A Healthography approach: Mapping maternal and child health data to more effectively target local needs

Background. States with poor maternal and child health (MCH) outcomes also tend to have fewer resources to tackle these problems; thus, being able to effectively identify the most vulnerable communities and available services becomes crucial. To respond to this need in South Carolina, a birth outcomes environmental scan was developed.    

Methods. Using ArcGIS 10.1, Microsoft SQL Server, and SAS, a dynamic PDF was created, which permits users to visually analyze dozens of spatial MCH data layers in a single county or Zip Code Tabulation Area-level map.  Numeric processing and database management operations, geocoding of health care provider and population locations, and network and spatial statistical analyses were conducted. 

Results.  The end result was an environmental scan tool that summarizes 40 pages of tables into 2 maps, which can be used by any stakeholder with access to Adobe PDF file format.  As clickable layers, the tool provides dynamic maps with the location of perinatal level hospitals, Healthy Start and Nurse-Family partnerships areas, Medicaid planning regions, perinatal regions/hospital catchment areas, and high deprivation areas, as well as MCH indices, such as low birth weight hotspots, primary care provider adequacy, child neglect, mean distance to providers, rural/urban designation, poverty level, % of births with C-Section, NICU stays, average days in NICU, C-Section charges, and 2013-2018 % change in female population.    

Conclusions. The scan is currently being used to strengthen state and local efforts to improve MCH outcomes and has increased stakeholder involvement and consensus, fostered broader data sharing, and prompted further dialogue.