Anna Barford

Worldmapper: The World as You've Never Seen it Before

This paper describes the Worldmapper project, which makes use of novel visualization techniques to represent a broad variety of social and economic data about the countries of the world. The goal of the project is to use the map projections known as cartograms to depict comparisons and relations between different territories, and its execution raises many interesting design challenges that were not all apparent at the outset. We discuss the approaches taken towards these challenges, some of which may have considerably broad application. We conclude by commenting on the positive initial response to the Worldmapper images published on the Web, which we believe is due, at least in part, to the particular effectiveness of the cartogram as a tool for communicating quantitative geographic data

Re-evaluating self-evaluation. A commentary on Jen, Jones, and Johnston (68:4, 2009)

In a paper recently published in Social Science & Medicine, ‘‘Global variations in health: Evaluating Wilkinson’s income inequality hypothesis using the World Values Survey’’, and one in another journal Jen, Jones and Johnston provided analyses of selfrated health, using data from theWorld Values Survey (Jen, Jones, & Johnston, 2009a, 2009b). They showed that income is significantly associated with self-rated health; higher incomes being related to better health. Although they found that self-rated health varied between countries, they did not find an independent effect of income inequality on self-rated health. The authors concluded that their analyses provided a test, and refutation, of what they described as the ‘‘Wilkinson hypothesis’’. Briefly stated, the ‘‘Wilkinson hypothesis’’ is that population health in rich countries tends to be better in societies where income is more equally distributed. There are now more than 200 analyses of the nature of this relationship, and reviews of these studies have come to conflicting interpretations of the evidence, with researchers disagreeing over methodological issues, such as the scale at which inequality is measured, whether or not various control variables should be interpreted as confounders or mediators, and the appropriateness of various statistical models (Lynch et al., 2004, Macinko, Shi, Starfield, & Wulu, 2003, Subramanian & Kawachi, 2004,Wilkinson & Pickett, 2006). In the context of this controversy, do Jen et al’s (2009a, 2009b) analyses put a final nail in the coffin of the ‘‘Wilkinson hypothesis’’? In this paper, we consider the relationship between ‘health’ (the outcome in the Wilkinson hypothesises to be affected by income inequality) and ‘self-rated health’ (the outcome analysed by Jen and colleagues). We argue that ‘health’ and ‘self-rated health’ cannot always be assumed to be proxies for one another. We also suggest that if, as Jen et al. find, average levels of self-rated health tend to be higher in more unequal societies, that this has something to tell us about the psychosocial effects of living in unequal societies.

The inequality hypothesis: thesis, antithesis, and a synthesis?

In the pages of this journal Min Hua Jen, Kelvyn Jones and, Ron Johnston recently presented a paper claiming to have evaluated Richard Wilkinson’s hypothesis that social inequality damages the health of populations (Jen et al., 2008). It was an interesting paper with findings not originally recognized in Wilkinson’s hypothesis, but it suffers from one major flaw: the findings are not a direct evaluation of Richard Wilkinson’s hypothesis. We show why below. It is important to point this out as the balance of much very new evidence now points towards inequality having damaging effects on society in all kinds of ways (Wilkinson and Pickett, 2009), not just in terms of health (but for a review of that see Ram, 2006) and it would be unfortunate if the value of these new findings were cast into doubt by studies that did not evaluate the actual hypothesis, but something else, which in turn turns out to be quite interesting. In hindsight it is easy to see how Jen et al. could have thought that they were evaluating the inequality hypothesis. Part of the argument of their paper is that quite complex methods of synthetic data creation and multilevel modeling are needed to evaluate the inequality hypothesis. This might be the case, although others find the existing evidence in support of Wilkinson’s hypothesis to be near overwhelming (Dorling et al., 2007 provide an argument for extending his findings to poorer countries). However, it is possible that it was dealing with that complexity of synthetic data and multiplicity of hypothesized levels which led to the very simple oversight we highlight below. We should note that our response is far from being a simple critique, as we find Jen et al.’s analysis and findings very interesting, just in a way that they didn’t. This is thus an attempt at a constructive critique and we hope it is seen in that way and

