Describing infant health disparities using nurse home visitation and GIS

Background: Child health disparities vary by geographic region. Census data is useful in child services planning. As Geographic Information Systems (GIS) software has become more affordable and user-friendly, non-profit community agencies can utilize GIS to address internal functions related to enhancing service provision. GIS technology is powerful when coupled with Electronic Health Record (EHR) data collected by the community agency at the client level. Hypothesis: Clients in this nurse home visitation service area will correspond to areas identified as health disparate by Census data 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 through a community agency during 2009. During home visits, registered nurses collect client data using a proprietary EHR on laptop computers. Child data include birthweight, prematurity, risk factors, nutrition, education, immunization status and child development (Ages & Stages Questionnaire). Relevant maternal data will be included where appropriate. All client addresses have been geocoded and added to ArcGIS software, along with Census tract data from the 2000 Census including race, education, income, and housing status. Results: Plotting infant health data over Census data resulted in a high degree of association between client addresses and areas traditionally identified as economically and socially disadvantaged. Conclusions: Through affordable software and online training, the use of GIS by community-based organizations is feasible. Organizations can use GIS to identify and serve populations and target service delivery.