226314 Community Context in Understanding Geographic Disparities in Social Determinants of Health

Wednesday, November 10, 2010 : 8:30 AM - 8:45 AM

Steven Woolf, MD , Virginia Commonwealth University, Department of Family Medicine, Fairfax, VA
Steve Sedlock , Virginia Network for Geospatial Health Research, Richmond, VA
Amber Haley, MPH , Center on Human Needs, Virginia Commonwealth University School of Medicine, Richmond, VA
Benjamin Evans, MHSA , Center on Human Needs, Virginia Commonwealth University, Richmond, VA
Emily Zimmerman, PhD , Center on Human Needs, Virginia Commonwealth University, Richmond, VA
Brian Smedley, PhD , Health Policy Institute, Joint Center for Political and Economic Studies, Washington, DC, DC
     
Objective: Provide tailored reports on geographic disparities in social determinants of health in four communities participating in the “Place Matters” initiative: Boston, Baltimore, the South Delta Region of Mississippi, and the San Joaquin Valley of California.

Method: Guided by community input to identify domains of interest and local policy priorities, we combined geocoded data from multiple sources (e.g., U.S. Census Bureau, private databases, local health departments) to map within-community disparities in social and economic conditions and health outcomes. We used multilevel geospatial clustering analysis from the block group up to the county level to examine correlations.

Results: Unfavorable social, economic, and environmental conditions were concentrated among minority, poor, and depressed neighborhoods, but geographic disparities in certain indicators were of special interest to the communities. These included historical neighborhood segregation by race in Boston, poor housing and limited fresh food access in Baltimore, scarcity of parks, recreation areas, and supermarkets in rural Mississippi, and inadequate access to healthcare in the San Joaquin Valley. GIS maps illustrating the disparities and their association with health outcomes will be presented.

Conclusions: Geographic study of social determinants of health that is guided by local community input can be useful in documenting relevant disparities that are amenable to actionable policy solutions. The advantages of a community-specific view of the relationship between health outcomes and social, educational and housing policy will be discussed.

Learning Areas:
Public health or related research

Learning Objectives:
Learning Objectives 1. Illustrate the community specific connection between social factors and health disparities. 2. Describe the groups at most risk of premature death in each area. 3. Discuss the potential for re-framing social policy as a means to address health disparity.

Keywords: Geographic Information Systems, Social Inequalities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator for the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5032.0: Signs and Consequences of Disparities in Health Care