SpruceRoots Magazine - December, 1998

by John McCartney Farrell


Cartography has come along way, baby. Not the least since medieval maps depicted the extremities teeming with monsters and mythological wonders, dragons with two heads and serpents that eat their own tails.

Maps are powerful talismans, providing images of place and experience. They give us context to our social reality, paint graphic relationships from disembodied facts, give us direction by marking where we've been.

These are my thoughts as I inch my way through the Mortality Atlas of British Columbia, the "Geography of Death." It is within a limited palette of sober earth tones that a story develops; a story where chronic lung disease, diabetes, even suicide are represented by colours on a map. Turning to "motor vehicle related deaths," I look to the north and see slabs of terra cotta and know that there are more parents weeping over dead children here than elsewhere in BC.

Powell River and area is a solid block of burnt sienna - the colour of cancer. It is a stark illustration of concentrated disease. The rest of the map is devoid of colour. This area had the highest rate of breast cancer in the province. Or, at least it did from 1985-1993 when the first atlas was published. There are 21,000 people who live in a region that includes the island communities of Texada, Savoury and Lasqueti. Up until a couple of years ago, roughly one-third of the population drove along Hwy. 101 to punch the clock at the local sawmill. One could be led to make a direct correlation between environmental pollution and breast cancer.

"Whoa," says Leslie Foster, as if he were taming a runaway horse. "Part of the reason for this kind of mapping is to show a pattern. Then it's up to local people to investigate why. You can't just come to a set of conclusions. That was one of the criticisms of the Atlas - that people would come to conclusions and that would cause widespread panic."

As architect of the Geography of Death, Foster predicates his statements with caution, peppering his conversation with caveats. He spent two years putting the Atlas together at a time when he doubled as the assistant deputy minister of health for the province. He's now part of a committee with Vital Statistics putting the finishing touches on another atlas due to be published next year.

The goal of this type of mapping, he says, is to describe and then distribute relevant health information at the community level to those concerned about health issues. It is hoped that specific health challenges can be addressed by those people living in the affected area.

"What I find the Atlas useful for is to try and get communities to ask themselves things like: I live in Williams Lake so why is the infant mortality rate so different - higher or lower - than Quesnel?"

Foster is prudent in seeing the maps as a guide rather than prescription. Trends change. The latest health statistics now show Fernie, Maple Ridge and Vernon as having significantly high rates of breast cancer. The reason? A lot has changed in the past decade in terms of early detection and prognosis for treatment. Those factors may have had an impact.

"It's important to remember that these are trends. All the maps are doing is highlighting all the areas that were either statistically significantly high or statistically significantly low. Basically we looked at those in the top 10% versus the bottom 10% and indicate whether this was statistically significant. You can get high values but it may be because of some odd data. So we test these to ensure it's not a fluke."

Mapping death is not so novel an exercise. In fact, the past two decades have spawned more than 40 mortality atlases, produced in over 20 countries. Epidemiologists have been systematically studying the dispersion of disease for the past two centuries. But recent breakthroughs in data gathering and processing are vastly increasing the power and availability of geographic analysis and mapping technology.

Geographic analysis is being used for everything from examining distribution of health care resources to mapping medical procedures. How come this area up here has so many appendectomies per standard population versus this other one? You might well ask.

Geographical analysis reaches into all areas of our culture, from mapping heritage to ecosystems and land-use planning. Probably some of the most exciting mapping is taking place in urban areas as tools for making and breaking social policy.
Last year, for example, the good people of Vallejo, California, a short drive from San Francisco, demanded that the city council take action to prevent alcohol and drug-related crime. Similar cries for action had gone unheard in the past. So, this time, a community group came armed with maps. Rates of alcohol and drug-related arrests and other incidents were charted block by block on a map that also showed the locations and spacing of retail liquor outlets.

The community was able to show a direct correlation between crimes committed in relation to the geographical location of a liquor store-six crimes per year within a 1,000-foot radius of the liquor store. And, double the number of liquor outlets in a given block doubles the crime rate.

In the end, the maps were convincing. The community was able to
get a city ordinance banning construction of new retail liquor outlets within 1,000 feet of existing liquor stores or bars.

There may be nothing new about using geography to influence health and social policy, but looking at mapping in a new light can help redefine our assumptions and provide another way of seeing beyond the fears of the uncharted.


SpruceRoots Magazine - December, 1998