Improving Disease Surveillance by Incorporating Residential History

Surveillance data related to chronic diseases typically involves a time component, often a birth date or date of diagnosis, and a spatial component, usually residence at time of diagnosis, to some degree of accuracy. However, if we are interested in studying the spatial patterns of a disease such as leukemia or bladder cancer, the current locations of the cases would be almost irrelevant to our study. The important information regarding the relationship between location and disease would be the residential history, especially if there is a trigger point. If the disease of interest has a trigger point, then where the person resided at that time point is critical. Typically we do not know the exact time the disease was acquired. To overcome this concern, we incorporate a subject's residential history, which we weight by the incubation distribution specific to the disease of interest.

The goal of this research is to enhance methods used in disease surveillance by incorporating knowledge of the incubation distribution of the disease of interest. The incubation distribution, combined with the residential histories of the subjects, gives information regarding the spatial and temporal relationship between the cases. If the cases are distributed differently from the controls then an explanation of this discrepancy is in order. We use the M-statistic (Bonetti 2005) to evaluate the significance of these new distance distributions and the work of Sartwell, Armenian and Lillienfeld to define the incubation distributions.