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This presentation discusses using GIS to evaluate social determinants of health, including race, income, access to resources, and healthcare utilization. The goal is to identify areas in need of health resources and implement interventions to improve healthcare utilization. The research involves a community-based participatory approach, involving key stakeholders like healthcare providers, community advisory boards, and academic experts. By examining critical variables and themes related to social determinants, the team aims to create a composite map for targeted interventions at the neighborhood level.
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Using GIS to Evaluate the Social Determinants of Health Michael Dulin
Disclosures • I have no relationships to disclose. • I will not discuss off label use and/or investigational use in my presentation. • Funding from: • NIH (R01 MD006127) • The Robert Wood Johnson Foundation • NIH (R24 MD004930)
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
Community-Based Participatory Research Community Advisory Board (CAB)
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
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
Survey Variable Selection Process Research Team Key Actors CAB Latino Community & Healthcare Providers
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
Latin American Born Population who Entered the US after 2000 and not US Citizens
Hispanic Children Speaking Spanish at Home - Not Proficient in English
Latin American-Born Population that Entered the U.S. in 2000 or Later
Combining Variables • Variables Identified are Normalized • CAB asked to Weigh Each Variable • Variables are combined • CAB Adds Exclusion Criteria • Composite Map Created Dulin MF, et. al. Geographic Information Systems (GIS) demonstrating primary care needs for a transitioning Hispanic community. J Am Board Fam Med. 2010 Jan-Feb;23(1):109-20. Dulin MF, et. al. Using Geographic Information Systems (GIS) to understand a community’s primary care needs. J Am Board Fam Med. 2010 Jan-Feb;23(1):13-21
Neighborhood Evaluation / Ground Truthing • Drill Down to the Neighborhood Level • Validation Process Started • Qualitative / Photovoice • Quantitative • Begin to Build Intervention Team