ABSTRACT
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Public health has been defined as “the science and art of preventing disease, prolonging life, and promoting health through the organized efforts of society.” This definition was arrived at in the inquiry established to consider the future development of the public health function including the control of communicable disease in England (Acheson, 1988). The inquiry was set up following failures in the system to protect the health of the public from two major outbreaks of communicable disease caused by salmonella and Legionnaires’ disease. Since then, a number of health scares have highlighted the need for continuing improvements in public health protection systems. Recent high profile examples include the outbreak of severe acute respiratory syndrome (SARS) and variant Creutzfeldt-Jakob disease, the human form of bovine spongiform encephalopathy commonly known as mad cow disease. The description of disease epidemiology typically has three elements: time, place, and person. Describing the outbreak and spread of a communicable disease therefore explicitly includes a spatial component. Although this has long been recognized (e.g., the investigation of cholera outbreaks in London by John Snow), an important barrier to examining the spatial element of disease outbreaks has been the lack of both digitized spatial data and the computer tools for mapping and spatial analysis.
