Online Program

325441
Disparities in mortality across geographic scales in Texas


Wednesday, November 4, 2015 : 8:30 a.m. - 8:50 a.m.

Lawrence Panas, MA, Department of Preventive Medicine & Community Health, University of Texas Medical Branch at Galveston, Galveston, TX
John Prochaska, DrPH, MPH, Department of Preventive Medicine & Community Health, University of Texas Medical Branch, Galveston, TX
Public health researchers rely on statistics developed by multiple parties to understand the health of their target populations. Unfortunately, at the local level geographies, small sample sizes and large variations can render drawing conclusions extremely difficult. This presentation examines the impacts of aggregation at multiple levels of geography and examines differences in findings in terms of racial and ethnic disparities in all cause and cause-specific mortality in Texas based on different geographic levels of analysis.

Data for this study were obtained from the Census Summary Files (SF) 2 and 4 for the year 2000, the Rural Health Research Center Rural-Urban Commuting Area Codes (RUCA), Texas Department of State Health Services Border and Public Health Region definitions, and Texas Vital Statistics for Multiple Causes of Death. Data were aggregated by public health regions, counties, and census tracts. Death counts were analyzed using hierarchical modeling controlling for individual level demographics and geographic level factors including poverty, ethnic density, proximity to the border, and rural-urban status, as well as visually using geographic information science (GIS).  

Findings from thematic mapping indicate that non-Hispanic Whites have some of the highest rates of mortality for all causes across all levels. Non-Hispanic Blacks were largely at lower risk, overall, than non-Hispanic Whites, and Hispanics had the lowest rates across all groups. When using smaller-scale geospatial identifiers, results show greater variation in the needs and risk of different areas. This is especially true with census tracts where differences in rates can vacillate wildly in a small area.

Learning Areas:

Epidemiology
Other professions or practice related to public health
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Describe the application of geospatial epidemiology to examine differences in mortality across different geographic levels. Compare differences in rates across geographic levels across racial/ethnic stratifiers.

Keyword(s): Mortality, Geographic Information Systems (GIS)

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I led the development and conduct in the research for this project including development of rates, mapping of rates, and the analyses for hierarchical linear modeling.
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.