Since the late 18th Century, health indicator maps have played a crucial role in the spatial description of disease. More than two hundred years have elapsed between the earliest works in 1798 on the yellow fever pandemic in New York and the current atlases on social and health indicators. During this time, spatial analysis techniques have made enormous progress.

The advent of complex mathematical models, advances in data processing systems and the availability of powerful Geographical Information Systems (GIS) have been extremely useful for both epidemiology and healthcare planning, management and policy, thus contributing to broadening our knowledge on public health, while also improving the design of healthcare intervention strategies in numerous countries.

Within this methodological area of research, DEMAP has proposed different statistical models to tackle the geographical distribution of health indicators and analysis of their trends over time, all of which have been published in journals specialising in mathematical statistics. The statistical methods used by DEMAP encompass the following:

• Hierarchical Bayesian models
• Multi-level modelsl
• Analysis of trends and time-limited series
• Deigning statistical models using R and S-PLUS software programmes

The main outcomes of this line of work are described in the publications section on this web site.

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Currently, one of the most frequent applications of spatial analysis is to address the geographical distribution of disease in small areas, either in terms of mortality or incidence. In scientific literature, this is called disease mapping. The methods applied in this area of study enable us to analyse and view the geographical pattern of any health indicator, using maps with pre-established administrative or territorial divisions, or maps that are specifically devised for the study’s aims. The methods developed so far have been implemented successfully in a number of countries with a view to establishing Incidence and Mortality Atlases which have pinpointed the geographical pattern of the most frequent diseases and identified groups of cases.

Healthcare policies, health determinants, technology and the use of healthcare resources all change over time and have an impact on public health. As a result, monitoring health indicators must take into account evolution over time, as well as spatial distribution.

Within this line of work, the research conducted by DEMAP centres on the spatio-temporal distribution of all-cause and specific mortality, cancer prevalence and the healthcare resources available in various geographical areas in Spain. Municipality and census were used as the unit for territorial analysis. Amongst other achievements, this research has led to designing a Mortality Atlas for the Capital Cities of Andalusia, the Dynamic Mortality Atlas for Andalusian Municipalities or the Map of Social-Healthcare Resources for the Elderly in Andalusia. The main outcomes of this line of research are described in the publications and products links on this web site.

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DEMAP is a research group of the Andalusian School of Public Health within the Biomedical Research Institute of Granada. DEMAP comprises specialists in Spatial Epidemiology and Statistics, Information Systems, Public Healthcare and Management of Healthcare Services, with broad experience in Health Geography, ecological designs and analysis of small-area epidemiological case-studies.

DEMAP (Spanish acronym for the group) stands for Spatial Distribution of Morbility and Mortality in Small Areas which is one of the team´s main activities. Sinc 1999, DEMAP has been engaged primarily in three research areas:

           Spatial distribution of health outcomes

           Definitions of new social and demographical indices to characterise and classify geographical areas

           Proposals for methods to analyse small area epidemiological studies

Implementing these research line has enhanced understanding of the social, demographic and healthcare differences that exist between various geographical areas in Spain. The main results achieved are described in the sections publications and products on this web site. The primary goal of the various initiatives underway within DEMAP is o contribute towards new measures that will enhance public health, to monitor achievements and to promote healthcare policies that focus on prevention and planning of health resources.