Background: Climate change has a significant impact on population health. Population vulnerabilities depend on several determinants of different types, including biological, psychological, environmental, social and economic ones. Surveillance of climate-related health vulnerabilities must take into account these different factors, their interdependence, as well as their inherent spatial and temporal aspects on several scales, for informed analyses. Currently used technology includes commercial off-the-shelf Geographic Information Systems (GIS) and Database Management Systems with spatial extensions. It has been widely recognized that such OLTP (On-Line Transaction Processing) systems were not designed to support complex, multi-temporal and multi-scale analysis as required above. On-Line Analytical Processing (OLAP) is central to the field known as BI (Business Intelligence), a key field for such decision-support systems. In the last few years, we have seen a few projects that combine OLAP and GIS to improve spatio-temporal analysis and geographic knowledge discovery. This has given rise to SOLAP (Spatial OLAP) and a new research area. This paper presents how SOLAP and climate-related health vulnerability data were investigated and combined to facilitate surveillance. Results: Based on recent spatial decision-support technologies, this paper presents a spatio-temporal web-based application that goes beyond GIS applications with regard to speed, ease of use, and interactive analysis capabilities. It supports the multi-scale exploration and analysis of integrated socio-economic, health and environmental geospatial data over several periods. This project was meant to validate the potential of recent technologies to contribute to a better understanding of the interactions between public health and climate change, and to facilitate future decision-making by public health agencies and municipalities in Canada and elsewhere. The project also aimed at integrating an initial collection of geo-referenced multi-scale indicators that were identified by Canadian specialists and end-users as relevant for the surveillance of the public health impacts of climate change. This system was developed in a multidisciplinary context involving researchers, policy makers and practitioners, using BI and web-mapping concepts (more particularly SOLAP technologies), while exploring new solutions for frequent automatic updating of data and for providing contextual warnings for users (to minimize the risk of data misinterpretation). According to the project participants, the final system succeeds in facilitating surveillance activities in a way not achievable with today's GIS. Regarding the experiments on frequent automatic updating and contextual user warnings, the results obtained indicate that these are meaningful and achievable goals but they still require research and development for their successful implementation in the context of surveillance and multiple organizations. Conclusion: Surveillance of climate-related health vulnerabilities may be more efficiently supported using a combination of BI and GIS concepts, and more specifically, SOLAP technologies (in that it facilitates and accelerates multi-scale spatial and temporal analysis to a point where a user can maintain an uninterrupted train of thought by focussing on "what" she/he wants (not on "how" to get it) and always obtain instant answers, including to the most complex queries that take minutes or hours with OLTP systems (e.g., aggregated, temporal, comparative)). The developed system respects Newell's cognitive band of 10 seconds when performing knowledge discovery (exploring data, looking for hypotheses, validating models). The developed system provides new operators for easily and rapidly exploring multidimensional data at different levels of granularity, for different regions and epochs, and for visualizing the results in synchronized maps, tables and charts. It is naturally adapted to deal with multiscale indicators such as those used in the surveillance community, as confirmed by this project's end-users.

Spatial information for coastal risk assessment is inherently uncertain. This uncertainty may be due to different spatial and temporal components of geospatial data and to their semantics. The spatial uncertainty can be expressed either quantitatively or qualitatively. Spatial uncertainty in coastal risk assessment itself arises from poor spatial representation of risk zones. Indeed, coastal risk is inherently a dynamic, complex, scale-dependent, and vague, phenomenon in concept. In addition, representing the associated zones with polygons having well-defined boundaries does not provide a realistic method for efficient and accurate representing of the risk. This paper proposes a conceptual framework, based on fuzzy set theory, to deal with the problems of ill-defined risk zone boundaries and the inherent uncertainty issues. To do so, the nature and level of uncertainty, as well as the way to model it are characterized. Then, a fuzzy representation method is developed where the membership functions are derived based on expert-knowledge. The proposed approach is then applied in the Perce region (Eastern Quebec, Canada) and results are presented and discussed.