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It is very odd that national health organizations are not reporting COVID-19 cases aggregated into health regions even though provinces and territories are mostly reporting them in that way. And where is the national health framework datasets?

Framework data are a “set of continuous and fully integrated geospatial data that provide context and reference information for the country. Framework data are expected to be widely used and generally applicable, either underpinning or enabling geospatial applications” P.7.

Federal Electoral Districts for example, are the official framework data for Elections Canada and these data are updated for each election.  They are used to administer elections, report the results of exit polls during the elections, and show the results after an election.  Framework data are available in multiple formats as well as in cartographic or mapping products for Geographic Information Systems (GIS) such as ESRI, MapInfo or Tableau (Shapefiles), in KML formats for GoogleMaps, and in standardized online mapping GML Formats which also happens to also be a Treasury Board Secretariat of Standard for Geospatial Data. Election result data are aggregated into these framework data along with other socio-economic data, and once these data are mapped we can compare and can tell a more nuanced local, regional and national story, we can see patterns across the country.  The benefit of framework data are many, what is also great is they are created once by an authoritative source, they are updated and reliable, they are used many times, they are open data and everyone knows where to get them.

Considering that health care spending is one of the largest expenditures we have as a nation state, and it would be expected that in an era of accountability and transparency and where outcomes based management is the norm, it is astonishing that health data including its social determinants data are not disseminated in this way.  Yes, there are privacy issues, but we are capable of addressing those with the Census and Elections, which means we can also do so for health. We need to have an evidence based conversation about population health now more than ever, and we will need these data to tell a socio-economic story as well. Could we have done better? Who is doing great and why and who is not doing so great and why, what can we learn and what is the remedy?

Numerous useful and insightful interactive maps were published after the elections (CBC, CTV, Macleans, ESRI and many others), and these generated much discussion, people could see the results, they could situate themselves, they could see what friends and family in other places were experiencing.  Analysts and policy makers also had what they needed to understand and plan a new context. This is what democratic evidence based data journalism and policy making is all aboutt!

Natural Resources Canada is normally the producer of Canada’s framework data but it does not produce a health region framework dataset for Canada.  Arguably, these data would not only be useful during a pandemic, but also for administering and reporting health associated with natural resources such as allergies in the spring and fall, food insecurity, health and farming, or health after a natural disaster such as flooding and fires.  They data would also be useful to see where money is spent providing Canadians with the evidence they require to advocate for change.

So why no national heath reporting by their administrative boundaries and where is the health region framework dataset?

National Health Reporting Canada:

Virihealth.com and ESRI Canada produced the the first National ge0-COVID-19 reporting:

https://virihealth.com/

https://virihealth.com/

https://resources-covid19canada.hub.arcgis.com/app/eb0ec6ffdb654e71ab3c758726c55b68

https://resources-covid19canada.hub.arcgis.com/app/eb0ec6ffdb654e71ab3c758726c55b68

Federal Government:

Canada as a federation has jurisdictional divisions of power, and one of those jurisdictional  divides is health. We have the Canada Health Care Act (CHA) that

“establishes criteria and conditions related to insured health services and extended health care services that the provinces and territories must fulfill to receive the full federal cash contribution under the Canada Health Transfer (CHT)”.

The Canada Health Transfer (CHT) provides long-term predictable funding for health care, on a per capital basis and

“supports the principles of the Canada Health Act which are: universality; comprehensiveness; portability; accessibility; and, public administration”.

The provinces and territories receive cash transfers to deliver health care to Canadians and health care data reporting is done by the each province and territory separately. This alone justifies the creation of a national health region framework dataset. Which organization should be responsible for it?

There are three main organizations which are part of the Canada Health Portfolio  that currently report official COVID-19 cases. At the moment, they do not publish COVID-19 case data by health regions.

Health Canada ”is the Federal department responsible for helping Canadians maintain and improve their health, while respecting individual choices and circumstances.” Health Canada is an official and authoritative national source of COVID-19 data and it publishes the Coronavirus disease (COVID-19): Outbreak update. Reporting includes an interactive map and a line graph of data by Province and Territory.

