Spatial and Contextual Epidemiology (EPID 684)

John Snow’s famous map of Cholera deaths during the 1854 Golden Square outbreak

Course Goals

In this course, we will take an exploratory and collaborative approach to defining and understanding the key problems and approaches to spatial problems in epidemiology and public health.  Through reading historical and contemporary examples of spatial analysis in public health, completing hands-on labs that give a sense of how key mechanisms and methods work, and pursuing an independent research project, you be able to identify the most important biological, social and environmental mechanisms that drive spatial patterns of risk.

You will be able to answer key questions about the relevant spatial scale of analysis for a given problem (e.g. neighborhoods vs. cities) and identify key spatial statistics for characterizing spatial clustering relevant to your public health topics of interest.  At the end of this term, you will have a strong foundation for pursuing additional study of specific topics in spatial epidemiology, advanced statistical methods relevant to spatial analysis, and the creation of maps and other data visualizations that effectively convey these ideas.

Class Meetings

We will have 28 total class meetings, which we will use for a mix of discussion, hands-on activities and project work. The topics we focus on in our in-class sessions are selected to support your own work on the semester-long Roadmap Project

This semester, we will meet in SPH I 2695 from 1:30-2:50pm, Tuesdays and Thursdays, beginning 1/5. If you are unable to attend class in-person, please use this zoom link to participate remotely.

Please review the course policies for information about attendance, grading and other issues.

Laying the Foundations: What is spatial epidemiology?

In this first module, we will start to get our heads around what we actually mean when we talk about spatial epidemiology. First and foremost, we’ll ask the question of why space matters in public health, when it does and does not, and what tools are available to us to diagnose and address spatial problems where they exist.

Date Topic
01/05 (Thu) Where are we going?
01/10 (Tue) Maps and More
01/12 (Thu) Spatial epidemiology is all about relationships
01/17 (Tue) What tools can we use to understand spatial variation and clustering?

Spatial analysis and the foundations of modern epidemiology

In this module, we will use an important but often-mischaracterized historical example - the 1854 Broad Street Cholera outbreak and John Snow’s historic analysis and intervention in it - to explore what it is that makes a public health problem a spatial one. Specifically, we will look at how this particular outbreak was shaped by the confluence of biological, social, and environmental mechanisms.

Another important component of this story is one of problem definition: Is the problem transmission of an infectious pathogen, or the spatial aggregation of foul-smelling, disease-causing air?

During this module, we will use Snow’s challenges in convincing a skeptical public and medical establishment of the infectious etiology of Cholera as a springboard for the type of problem definition that is the focus of the Postcards from the Road assignment. This will culminate in presentations at the end of this module, and we will use some of the class time prior to these presentations to make progress on this project.

Date Topic
01/19 (Thu) Walking into a Cholera epidemic
01/24 (Tue) Class cancelled
01/26 (Thu) Miasma vs. Germ Theory
What is the origin? assignment due
01/31 (Tue) Using maps to make the case
02/02 (Thu) From the pump handle to the present

Introducing the multi-level approach to spatial variation

Date Topic
02/07 (Tue) Distinguishing between individual and place effects
02/09 (Thu) Introduction to hierarchical models of spatial variation

Destination Project Progress

Date Topic
02/14 (Tue) Destination presentations
02/16 (Thu) In-class project workshop


Date Topic
02/21 (Tue) A step-by-step work-through of the radon example
02/23 (Thu) Cancelled due to 🥶 Ice Storm 🥶

Spring break - no class! 02/28 (Tue) & 03/02 (Thu)

Date Topic
03/07 (Tue) Making sense of clustered environmental exposures
03/09 (Thu) Clustered environmental exposures cont’d

Postcards from the Road

Date Topic
03/14 (Tue) Postcards from the Road I
03/16 (Thu) Postcards from the Road II
03/21 (Tue) Postcards from the Road III
03/23 (Thu) Postcards from the Road IV

Connecting measures of risk clustering to spatial variation in health outcomes

Date Topic
03/28 (Tue) Connecting residential segregation to inequitable disease outcomes
03/30 (Thu) Project Workshop
04/04 (Tue) Local variation in segregation exposure and its impact on individual health outcomes
04/06 (Thu) Segregation, structural racism, and infection

Coming around the bend: The present and future of spatial epidemiology

Date Topic
04/11 (Tue) Final Product Workshop
04/13 (Thu) What is the social vulnerability index?
04/18 (Tue) Last Day! Wrap-Up
04/26 (Wed) Final Product Submission