Monitoring of Public
health accessing indicators by zip code in Tehran City
Mr.
Bahador ighanian
Miss.
Azadeh Tavakoli
Miss.
Shahrzad Tebyanian
Geographical
Information System is a computerized system for managing and analyzing the
geographic information. It has the capability to gather, save, analyze and show
the geographic information. Considering utilizing of zip codes has segregation
of information in residential usage, the experts of the ministry of health and
medical support this method (utilizing zip codes) as the best way to reach to
their aims. Digitizing 18 sheets of the plans of Tehran; and making GIS shape
file then gathering data of Hospitals, pharmacies, Doctors (as public health
indicator). and Gas station, industry factories and … (as harmful factors) from
any sources such as internet; hopefully most of services have zip code in
contact information and the others have phone number and addresses. by them we
can find zip code on internet or a specified program from Geo coding center of
post, in first step we gathering data from two sources one of them coordinated
by UTM (Universal Transverse Mercator Geographic Coordinate System) and the
other from Yellow page by zip code, then start to create shapes of access to
health indicators for residential and non residential area and show accessing
indicators to the health factors base on social and economical, … context. In
this survey we monitor outcrops of pharmacies and clinical services
distribution.
This
method can be use in several cases such as ;Sustainable development, EOC GIS
(Emergency Operation Center),Crime GIS, Educational management, Economical
cases and any other macro managements system
Monitoring
of Public health accessing indicators by zip code in Tehran City
Mr.
Bahador ighanian
Miss.
Azadeh Tavakoli
Miss.
Shahrzad Tebyanian
Introduction
After I was acclaim to be prepared to do voluntarily the GIS (Geographical
information System) services (information management system) for the center of
cancer research (orders by Society of support children suffering from cancer),
under the supervision of Prof Moosavi Jarahi, asked me to participate. So the author
has been voluntarily cooperating with this center since 7 years ago in the
issue of the survey of the epidemy of rampant cancers in Tehran province by
geographical information system. I decided to have a personal survey; in health
cases by available data; in internet, and after a while; I found many
indicators are available, and most of them prepared by yellow pages organization
of Tehran municipality (Ketab Aval) www.avval.ir
. I gathered data from this site; also called them and talked to the Data
Administrator Mr. Mahalati; and he helped me very kind and offer a new product
of his organization; it was a DVD for professional users, in fact it is a Data
DVD that supported by a powerful program, I use it for some additional data.
Before everything I insert my previous survey steps for complete
explanation of methodology.
Generally (the location information system) or Geographical Information
System (GIS) as it's shown by the title, is initially a system which edits and
analyzes the entire information of a specific location of geographic zone.
This is a computerized system for managing and analyzing the geographic information.
It has the capability to gather, save, analyze and show the geographic
information. The final aim of geographic system is to protect the decisions
which are made according to the geographic data and the basic function of this
kind of systems is to obtain the information that are gained by the syntax of
the different layers of data with different procedures and various viewpoints.
The method which is mentioned in this research, according to Mr.
Bastani, the prior supervisor of Iran codifying office, has been used for the
first time and in spite of search in internet, no equivalent was found for it.
The reason could be firstly, this method of codifying is used in developed
countries and because it's near 200 years since those countries has been
industrialized the geographic and descriptive plans of different parts of their
country have been prepared and utilized since that time.
Secondly, development prevents those societies from prevalence of the
epidemic diseases so there is no reason for them to use this method or any kind
of other methods which will be mentioned soon after. We found only one
instance, which was suggested by Oxford university to search about health GIS,
According to the zip code. That article mentioned the same method and advised
to use it for health management. But there were no details or special sub
theory in it.
After one month I found another instance in "international journal
of health geographic" that was about heart failure patients in Calgary,
Canada in 2003 according to zip codes to find the transmittal of diseases in
the city.
http://www.ij-healthgeographics.com/content/3/1/5
Methods and Materials
At the first step, the most
important item for The Cancer Institute was the methodology of covering all existent
information. Generally, the information assembling system of The Center of
Cancer was according to the information of the patient's files (self
declaration) in hospitals and medical centers which then has been registered on
the specific forms of patients by the personnel and students in The Center of
Cancer. Patient's address is one of the most important items in this forms
which had some disadvantages. First, the patient's addresses were not precise,
because the standard postal address has three parts, last pass way, penultimate
pass way and sector. So as most of the people do not know about this, they do
not follow the standards.