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

Public Health Agency of Canada (PHAC) promotes and protects the health of Canadians through leadership, partnership, innovation and action in public health and it does so by: Promoting health; Preventing and controlling chronic diseases and injuries; Preventing and controlling infectious diseases; Preparing for and responding to public health emergencies; Serving as a central point for sharing Canada’s expertise with the rest of the world; Applying international research and development to Canada’s public health programs; and Strengthening intergovernmental collaboration on public health and facilitate national approaches to public health policy and planning. PHAC now disseminates an excellent interactive dashboard entitled the National Epidemiological Summary of COVID-19 Cases in Canada. Their data sources are: Public Health Agency of Canada, Surveillance and Risk Assessment, Epidemiology update; Natural Resources Canada – Grey basemap with Credit: COVID-19 Situational Awareness tiger team Powered by ESRI-Canada and COVID-19 Canadian Geostatistical Platform, a collaboration between Public Health Agency of Canada, Statistics Canada and Natural Resources Canada.

https://phac-aspc.maps.arcgis.com/apps/opsdashboard/index.html#/e968bf79f4694b5ab290205e05cfcda6

https://phac-aspc.maps.arcgis.com/apps/opsdashboard/index.html#/e968bf79f4694b5ab290205e05cfcda6

Canadian Institute for Health Research (CIHR) is the Government of Canada’s health research investment agency and its mandate is to “excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system.” Although a research funding organization, CIHR could publish a national framework dataset of health units to help researchers in Canada and to also to disseminate the findings of research either about COVID-19 or any other research according to those administrative boundaries. (Update 07/04/2020 CIHR does not have a framework data file)

A national non-governmental organization, the Canadian Institute for Health Information (CIHI) also disseminates national comparative health data, mostly about the administration of health and it would make sense for them to also publish data by health units and to have such a framework dataset. CIHI is an independent, not-for-profit organization that provides essential information on Canada’s health system and the health of Canadians. (Update 07/04/2020 CIHI does not have a framework data file). CIHI’s mandate is

“to deliver comparable and actionable information to accelerate improvements in health care, health system performance and population health across the continuum of care”.

Natural Resources Canada is the producer of most of Canada’s Framework data, and it could with the help of the Canadian Council on Geomatics Provincial and Territorial Accord could create this framework file and this was discussed at the 4th Annual SDI Summit meetings hosted in Quebec City in the Fall of 2019.

Statistics Canada produces Provincial and Territorial Health Geographies and it does seem to have a national GIS Health Regions: Boundaries and Correspondence with Census Geography file for 2018, and if that is the case, why are health geographies not reported by these boundaries? (Update 07/04/2020 StatCan has a 2018 GIS national health geography file).  Here is a PDF version of the 2018 map.

https://www150.statcan.gc.ca/n1/pub/82-402-x/2018001/maps-cartes/rm-cr14-eng.htm

https://www150.statcan.gc.ca/n1/pub/82-402-x/2018001/maps-cartes/rm-cr14-eng.htm

Provincial and Territorial Official COVID-19 Case Reports and health geographies:

Below I have compiled a list of official COVID-19 Case reporting by province and territory, and when I could find them, I included a link to health administration geographies. That does not mean that data are reported in maps, but data are generally tabulated according to health administration geographies.

Alberta

British Columbia

Manitoba (Updated RHA and Map info. 07/04/2020)

Newfoundland and Labrador (Updated RHA and Map info. 07/04/2020)

New Brunswick (Updated RHA and Map info. 07/04/2020)

North West Territories

Nova Scotia

Nunavut

Ontario

Prince Edward Island (Updated Health PEI info. 07/04/2020)

Quebec (Updated Map info 08/04/2020)

Saskatchewan

Yukon (Updated Health Region info. 07/04/2020)

I have emailed each of the Provincial and Territorial governments to confirm that I have the latest heath geography framework data.  I have received updates from Yukon, Quebec,  PEI, New Brunswick, and Manitoba, and have updated map data accordingly. I have also received correspondence from Statistics Canada, and CIHI.

