Ecology and prevention of Lyme borreliosis 351
Marieta A.H. Braks, Sipke E. van Wieren, Willem Takken and Hein Sprong (eds.) Ecology and prevention of Lyme borreliosis
Ecology and control of vector-borne diseases Volume 4
DOI 10.3920/978-90-8686-838-4_25, © Wageningen Academic Publishers 2016
25. Grasping risk mapping
Marieta A.H. Braks
1*
, Annemieke C. Mulder
1
, Arno Swart
1
and William Wint
2
1
National Institute for Public Health and the Environment, Centre for Infectious Disease Control,
Antonie van Leeuwenhoeklaan 9, 3720 BA Bilthoven, the Netherlands;
2
Environmental Research Group
Oxford, Department of Zoology, University of Oxford, South Parks Road, OX1 3PS, United Kingdom;
marieta.braks@rivm.nl
Abstract
A picture is worth a thousand words, and so many Lyme borreliosis risk maps have been produced
and published in the scientific and grey literature or on websites. The focus of these is usually
on the technical and scientific aspects, and facilitating interpretation by their users is frequently
overlooked. Designing the maps is made difficult by the complexities of the disease system, the
often black box methods used to produce the models from which the maps are derived, and the
fact that many of the maps are of risk indicators rather than direct risk measures used by the public
health community. In the current chapter, we explore the various research questions, data and
tools that underlie available risk maps. We investigate how risk maps fit in a risk analysis framework
of Lyme borreliosis, including risk assessment, risk management and risk communication,
exemplified with risk maps at Pan-European, national and local scale.
Keywords: exposure, hazard, risk maps, risk analyses, scale
Introduction
Risk maps used in public health are visual representations of intricate geographic data that provide
a quick overview of the health risks. Ample examples of Lyme borreliosis risk maps for Europe and
the United States have emerged, usually depicting the spatial distribution of (infected) ticks or
(less often) disease incidence. The users often interpret these intuitively, rather than objectively
understanding the full scope of the model output, which is often derived from spatial modelling
techniques (Mannelli et al. 2016, Vanwambeke et al. 2016a).
The intuitive aspect of a risk map is both its strength and its weakness. In this chapter, we aim to
provide some guidance on the objective interpretation of risk maps. First, we examine two topics
that largely determine the features of a risk map, namely: (1) the underlying research question
(what kind of risk metric is mapped and for whom and why?); and (2) availability of data and tools
(how can available data be mapped usefully?). Second, we review different kinds of risk maps
available for Lyme borreliosis, with special attention to those concerning the Netherlands. It is
not our objective to review the various spatial modelling techniques (Ozdenerol 2015), but rather
to evaluate the utility of the output maps for risk analysis of Lyme borreliosis. In conclusion, we
provide guidance for the stakeholders (i.e. risk map consumers) and for researchers (i.e. map
developers) confronted with these issues.
Research question
While most people have strong intuitive ideas about what ‘risk’ entails, defining, interpreting and
subsequently dealing with risks in evidence-based policy making appears to be rather an intricate
task. Because risk can mean different things to different people or in different circumstances, risk
cannot be captured in a single definition. An important source of confusion in the interpretation is
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