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Moving Beyond the Map: Geospatial Analysis applied to Public Health and the Changing View of Health Equity
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Moving Beyond the Map: Geospatial Analysis applied to Public Health and the Changing View of Health Equity

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Presentation by at the 2009 Virginia Health Equity Conference.

Presentation by at the 2009 Virginia Health Equity Conference.

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  • Disaggregation and target areas, based on more specific locational data of incidences, and where to specify intervention. We can always aggregate back up – get as small as possible.
  • The issue of infant mortality cuts across jurisdictional boundaries. Predictive Kriging at the block group level. Police model: With high-probability, the next infant deaths will be in this area. Using this for grants.
  • Mean-weighted centers. Clusters helping for clinic placement.
  • 1200 to 2000 women walking around with undiagnosed breast cancer. Residual analysis compared between Northern VA and the state standard, we determined that there are potentially X amount of undiagnosed breast cancer incidences. This relates back to the fact that we know, through the Cancer Registry, that we have very high levels of late-stage breast cancer in these areas. High percentage of late-stage diagnosis of breast cancer in other data. The next slide shows the mortality data that confirms this slide.

Moving Beyond the Map: Geospatial Analysis applied to Public Health and the Changing View of Health Equity Moving Beyond the Map: Geospatial Analysis applied to Public Health and the Changing View of Health Equity Presentation Transcript

  • Moving Beyond the Map
    • Geospatial Analysis applied to Public Health and the Changing View of Health Equity
    Steve Sedlock, Executive Director The Virginia Network for Geospatial Health Research, Inc. Virginia Health Equity Conference – September 10-11, 2009
  • Computer Mapping and Geographic Information Systems (GIS)
    • Most common use – The creation of land records.*
    • Other common uses – cartography, visualization, spatial data management.
    * 2008 Geospatial Technology Report, Geospatial Information & Technology Association (GITA), Aurora, CO.
  • Computer Mapping and Geographic Information Systems (GIS)
    • Analytical processes usually rank lower, with regard to usage.
      • Spatial analysis
      • Geostatistical analysis
      • Network analysis
    • This type of functionality is typically not available in core GIS (added purchase).*
    * ESRI extensions include Spatial, Geostatistical, Network, Tracking, and Survey Analysts. These are separate from the core ArcGIS Desktop functionality.
  • Geographic Visualization
    • Support material for reports, charts, and graphs.
    • In order to justify the purchase of GIS software, an organization must get a higher level of usage.
    • Simply as a support tool, GIS will have problems sustaining itself.
  • Geospatial Analysis Providing an Expanded Use of GIS in Public Health
    • Predictive Modeling – identifying “hot spots” where disease or problems are occurring.
    • Time-distance analysis – identifying medically-underserved areas (MUAs).
    • Service area analysis – determining the appropriate placement for clinics.
  • Early Pioneer
    • John Snow’s Cholera Map from 1885
    • Map with multiple layers showing a disease outbreak.
  •  
  •  
  • Predictive Modeling of Infant Mortality
    • Example: City of Richmond
      • In 2007, City rate of 12.4 deaths per 1,000 live births was well above the state rate of 7.7*
      • Is infant mortality a geographically widespread problem in the city?
      • Predictive modeling, through the use of geospatial process called Kringing, tells us “No.”
    * Source: Virginia Department of Health – Health Statistics Report, 2007.
  • Richmond VA Infant Deaths, 1990-2005 Predictive Kriging Analysis
  • Predictive Modeling of Infant Mortality
    • Example: City of Richmond
      • Problem is more focused on an area in eastern Richmond and East-Central Henrico County.
      • The problem is cross-jurisdictional.
      • Reframing the answer to the problem:
        • Potential for the city to geographically identify “hot spots” and focus resources.
      • Next level of analysis –the social, behavioral, and environmental variables that could be contributing to this problem.
      • Potential Intervention:
        • Police know where the next murder is likely to take place.
        • Predict where infant mortality is going to occur.
  • Infant Mortality – Optimum Clinic Placement
    • Example: Tidewater area
      • In 2007, Planning District 20 rate of 10.7*
        • Norfolk – 16.4
        • Portsmouth – 7.3
        • Chesapeake – 12.3
      • Predictive modeling, using geospatial process called Kernel Density analysis, focuses in on an area that crosses between Norfolk, Tidewater, and Chesapeake.
    * Source: Virginia Department of Health – Health Statistics Report, 2007.
  •  
  • Infant Mortality – Optimum Clinic Placement
    • Example: Tidewater area
      • Mean-weighted center establishes the best locations for maternity clinics in the “hot spot” area.
      • Next level of analysis -- the social, behavioral, and environmental variables that could be contributing to this being a “hot spot” area.
  • Breast Cancer – Predicting Locations of Under-Reporting
    • Example: Statewide
      • Based on multiple analyses, determine the potential number of undiagnosed breast cancer cases.
  •  
  • ! ( Mammography Units
  • Breast Cancer – Predicting Locations of Under-Reporting
    • Example: Statewide
      • Southern Virginia potentially has 2,000 undiagnosed cases of breast cancer.
      • Mammography locations reflect a lack of facilities in this area.
      • Next level of analysis -- the social, behavioral, and environmental variables that could be contributing to Southern Virginia’s potential under-reporting.
  • Psychiatric Facilities – Drive Time Analysis
    • Example: Statewide
      • Areas within one hour of a psychiatric bed facility.
  • Psychiatric Facilities – Drive Time Analysis
  • Thinking and Planning Geospatial with Regard to Public Health
    • Data distribution
    • Confidentiality
    • Cost and Economies of Scale
    • Maintaining objectivity through independent research
    • Reframing the question.
  • Thank you! Moving Beyond the Map Steve Sedlock, Executive Director The Virginia Network for Geospatial Health Research, Inc. Phone: 804-264-3325 Email: [email_address]