For the moment ESRI Canada and some of the Provinces and Territories are reporting Official COVID-19 Cases by health region geographies.  Why aren’t Health Canada and the Public Health Agency of Canada doing so?  And where is the National Health Region Framework Data file?

Data are the oxygen of science

Watching this is a great New Years morning activity, and for Sep Kamvar I fell that data and statistics are the new black!  This is worth the 1 hour of your time!  dam, most online TV shows are 42 minutes and you learn way less…I should know :(

Merci Karl!

It looks like a biased toward industry monitoring agency Regional Aquatics Monitoring Program (RAMP) has left the public in the dark about fish abnormalities in waters in and around the oil sands sites.  It is also a case where the monitoring agency is aggregating the data into annual reports and not providing the raw data for others to scrutinize.

“That is the problem. To get the actual data, you need the raw data,” not just annual reports, said Kevin Timoney, an Alberta ecologist and oil sands researcher. “They release just enough so they can say that they did, but they don’t give you enough to see what’s really going on.”

Pembina Institute: “An essential component of any credible monitoring program is that all the data should be available to the public,

Hundreds of deformed fish found in rivers running through the Alberta oil sands have been collected and documented by an industry-led monitoring body, The Globe and Mail has learned, but the findings were not shared with the public or key decision makers in government.

That body, the Regional Aquatics Monitoring Program (RAMP), has been criticized in scientific quarters as secretive and is under the scrutiny of three reviews. Former environment minister Jim Prentice ordered one of those reviews after being shown photos this fall of a few malformed fish, and it was delivered Thursday to Environment Canada.

The Monitoring agencie’s Steering Committee is mixed between Oil industry, public health agencies, First Nations and government with very heavy emphasis on big oil industry:

Alberta Energy Resources Conservation Board (formerly Alberta Energy and Utilities Board Health Canada
Alberta Environment Husky Energy
Alberta Sustainable Resource Development Imperial Oil Resources
Canadian Natural Resources Ltd. MEG Energy Corp.
ConocoPhillips Canada Nexen  Inc.
Devon Canada Corporation Northern Lights Health Region
Environment Canada Regional Municipality of Wood Buffalo
Fort McMurray First Nation Shell Albian Sands
Fisheries and Oceans Canada Suncor Energy Inc.
Fort McKay First Nation Syncrude Canada Ltd.
Hammerstone Corporation Total E&P Canada Ltd.

I tried to find out who the members of the technical committee are but only found the following org chart which illustrates that the 3 non government stakeholders are First Nations or Metis Groups and these are dwarfed between industry and government. On the Government side you also see an Energy and Utilities Board, while on the industry side, by the largest number representatives,  is the petroleum & energy industry:
The following are the labs RAMP states it subs it’s work to.  I do not know enough the science to assess them.  I do wonder if they would have the raw data in their shops and if they would release these to the public.  A lab that is sub-contracted may or may not be the owners of the data and may or may not have given up the rights to publish them.  This is often the issue with the procurement of data, for instance, survey engineers claim IP on their data and share them with a city only for city assessments, but the city has to send citizens back to the survey engineer to view those data and the city cannot share these with citizens openly.  In this case, it would be more trustworthy to acquire the raw data from the labs directly.  However, it also depends who owns these labs.  They could very well be owned by the industries that need tests done, or they could be biased toward those industries as they would be their major source of revenue.

  • ALS Environmental – most water and sediment quality analyses
  • Alberta Research Council – some ultratrace metal analyses
  • AXYS Laboratories – sediment concentrations of PAHs
  • HydroQual – water and sediment toxicity analyses
  • Flett Research – mercury analysis in non-lethal fish tissue samples
  • Jack Zloty – benthic invertebrate taxonomy

RAMP shares its information only in annual monitoring reports.  There is an interactive web map of their monitoring sites.  The legend indicates fish tissue monitoring site, and I only found 2 fish tissue sampling sites that do not provide much data except that a sample was taken. According the the G&M article:

Much of the raw data collected by RAMP is kept private, deemed proprietary because of the industry funding. But even among its members, it has faced pressure to open up. Syncrude, which did much of the testing before RAMP’s inception, has called for data to be released, spokeswoman Cheryl Robb said.