Geographical perspectives on epidemic transmission of cholera in Haiti, October 2010 through March 2013

The current epidemic of El Tor cholera in the Caribbean republic of Haiti is one of the largest single outbreaks of the disease ever recorded. The prospects are that the epidemic will continue to present challenges to workers in public health medicine, epidemiology, and allied fields in the social sciences for years to come. This article introduces geographers to the environmental context of the Haiti cholera epidemic, the principal data sources available to analyze the occurrence of the epidemic, and evidence regarding its geographical origins and dispersal during the first thirty months of the epidemic, October 2010 through March 2013. Using weekly case data collated by the Haitian Ministère de la Santé Publique et de la Population (MSPP), techniques of time series analysis are used to examine inter- and intradepartmental patterns of cholera activity. Our analysis demonstrates a pronounced lag structure to the spatial development of the epidemic (Artibonite and northern departments → Ouest and metropolitan Port-au-Prince → southern departments). Observed variations in levels of epidemiological integration, both within and between departments, provide new perspectives on the spatiotemporal evolution of the epidemic to its March 2013 pattern.

The shape of the global causes of death

BackgroundWorld maps can provide an instant visual overview of the distribution of diseases and deaths.ResultsThere is a particular geography to each type of death: in some places many thousands of deaths are caused by a particular condition, whilst other equally populous areas have few to no deaths from the same cause.ConclusionPhysicians and other health professionals often specialise in the specifics of causes, symptoms and effects. For some practitioners gaining a worldview of disease burden complements smaller scale medical knowledge of where and how people are affected by each condition. Maps can make health related information much more accessible to planners and the general public than can tables, text, or even graphs. Ten cartograms based on World Health Organisation Burden of Disease data are introduced here; alongside seven based on data from other sources. The Burden of Disease cartograms are the latest in a much larger collection of social, economic and health world maps.

Health impacts of an environmental disaster: a polemic

At this early point in the 21st century a major concern that we face is the future possible effects of people-induced global warming. The predicted effects are severe, but argued by some to be avoidable if we act now. Here we consider the dimensions of another disaster: one for which not only the causes, but also their horrific consequences, are current worldwide. The implicit question is ‘why are we more worried about future disasters than those already occurring?’ The worldmapper collection of cartograms (where a map is used like a pie-chart to present data) is used here to illustrate the extent of international inequalities in health and living conditions, discussed in relation to other aspects of human lives. Though the shape that we can see the world is in is shocking, we can also envisage a positive future. We compare these current global times to more local past times experienced during the ravaging inequalities of Victorian Britain. We use Britain simply as an example. We end by suggesting a further step the current British Prime Minister could make in his thinking. Doing this we can see the potential for environmental reconstruction, which would result (as it did before) in considerable reductions in infant mortality. Our common future is not already mapped out; it is still to be won.

Shaping the world to illustrate inequalities in health.

Visualizing inequalities in health at the world scale is not easily achieved from tables of mortality rates. Maps that show rates using a colour scale often are less informative than many map-readers re-alize. For instance, a country with a very small land area receives less attention, whereas a large, sparsely populated area on a map is more obvious. Furthermore, unlike our visual ability to compare the lengths of bars in a chart, we do not have a natural aptitude for translating different colours or shades to the mag-nitudes they represent. Here we intro-duce another approach to mapping the world that can be useful for illustrating inequalities in health.Where do you think most infants in the world are born, where do most die and how have these measures changed since 1970? A map of birth rates would not help you much, unless you had the kind of memory that could associate several hundred areas with counts of their populations of young women, and had the ability to perform some quick mental arithmetic of rate reciprocals. Nor would maps of death rates help much in answering these questions. Seeing the world shaped by how many babies are born in a year is a more reli-able and rapid way of communicating these numbers (Fig. 1).This figure was created using soft-ware derived from that which is freely available online.