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Key Words geography, health services, research, policy analysis
* Abstract Geographic information systems (GIS) and analyses based on GIS have become widespread and well accepted. GIS is not the complete solution to understanding the distribution of disease and the problems of public health but is an important way in which to better illuminate how humans interact with their environment to create or deter health.
Public health and health care have been substantially transformed by information technology. No one can doubt that the rapid proliferation of computers and computer-driven information systems have changed how we organize health care, understand health needs, and deliver services. Computers have been networked through a digital data sharing protocol, commonly called the Internet, that transcends space and scale. Widely distributed users with simple machines can now work in tandem with large integrated systems in central places. This networking structure has been called cyberspace and represents a geography or reality that is sometimes termed virtual to contrast it from the more normal physical reality associated with people and places. Paradoxically, the same computers and networks that have on the one hand removed users from the constraints of space-of geography-have allowed them to more intimately understand the role of place, space, and distance through the use of geographic information system (GIS). This special minisymposium of the Annual Review of Public Health describes how GIS is being used in public health and, to a lesser extent, in health services. Our authors comment on how GIS has been used and how it will be used in possible future applications of this "suite" of technologies.
GIS has been touted as a transformational technology, but as we begin to use it more and more, we recognize that it is, like computers in general, a tool to facilitate evolutionary changes. The history of GIS parallels that of computation in general, with mapping and geographic studies being early beneficiaries of the increasing power of computers. As GIS began to be "discovered" by other fields of inquiry beyond geography, it was often billed as a universal solution for understanding data-in marketing, health care, and planning. In reality, it has been adopted, like another transformational technology-telemedicine (3), more like the advance of a seasonal spring tide than as...