In RAMP’s news section there is reference to an article indicating that they would make their database available to the public.  I could not find this database on their site and have sent them an email requesting to see it.  The email I recceived regarding this request is as follows:

Good morning Tracey,

Thank you for your e-mail.

As indicated by the media post you pointed out, the database will be available to the public by the end of the year and that is still our intention. Please check back next week.

Best regards,
Hailey
RAMP Communications

This is a classic lack of transparency situation and a seeming stacked deck leaning heavily toward meeting industry interests. It is very reminiscent of the Environment Canada refusal to share Mine Pollutant Data, a government agency supposedly overseeing the public interest not sharing key data.

This paper includes an awesome table (p.003) which outlines attributes related to research data sharing in academic health centres.  The table includes determinants of data access from the perspective of data storage, controls on access to data, and who determines access permissions.

The paper also includes 7 recommendations for Academic Health Centres (AHC) to encourage data sharing which I think can be modified to suit other contexts:

  1. Commit to sharing data as openly as possible, given privacy constraints.  Streamline institutional review boards, technology transfer, and information technology policies and procedures accordingly.
  2. Recognize data sharing contributions in hiring and promotion decisions, perhaps as a bonus to a publication’s impact factor.  Use concrete metrics when available. [I like that they understand the incentive structures of this group]
  3. Educate trainees and current investigators on responsible data sharing and reuse practices through class work, mentorship, and professional development.  Promote a framework for deciding upon appropriate data sharing mechanisms.
  4. Encourage data sharing practices as part of publication policies.  Lobby for explicit and enforceable policies in journal and conference instructions, to both authors and peer reviewers.
  5. Encourage data sharing plans as part of funding policies.  Lobby for appropriate data sharing requirements by funders, and recommend that they assess a proposal’s data sharing plans as part of its scientific contributions.
  6. Fund the cost of data sharing, support for repositories, adoption of sharing infrastructure and metrics, and research into best practices through federal grants and AHC funds.
  7. Publish experiences in data sharing to facilitate the exchange of best practices.

I have not looked at this literature in a while, but my sense is the discourse is moving away from problems to providing solutions.  Most importantly in the case of this paper, they are culture shifting since, in a sense they a pushing toward an open access ideology by creating an environment conducive to sharing by hiring the right people, providing the appropriate incentives, marketing successes, changing publication practices, educating and promoting open access within.  This is most interesting as this is the medical profession, a bastion of commerce and privacy concerns that is moving to open access faster than our Statistical Agency in Canada!

The full paper is available for free in myriad formats!

Piwowar HA, Becich MJ, Bilofsky H, Crowley RS, on behalf of the caBIG Data Sharing and Intellectual Capital Workspace (2008), Towards a Data Sharing Culture: Recommendations for Leadership from Academic Health Centers. PLoS Med 5(9): e183

The publisher, PLoS Medicine:

PLoS Medicine believes that medical research is an international public resource. The journal provides an open-access venue for important, peer-reviewed advances in all disciplines. With the ultimate aim of improving human health, we encourage research and comment that address the global burden of disease.

PLoS Medicine (eISSN 1549-1676; ISSN-1549-1277) is an open-access, peer-reviewed medical journal published monthly online by the Public Library of Science (PLoS), a nonprofit organization. The inaugural issue was published on 19 October 2004.

Jon Udell on Dartmouth Atlas of Health Care

Today’s New York Times has a story on regional variation in the availability and cost of health care. The story is accompanied by a “multimedia interactive graphic” — that is, a Flash visualization that chartsvariables on a U.S. map …For each mapped variable, mousing over the displayed hospital referral regions yields the local, state, and national values for that variable.

It’s nicely done. There’s no question that, as of mid-2007, this is cutting-edge data interactivity for the mainstream. But times are changing fast. The Times sourced this data from the Dartmouth Atlas of Health Care. It took me five minutes to download the surgical data, upload it to Dabble DB, and publish a similar map along with a complete tabular dump.

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