Second, most of the patients did not give any other addresses like where
they work or spend most of their times in, especially for the patients of other
cities. As you know, the signs of cancer can be detected in the places where
the patients may work in. All of these disadvantages were announced to The
Center of Cancer research but because The Center had no administrative
authority to ask hospitals to register the patients' precise information, the
current data was expected to be valid.
Thus, during the first two years we researched to prepare a plan of
scattering level of disease and the population of residents in different zones
according to these addresses. In this way, we had several sessions with the
experts of The Center of Geographic Information of Tehran. We were supported by
the president of that center, Mr. Moini and could use their data. Although the
most important item for The Center of Cancer was to access to the population of
residents of each zone, there was no proper data in The Center of Geographic
Information. It is necessary to say, too many studies and researches in
epidemiology has been done by The Center of Cancer and other centers but
because of the same reason that has already been mentioned, none of them is not
valid, nonetheless I will explain some of these efforts in the next part.
Characteristics of Zip Code
The custodian of the information of residents of each zone is the center
of statistics .So we referred to that center but unfortunately they had no plan
of gathered information of transmittal. Then we got in touch with central post
office because recently they have codified all zip codes in the country. They
sent us to the Postal Geographic Codifying Center of The Country, and then we
asked to have a meeting with members of the board of the ministry of post and
telegraph and telephone. The session was held and Mr. Hossain Abadi and Mr.
Bastani were attended. The result of the session was a proper explanation about
the qualities of zip code and all its documents. Briefly here they are:
The city of Tehran was divided to 8 postal centers. Digit 2 is not used
as it can be mistaken by digit 3 (in Farsi) and zero as it s alike dot (.) is
not used in codes. All of the digits of zip code have specific concept. For
instance all codes in the city of Tehran start with 1 and codes in Khorasan
province start with 5 and the codes in countryside of Tehran start with 3. As mentioned,
the city of Tehran divided to 8 regions. Postal zones 11 to 19 except 12. When
we go from main ways to sideways the codes go shredder:
1-
The country has been codified
by a Belgian contractor since 35 years ago.
2-
Each one of the manmade receives
a 10 digits code, even phone boxes.
3-
Each code has progressive
algorithm and each digit has one specific meaning.
4-
The whole country divided
to 11000 postal zones or as a technical postal phrase, "postal
patrols".
5-
About 22 millions 10 digits
codes have been registered for places that 1millions of them are residential
and about 2 millions of them are nonresidential.
6-
The method of dividing
these zones in the cities based on the aggregation of population and space but
out of the cities it depends on the roads and natural sites.
7-
The limits of zones in the
cities are pathways and streets so that none of the houses is located between
two zones. This method is used for all of the zones in the country.
8-
22 regions of Tehran are
covered by 1900 zones.
9-
The first 6 digits of zip
codes include geographic information.
10- Zip codes are never changed under any condition.
11- Each one of these 10 digits zip codes includes 29 fields of
information like usage sort in 29 separated guilds (residential,
administrative, commercial and governmental) telephone numbers and the name of
owners....
12- This information are
always updating, every day 2000 agents throughout the country and 200 agents in
Tehran pass their appointed zones on their feet to check the usage changes and
reconstructions of buildings. These agents have no contact to the residents and
observe, analyze and register the changes by themselves.
Considering utilizing of zip codes has segregation of information in
residential usage, the experts of the ministry of health and medical support this
method (utilizing zip codes) as the best way to reach to their aims. Because
these 10 digits zip codes have information about the residents of each zone,
they can calculate the population of zones by these codes and the coefficient
of family which was appointed for most of the cities or even villages by The
Center of Statistics of The Country.
For example this number is 4/1 for Tehran. We can also estimate the most
valid approximation of residents and houses by utilizing this system, because in
this system unlike The Center of Statistics Of Iran and the office of
registrations of Iran, no document is required to prove the originality of existence
of states and manmade constructions. Instead, the originality of existence is the
proof or document of being existed.
I, with the aid of Mr. Bastani, was introduced to the chief of the
department of Informatics in the Office of registrations of Iran, Mrs. Kazemi and she explained that zip codes are
registered on national identification cards but registration is according to applicant's
self declarations and is not verified to the information of office of codifying.
There is no scheme to register the changing accommodations yet which actually
changes the zip codes in national certification cards.
As most of the postal plans of zones are drafted by the first 5 digits
of zip codes, these plans are supposed to be the basic plans. The plans can be drafted
more attentively according to all 10 digits but considering, that level of
accuracy is not needed, only the first 5 digits are applied.
One of the plans that were drawn by the Office of Codifying is enclosed
(fig 1).
Digitizing Plans of the city of Tehran
(The phrase "digitizing" of the plans convey this concept that plans are not just
painting but contain information.)
