Heather Hart

Maps as Evidence in Health Care Service Improvement and Monitoring ©2015

This research seeks to understand how health care service analysts, planners and other public health stakeholders integrate maps as a form of evidence to support decision-making in public health. The study analyzes the inclusion of maps as evidence in the implementation science framework and the evidence-informed decision-making process used in public health.
The thesis includes two real-world case studies: (1) the Centre for Addiction and Mental Health’s System Improvement through Service Collaboratives initiative and (2) Toronto Public Health’s heat vulnerability assessment project. The first case study consists of an initiative to improve Ontario’s mental health care system performance, assist in health care planning, and improve access to integrated care and social support. Here, the study analyzes the role of maps of proposed administrative boundaries to re-organize the mental health care system and the intended use of maps of associated performance measures to monitor the resulting improvements. The second case study examines maps of intra-urban heat vulnerability to guide hot weather outreach and mitigation. It illustrates how mapping supports the prioritization of populations most vulnerable to extreme heat as measured by exposure and sensitivity and as a result, plan hot weather response for both senior and general populations in Toronto.
The results of this research contribute to Geographic Information Science and the Health Sciences by demonstrating how maps serve as evidence and inform public health decisions that affect large populations. The practical implications of this research are targeted at health care professionals who are interested in integrating maps to support decision-making in their daily work. This research also contributes to methodological approaches used in public health research.

Key words: GIS and public health; decision support; public health policy; evidence-based decision-making; implementation science; knowledge transfer