Doctor of Philosophy (PhD)


Geography & Anthropology

Document Type



Hand foot mouth disease (HFMD) is one of the widespread transmissible diseases that target preschool children, especially in urban regions in East Asia. Understanding the travel patterns of the HFMD patients helps us understand how the spatial behaviors of patients vary across space and what are the underlying forces. It is essential for understanding the healthcare market and planning for resource allocation. Foremost, health behavior and outcome change significantly across geographic regions of various urbanicities (i.e., degrees of urbanization) due to the uneven distribution of healthcare resource. In addition, health studies in the U.S. often use hospital service areas (HSAs) to define healthcare market areas, there is no definition of such regions in most developing countries including China, let alone any research on the variation of patient behaviors across these regions. This dissertation analyzes the HFMD patients' data in Nanchang to examine the geographic variability of their spatial behaviors across two types of regions: regions of different urbanicity levels and HSAs. For the former, this study utilizes big data such as mobile signaling data and a popular regionalization method such as the Regionalization with Dynamically Constrained Agglomerative Clustering and Partitioning (REDCAP) model to define homogenous regions of various urbanicities. For the latter, the research constructs the patient-to-hospital network and adopts the Spatially Constrained Louvain and Leiden (ScLouvain and ScLeiden) to delineate functional regions such as HSAs. The findings on the variations of patient spatial behaviors across areas of various urbanicities and HSAs have important implications in public health policy.



Committee Chair

Fahui Wang