Finally the author began to digitizing 18 sheets of the plans of Tehran
which had been drafted by The Office of Codifying, and then Mrs. Tavakoli voluntarily
finished the task in 1386. As our chosen procedures, first, the sheets of plans
were scanned as computer files, then the limits of zones were drawn by AutoCAD
software, after that, 18 sheets of plans were attached together and with the
aid of satellite images were changed to the actual scales with accuracy of 70 meters
false in 11 kilometers diametrically and it was expectable (Fig 3).
Then all plans of each postal center were plated and sent back to the
center to rectify the codes and unknown limits. Finally with confirmation of
The Office we reached to ultimate plans. You can see the final plan of the city
of Tehran in this image (fig 2).
In 1387 with the kindness of Mr. Nasiri, the president of The Codifying
Office and Mr. Javadi, all of the plans and traffic collision report were sent to the Center of
Cancer to apply this system for whole province, but most of the plans were like traffic collision report thus contained no geographic signs and also some of them
were too big in size so that only 8 sheets of plans of Karaj and Damavand were
utilizable. The plans of Karaj were finalized in 1388 and the plans of Damavand
in 1389 (fig 4).
For other zones of the country as it was not in the work coverage of The
Center of cancer, no plan was prepared.
But some of provinces independently prepared plans with different methods,
like plans of Ghazvin by Micro Station and plans of Tabriz by AutoCAD. This is
the location of postal zones plans of Tehran which was drawn for correction.
These are some of the individual advantages of this method:
1-
The complete conformity of the method with all the plans and
information in the country enable us to assemble all geographic plans according
to the method which in GIS is called "overlay". For instance we can
dismount ethnology plans, cell phone antennas plans, electricity transportation
lines and gas station locations with this method.
2-
Stability of codes and no
changing.
3-
Registration of descriptive
changes in the data bank of The Office of Codifying.
4-
Codifying all addresses,
even incorrect or incomplete addresses. This option plays an important role
through the goals of the institute, because no address even incorrect or
incomplete is eliminated. As it has been mentioned, all codes in Tehran begin
with 1, so all the information in The Institute of Cancer begin with 1 and
whatsoever the address is more clear and complete we can add more digits to the
code until getting to digit 5. For instance, whatsoever the names of streets in
the addresses are more attuned with the algorithm and whatsoever its sequence
is more precise we can add more digits to the codes. As an example, Roodaki Street
is situated in postal zone No 17, so the record has initially 17 as the code.
This street is on the junction of 7 postal zones which all of them begin with
175, so we add 175 to the code either. As the other item of the record, we have
another Street named Esfand, which is on the rand of 3 postal zones: 17569,
17568, 17567 and all of them begin with 6, so we add 6 to the record as well
and as a result our code becomes 1756. There is no other explanation in the
record so our code is narrowed just to 4 digits and in this way we attribute
one third to each one of 17569, 17568 and 17567 zones. If there is no address
in the record, as much as all the records belong to the city of Tehran, we
attribute 1/1900 (the number of all zones in Tehran) to each zone so actually
no record is eliminated.
Clarification of Information Methods
Various methods of clarification of existent information including 700
thousand informational records (500 thousand records of people who died due to
different kinds of cancer, buried in Tehran Behesht Zahra ,and 200 thousand records
of patients under medical) were analyzed and tested by different softwares like
ArcGIS, Arcview, Edvisi, Ilwis and AutoCAD. These methods contain, rechecking
the information by operators and clarification of information on the postal and
geographical plans by mentioned soft -wares. As AutoCAD has no capability to define
descriptive information for spots, is not a good choice. ArcGIS and Arcview
which are the most important soft wares of geographic information systems have availability
of various kind of information analyzing options but it is hard for an ordinary
operator to work with, so we have chosen Ilwis and Edrisi which both are
hydrologic software and easy to work with.
We received permission to use one of the patent software of The Office
of Geography and Postal Codifying and in this case Mr. Javadi and Shahmohammadi
were so cooperative.
This software has three parts of the address as the input (sector,
penultimate pass way, last pass way) and 5 digits code as its output. We can
also give just one word of the address to this software and get all the probable
addresses from it, and then the operator can chose the closest one.
Mrs. Tebyanian voluntarily clarified 2000 records during 4 months.
Although The Center of Cancer is a governmental center, no operator was
available.
At the end, considering the plenty of information and inability to codify
them by operators, I wrote a program to codify the addresses by FoxPro which
had a good result for 23000 chosen records. 52 percent of addresses received 5
digits codes, 41 percent received 4 digits, 6.3 percent received 3 digits and
only 0.7 percent received no codes.
