Reducing maternal and child health disparities using nurse home visitation and GIS

Background: The historical use of Geographic Information Systems (GIS) in public health settings has been largely under the domain of governmental and academic institutions. As GIS software has become more affordable and user-friendly, smaller, non-profit community agencies can begin to utilize GIS to better address internal functions, such as program planning, staffing, and funding applications. Methods: We will use GIS technology to present community level data on over 1700 mothers and 1900 babies living in St. Louis City and County, Missouri, receiving nurse home visits during 2009. During these home visits, registered nurses collect client medical data using an electronic health record on laptop computers. Maternal data include complete physical assessments and standardized tools for often stigmatizing conditions such as depression (CESD-20), stress (Everyday Stressors Index) and substance use. Child data include birth, immunization and development data (Ages & Stages Questionnaire). Client addresses were geocoded and added to ArcGIS software, along with Census tract data from the 2000 Census. Address data were layered over a variety of Census data including race, education, income, and housing status. Results: Layered maps indicated a high degree of association between client addresses and areas traditionally identified as health disparate based on Census data. Conclusions: Through affordable software and online training, the use of GIS from within a community-based organization is more practical now than ever. Organizations can use this technology to identify and serve populations who need services, and successfully plan for targeted service delivery.