city on any given day -- what happened last night, what's happening right now, what will happen over the next 24 hours. But a city's health is harder to put a figure on, either because of the complexity of data, the scarcity of data or the hiding of data behind locked doors. At the University of Chicago last week, a panel of researchers in medicine and the social sciences discussed how the health numbers of Chicago and other cities can be both collected and applied, enabling research on unprecedented scales and empowering citizens to improve their own wellbeing.

The panel, "Methods, Data, Infrastructure for the Study of Health in Cities," was part of the broader Health in Cities event, one of four Urban Forums held by the University of Chicago Urban Network encompassing the impressive breadth of city research on campus. Among the participants were several scientists who currently collaborating with CI researchers on how to use computation to better collect, analyze and share data. Kate Cagney, an associate professor of sociology and health studies, is working with the Urban Center for Computation and Data on their efforts to help plan and study the massive new Lakeside development taking shape on Chicago's South Side. Her team will conduct interviews of residents in the neighborhoods surrounding Lakeside both before and after construction to assess how many aspects of their lives -- including health -- are affected by this enormous addition to the city's landscape.

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"We have an opportunity to study the impact of building a neighborhood from the ashes," Cagney said. "New computational and data-intensive science techniques now exist to organize and analyze many disparate data sets, and these will allow for the study of Lakeside in unprecedented detail and produce insights due to real-time data."

While Cagney's study will look at the future of the South Side, Stacy Lindau's CommunityRx project works to connect the region's current assets with its neediest residents. CommunityRx is a continuation of the South Side Health and Vitality Studies mapping work to create a detailed, updated database of healthy resources in 50 square miles of South Side neighborhoods, such as grocery stores with fresh produce, workout facilities and specialty health care. Now, when a patient is seen at a participating health center, an algorithm takes their address and health condition and automatically prints out a personalized "Health.eRx" that tells the patient about the relevant resources near their home and connects them with a local community health information expert. Lindau, an associate professor of obstetrics/gynecology and geriatrics at University of Chicago Medicine and another UrbanCCD collaborator, hopes that this information will help physicians address patient needs that can't be fixed with a traditional prescription.

"We are good at diagnoses and prescriptions, but when it comes to connecting people with all the other things they need to be healthy, they fall off the cliff," Lindau said.

Two huge projects in earlier stages of operation were built on the potential of big health care data to further improve how physicians, hospitals and cities care for the ill. David Meltzer, associate professor of medicine, economics and public policy, described the Chicago Learning and Effectiveness Advancement Research Network, an infrastructure to share data and conduct large clinical trials across all of the academic medical centers in the Chicago area. Habibul Ahsan, Louis Block Professor of health studies, human genetics and medicine, is launching CoMPASS (Chicago Multiethnic Prevention and Surveillance Study), a long-term effort to study determinants and interventions for chronic diseases such as diabetes, cancer, cardiovascular disease and stroke which are disproportionately high in Chicago neighborhoods. A pilot study of 3,500 residents will begin enrolling later this year, but Ahsan hopes to eventually build a database tracking the long-term health of 100,000 adults in Cook County.

Until such a comprehensive database is available, computer models can help study how a disease originates and spreads across an urban environment. Diane Lauderdale, professor of epidemiology at University of Chicago Medicine, has worked with CI senior fellows Michael North and Charles Macal to create an agent-based model of Chicago's citizens and facilities to study community-associated infections from the bacteria MRSA. The team is currently using the model to test whether the rapid rise of these infections from 2001 to 2006 in Chicago was driven by the traffic in and out of the Cook County Jail, the largest single-site jail facility in the United States.

Assembling and deploying these complex models and databases could provide the critical push needed to answer questions about cities that may have seemed impossible until very recently, said panel discussant Elaine Allensworth, managing director of the Urban Education Institute.

"When we think about health in cities, we really struggle with the fact that all of these integrated systems go into one another," Allensworth said. "But by looking at data, we can actually make these problems that seem so difficult seem manageable...we can get a handle on the problem once we get the data and recognize how different systems are inter-related."

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