Program Algorithm
This is the algorithm of the program:
As the field of address in records of data bank of The Center of Cancer
were edited and finalized, inseparable detachment of different parts of
addresses were not possible, so the informational files of the codifying
program of The Codifying Office were assumed to be the base of the operation.
This program initially reads a record of this file then searches all the
addresses of patients in the data bank to find the address .As the addresses in
the files of The Office of Codifying were edited in three parts (sector,
penultimate pass way, last pass way ) The program firstly verifies all three
fields with data bank of cancer to attribute 5 digits codes to patient's
address, and then if two fields in one record are verified with data bank , 5
digits of zip code is attributed to the patient's address and finally all
records which have received codes are eliminated thus these records are moved
out of the comparing circle. At this stage, data bank of The Office of Codifying
is the base of the operation but each one of records are compared by the data
bank of the center of cancer, after that final decision is made.
When we were going through this method, at this stage, one medium data
bank has been produced and edited. Firstly, according to the field of
"last pass way" from the
information of data bank of the office of Codifying, all the remained addresses
are checked and first 4 digits of 5 digits zip codes are attributed to them and
are registered in the medium data bank. Then the addresses according to the
field of "penultimate pass way" and sectors are checked and compared and for each
accordance, one record is registered in medium data bank with first 4 digits of
5 digits zip codes and finally the verified 4 digits codes are separately counted
and the biggest number of accordance is registered as the final code in the
data bank of the center of cancer, but if the number of found accordance is
less than 10, only 3 digits are attributed.
There are other algorithms which have been utilized but it seems that,
this one is more logical and reasonable. This kind of algorithm unlike the
other data banks, especially financial data banks, has no static out crop
(certain output) and it searches for the closest items which is named Dynamic Out
Crop.
This program requires hours to
compare and give addresses to information so that the addresses which have been
declared by patients were not standard. As one of the goals of the cancer
institute was online services (finding addresses), the author prepared a valid
IP and enabled the program to have online services so every one who has username
and password can contact to the system and upload the address files which have
been stored in a folder with text format. The program is automatically run and
put the results in a specific folder. But the spent time (96 hours) were not satisfactory
so Mr. Mohammadi was appointed by the institute to provide the algorithm by
other software .But he was not dominate at Dynamic Out Crop systems so the task
had no result.
Also informatics expert of The Cancer Institute Mr. Golmahi was informed
to give the information files to the author of these pages or any other
organization with no name and personal information, because it is against the
security of information policy, thus the received files of that center only
contain certification codes and registered addresses in forms.
As the zip codes have been publicized, geographic coordinates of every sector were actually informed to
the residents. This incident has new and various usages which will be mentioned
afterwards.
Besides, 10 digits zip codes produce
different kinds of information which some of them are:
-
Water – electricity –
telephone and gas bills can be separately provided and announced to the
consumers. As these bills are financial documents, should be very precise.
-
Registration in Vehicle
Registration Office in police department is assumed as a valuable data bank.
-
Registration in passport
office of police department.
-
Registration in registry
office.
-
Bank accounts.
Meanwhile of this project, I explained algorithm to Iran University of
Medical Sciences Research Section and they used it to analyze the epidemic disease of
Fibroma Dr Mr. Bidari and Dr Mrs. Totonchi. The experts of The Office of
Codifying and Geography and Iran University of Medical Sciences Research
Section had a session and decided the informatics unit of The Office of
Codifying chose 2500 telephone numbers from each zone according to aggregation
of residential usage and render these numbers to Iran
University of Medical Sciences Research Section . For example, from some postal
zones 5 numbers has been chosen, from the others 1 to 3 telephone numbers and
even there were zones which no number has been chosen from, because of the
majority of nonresidential usage of those zones. Finally a number of doctors
who work in the center make contact to these telephone numbers and checked the
information with the residents and registered new information which had
contradictions with The Office of Codifying on specific forms and have received
new telephone numbers from the residents. Now they are analyzing the statistics
and waiting for results.
As I said at the first; I decided to do a personal survey by this
methodology in health case, I look for health indicators in internet; and found
medicine; are main factor for treat of any disease, in fact if the patients
don’t need to any medicine for treatment; at all it is not health threats.
Based on this theory, I tried to locate pharmacies in the Tehran city and
extract its rate by population as first factor and after that I located
hospitals, because first death factor in my country is car accident and
Emergency services are available in the hospitals and second one is heart
attack and because of that I located cardiologists, I want to show possibility
of; how we can make features of any cases included health by free data and at
the first step I choose health factors.
