Keddem, S., Barg, F. K., Glanz, K., Jackson, T., Green, S. & George, M. (2015). Mapping the urban asthma experience: Using qualitative GIS to understand contextual factors affecting asthma control. Social Science & Medicine, 140, 9-17.

​

Keddem et al, (2015) examined the environmental and sociodemographic factors that contributed to Asthma in neighbourhoods. The researchers believed that neighborhood features contributed to the uneven distribution of health outcome, and asthma in particular, was connected to factors like crime, violence and environmental triggers. Since asthma incidence and outcomes varied across the United States, they believed that geography played a role in affecting asthma incidence and outcome. Kedde, et al. used a mixed-method design, combining research techniques like freelisting, qualitative surveying, and GIS analysis to answer questions like what are the experiences of urban adults with asthma in controlling their asthma symptoms and how are these experiences related to where they live (p.10).

 

The samples of this study were collected in five zip code regions in West Philadelphia. These regions were targeted because they had the highest rate of asthma in the city of Philadelphia (p.10). Within this region, the research qualitatively chose participants using a purpose quota sampling approach so that the 35 participants equally represented both gender group. And then, freelisting responses to 5 questions were collected from the participants. Freelisting required each respondent to list all the words they would use to describe a specific construct (for example, list all the things that make your asthma act up). The responses would later be combined to identify salient constructs and boundaries of a particular domain for members of the group (p. 10).

 

After the phase one “Patient Data Collection”, phase two of the research involved “Spatial Data Collection”. Address level crime incident and sanitation collection data were obtained from the city’s police and streets departments. Based on the freelisting result, the research team chose to map six neighborhood factors: vacant properties,illegal dumping, parks, tree canopy, aggravated assaults, and theft (p.11). Kernel density function in ArcGIS was used to calculate and display the density of theft, assault, illegal dumping and housing vacancy. A weighted visualization of density was adopted in this analysis to eliminate unequal population distribution problem. Further, the researcher standardized the layers by sorting them based on the distribution of values across all cells. Therefore, factors related to neighborhood vacancy and abandonment were weighted more heavily than crime and assaults. At last, a map was produced to present the areas across West Philadelphia that pose the most or the least influence on asthma control.

 

After conducting the analysis, Keddem et al. concluded that the primary trigger of asthma was psychological stress linked to asthma. Moreover, community level factors like community violence increased individual asthma risk.

 

We would give this paper a 9/10. We believe that this study is a good example of combining qualitative social surveying method with GIS. Conventionally, GIS is used to analyze quantitative data. This study demonstrates how to display qualitative data over a large spatial area. To do so, they standardized their analysis twice. They had weighted visualization of population density so that neighbourhood characteristic, rather than neighbourhood population size played a role in affecting asthma control. Then, they assigned risk values to each factor to standardize the layers. The potential drawback of this research is that the x is too small. Even though it was a qualitative study, and the research chose representative participants, 35 people could not reflect asthma control pattern in five zip code region. More people should be interviewed and surveyed to obtain an unbiased result.