Using GIS to Evaluate the Social Determinants of Health (Text Version)

Slide Presentation from the AHRQ 2011 Annual Conference

Using GIS to Evaluate the Social Determinants of Health

Slide Presentation from the AHRQ 2011 Annual Conference

On September 19, 2011, Mike Dulin made this presentation at the 2011 Annual Conference. Select to access the PowerPoint® presentation (6.8 MB). Plugin Software Help.

Slide 1

Using Geographic Information Systems (GIS) to Evaluate the Social Determinants of Health

Michael Dulin

Slide 2

Disclosures

• I have no relationships to disclose.
• I will not discuss off label use and/or investigational use in my presentation.
• Funding from:
  • National Institutes of Health (NIH) (R01 MD006127).
  • The Robert Wood Johnson Foundation.
  • NIH (R24 MD004930).

Slide 3

Background

Image: A map labeled "Percent Hispanic by Census Tract" shows the growth of the Hispanic population in a sample county of North Carolina between 1990 and 2005.

Slide 4

Goal

• Examine the relationship between social determinants and health outcomes.
• Design and validate GIS models that can identify areas within our community in need of health resources.
• Implement community-based interventions to improve appropriate healthcare utilization.

Slide 5

Community-Based Participatory Research

Community Advisory Board (CAB)

Image: Venn diagram showing the structure of the CAB: The Research Team is entirely inside the CAB; the Latino Community and Healthcare Providers overlap slightly with both.

Slide 6

Community Advisory Board (CAB)

• Healthcare System (Providers, Administrators).
• School Board.
• City/County Management.
• Parks Department.
• Law Enforcement.
• Community.
• Academic (Social Sciences, Statistical Support, GIS).
• Health Department.

Slide 7

Variables

• Race / Ethnicity.
• Income.
• Access to Grocery Stores.
• Distance to Green Space.
• Access to Public Transportation.
• Access to Healthcare.
• Social Network.
• Hospitalizations.
• ED Visits.
• Primary care Treatable ED Visits.
• Utilization of Primary care.
• Quality of Life.

Slide 8

Variable Selection Process

Image: A flow diagram labeled "Variable Selection Process" is shown.

Slide 9

Themes Identified / Data Elements Selected

• Education—Hispanic Population Speaking Spanish at Home and Not Proficient in English.
• Economic Status—Hispanic/Latino Families below the Poverty Line.
• Acculturation—Time of Arrival/Latin American-born Population who Entered U.S. in 2000 or Later and are Not U.S. Citizens.
• Safety—Violent Crime Rate.

Slide 10

Percent Hispanic (2010)

Image: A map labeled "Percent Hispanic (2010)" shows the Hispanic population in a sample county.

Slide 11

Access to Public Transportation

Image: A map labeled "Access to Public Transportation" shows data for a sample county.

Slide 12

Violent Crime Rate

Image: A map labeled "Violent Crime Rate" shows data for a sample county.

Slide 13

Emergency Department for Primary Care

Image: A map labeled "Emergency Department for Primary Care" shows data for a sample county.

Slide 14

Latin American Born Population Who Entered the U.S. After 2000 and Not U.S. Citizens

Image: A map labeled "Latin American Born Population who Entered the U.S. after 2000 and not US Citizens" shows data for a sample county.

Slide 15

Hispanic Renter-Occupied Housing

Image: A map labeled "Hispanic Renter-Occupied Housing" shows data for a sample county.

Slide 16

Hispanic Hospitalization Rate

Image: A map labeled "Hispanic Hospitalization Rate" shows data for a sample county.

Slide 17

Median Household Income

Image: A map labeled "Median Household Income" shows data for a sample county.

Slide 18

Hispanic Children Speaking Spanish at Home—Not Proficient in English

Image: A map labeled "Hispanic Children Speaking Spanish at Home—Not Proficient in English" shows data for a sample county.

Slide 19

Hispanic Families Below the Poverty Line

Image: A map labeled "Hispanic Families below the Poverty Line" shows data for a sample county.

Slide 20

Hispanic Patients Using a Safety Net Clinic

Image: A map labeled "Hispanic Patients Using a Safety Net Clinic" shows data for a sample county.

Slide 21

Hispanic Families

Image: A map labeled "Hispanic Families" shows data for a sample county.

Slide 22

Hispanic High School Graduation Rate

Image: A map labeled "Hispanic High School Graduation Rate" shows data for a sample county.

Slide 23

Hispanic Population That Moved from Abroad in the Past Year

Image: A map labeled "Hispanic Population that Moved from Abroad in the Past Year" shows data for a sample county.

Slide 24

Hispanic Single Mother Families

Image: A map labeled "Hispanic Single Mother Families" shows data for a sample county.

Slide 25

Hispanic Unemployment Rate

Image: A map labeled "Hispanic Unemployment Rate" shows data for a sample county.

Slide 26

Latin American-Born Population

Image: A map labeled "Latin American-Born Population" shows data for a sample county.

Slide 27

Latin American-Born Population That Entered the U.S. in 2000 or Later

Image: A map labeled "Latin American-Born Population that Entered the U.S. in 2000 or Later" shows data for a sample county.

Slide 28

Latin American-Born Population Who Are Not U.S. Citizens

Image: A map labeled "Latin American-Born Population" who are not U.S. Citizens shows data for a sample county.

Slide 29

Combining Variables

• Variables Identified are Normalized.
• CAB asked to Weigh Each Variable.
• Variables are combined.
• CAB Adds Exclusion Criteria.
• Composite Map Created.

Slide 30

Composite Map

Image: A map labeled "Composite Map" shows data for a sample county.

Slide 31

Neighborhood Evaluation / Ground Truthing

• Drill Down to the Neighborhood Level.
• Validation Process Started:
  • Qualitative / Photovoice.
  • Quantitative.
• Begin to Build Intervention Team.

Slide 32

Image: A street map of Tract 1702 in the sample county shows Hispanic/Latino Population by Block.

Slide 33

Image: A table labeled "Census Tract Profile" shows demographic data for the sample county.

Slide 34

Image: A street map of Tract 1918 in the sample county shows Hispanic/Latino Population by Block.

Current as of December 2011

Internet Citation:

Using GIS to Evaluate the Social Determinants of Health. Slide Presentation from the AHRQ 2011 Annual Conference (Text Version). December 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/annualconf11/bazemore_dulin_mobley/dulin.htm