Results
Finally, the result of this survey was a pack of figures and plans that
you can see the initial plans based on given information in this part.
Figures
Discussion
As the shapes describe better than the words; they show that the most
aggregated zone of health services is available in commercial area and have not
good dense in residential area and most problems is in industry zones that
collect in west and east side of city and the injured people in these zone;
don’t have quick access to emergency services. Also at night some areas don’t
have good access. Also I found some relation between this survey and first one;
in cancer cases, that we have a threat in same places because of health service
Zip codes are obtainable from many registry documents and urban services
bills so we can use it in different fields.
1-
Considering the compatibility
of severance of residential and nonresidential usage, utilizing the method in the field of crisis management
EOC GIS, enable us to reach the precise estimation of probable victims of
natural plagues in each zone. Also considering the exact number of existent
buildings, we have the approximate amount of collapse and have the ability to
manage the required machineries. Also considering the registration of zip codes
in the bank, the national codes of people who need second aids due to the
plagues are available.
2-
In the fields of education,
considering the registration of zip codes on national certification cards, we
can get to a clear image of the number and sex of the people who are under coverage
of education system in each zone and then we can manage the cases.
3-
In the field of permanent
development, considering the registration of these codes in water – electricity
– telephone – gas bills, registry documents of automobiles and visas, we can interpret
the development and as a result, deliberate the income distribution level in
each zone. We can also use this information in sociology and economy. During
last two years, some sessions were arranged and two experts of UNDP (United Nation
development) Mr. Farzin and Mr. Heydar Nadim as the attendees were attracted to
this method especially the issue of connection of this code and the registry
number of automobiles which plays an important role in the case of family
economy but as the decisions about new drafts are practically made in the UN
center, this proposal had no final result.
4-
This method has been
submitted to UNAIDS (United Nations AIDS) and the experts of that center found
it interesting and useful but for the same reason, it has no result. We rendered
the method to UNICEF and WHO as well, but still the result was nothing.
5-
In the field of traffic,
considering the number of automobiles in each zone and aggregation of
administrative – educational – commercial (nonresidential) centers in zones
which indicate the path of urban trips, we can have a precise image of
traffic in different hours of day and night which can be analyzed and utilized
for traffic management.
6-
In the field of security,
registration of crime locations and victims and criminals habitats can be
useful for violence probability occurrence, featuring crime
prediction and police patrol management. For instance, we can insert the annual
information to the plans and obtain a general image of different kind of crimes
probability (murder, street fights ,banditry ) occurrence in each zone, and in
this way we can send more preventive patrols to risky zones and make the number
of patrols in non risky zones less. And as a result it is a good criterion in
police management. A mathematical model which is a combination of parameters
like number of cars and selling and buying of automobiles in each city or town,
bank transaction ... can be submitted and this model enable us to obtain a
connection between coefficient of correlation of crime occurrence and these
parameters which are among the most important economic and social indexes, then
we can update the model, according to this procedure.
7-
Another advantage of this
method is obtaining information from different social classes with the procedure
of self clarification by short message service, because the connection network
of the country with 35 million subscribers covers 90 percent of the population
of the country has too many advantages toward the internet which has 15 million
subscribers and covers 60 percent, so has a low penetration coefficient.
Meanwhile the expense of each internet connection is 1 million riyals while we
can connect to mobile network only with 350 thousands riyals.
As you can see, health function of is one of
the secondary usage of this method and the most important function is in the
field of top level politic management of the country. For instance, observing
the amount of car and estate trading – health and medical services – bank interactions
– going in to and out from the country
and etc, enable us to have clear image of current events all over the
country and with a mathematical model we can made too many different
conclusions. We can get to various coefficients of correlation as well to chase the changing
of each one of these elements (most important economic criteria) to estimate
the rate of distribution of wealth and level of security, health and education
with no need of direct analysis of each one of these elements separately.
References
1-
Geology Organization Of The
Country, Earth Science Management
2-
Shahid Beheshti University,
Hygiene Department
3-
Cancer Research Of Iran Institute Of
4-
Collection of articles Of
Epidemiology Conference – Shahrood University – 1389
5-
Society Of Epidemiologists
Of Iran
6-
World Hygiene Organization
7-
Accessory of Geography and
Codifying Of The Country
8-
Universal Postal Union
9-
Khaje Nasir'o'din Toosi
University, Geomatic Department
10- Wikipedia
11- Environmental Systems Research Institute(Esri): the GIS software
leader
