Last Day!

EPID 684
Spatial Epidemiology
University of Michigan School of Public Health

Jon Zelner
[email protected]


  • What is spatial epidemiology?

  • Passing some insight to the next generation of students.

  • Projects

What is spatial epidemiology anyway?

  • My major goal of this term was to finish with a better sense of this than when we started

  • Also to help/encourage you to integrate these ideas into your own work.

  • How did we do?

Image generated from the prompt spatial epidemiology in the Midjourney AI image maker

An AI 🤖 Augmented tour of spatial epidemiology

  • Presents an interesting qualitative summary of ideas/images out there on the topic.
  • Fun (if you like that sort of thing)
  • More productive than making random images of dogs doing silly things.

"Dogs arguing at the UN general assembly"

Maps are a key entrypoint to spatial analysis, but not the end

spatial epidemiology mapping

Tobler’s “First Law” and other theoretical perspectices help guide us

Everything is related to everything else. But near things are more related than distant things.” -Waldo Tobler, 1969

Image generated by putting TFL into Midjourney

John Snow’s hands-on approach was key to his success

“He sits alone in his cluttered flat, frogs croaking 🐸 around him, illuminated only by candlelight. After a few minutes tinkering…he fastens the mouthpiece over his face and releases the gas. Within seconds, his head hits the desk. Then minutes later, he wakes, consults his watch through blurre vision. He reaches for his pen, and starts recording the data.”

↖️ A lightly edited version of this quote.

Understanding cities as socio-epidemiological systems is key

“The bird’s-eye view of the city, the sense of the urban universe as a system, as a mass phenomenon—this imaginative breakthrough is as crucial to the eventual outcome of the Broad Street epidemic as any other factor.” (1, p.97)

Merging an image of the Ghost Map with victorian london street scene

Scale, scale, scale…and more scale!

multi-scale epidemiological system including individuals, households, cities, states and countries --ar 16:9

Our mental (spatial) models of how these systems work are sticky

mental models, epidemiology, Inspired by Greenhalgh (2)

evidence-based medicine

Dislodging these requires interrogating the values and biases baked into the ways we measure…everything.

Suggestions for accurately measuring the nature of and impact of structural racism on health outcomes (From Adkins-Jackson et al., 2021 (3))

Our analytic models need to align with our theoretical ones

“Moran’s Eye”

multilevel spatial statistical model, scientific drawing, color

For me, applied spatial epidemiology is about mess management

“What we do experience are large and complex sets of interacting problems, dynamic systems of problems… [W]e refer to these as messes. Our focus is on the management of messes rather than the solution of problems.”

From Ackoff 1981, “The Art and Science of Mess Management”

disease detective

The future of spatial epidemiology needs to be dominated by better ideas and not just new technologies

spatial epidemiology in the year 2100

spatial epidemiology in the year 2500

This is where I need your help

  • Spatial epidemiology sometimes comes across as very technical and inaccessible.

  • One goal with this course was to debunk that a bit while also introducing you to some of the tools.

  • I recently wrote a blog post about this for people who want to try their hand at spatial analysis but are intimidated for one reason or another.

  • But: The piece is missing a final diagram that is the counterpoint to this one showing what spatial epid. actually is 👉

  • Asking you to help me build a more accurate diagram that reflects your experiences and the ideas in the piece.

My (non-AI) interpretation of what spatial epidemiology looks like to the uninitiated.

That’s it!

  • Feel free to stay and work on projects/chat for the rest of today.

  • Please submit final products including brief (1-2 para) self-assessment and self-grade by 4/26.

  • Stay in touch!


Johnson S. The Ghost Map: The Story of London’s Most Terrifying Epidemic–and How It Changed Science, Cities, and the Modern World. Reprint edition. London: Riverhead Books; 2007.
Greenhalgh T. Miasmas, mental models and preventive public health: Some philosophical reflections on science in the COVID-19 pandemic. Interface Focus [electronic article]. 2021;11(6):20210017. ( (Accessed January 11, 2022)
Adkins-Jackson PB, Chantarat T, Bailey ZD, et al. Measuring Structural Racism: A Guide for Epidemiologists and Other Health Researchers. American Journal of Epidemiology [electronic article]. 2021;kwab239. ( (Accessed February 8, 2022)