Online Program

Novel approaches to elevated blood lead level using geospatial methods and the electronic medical record

Monday, November 2, 2015 : 10:50 a.m. - 11:10 a.m.

Laura Schuch, MPH, Department of Geography, Kent State University, Kent, OH
Andrew Curtis, Ph.D., Co-Director of the GIS, Health & Hazards Lab, Department of Geography, Kent State University, Kent, OH
Joel Davidson, MD, Locust Pediatrics Care Group, Children's Hospital Medical Center of Akron, Akron, OH
Purpose: Fine geographic scale geospatial technologies now offer opportunities to approach neighborhood / residential lead exposure in an active rather than passive manner. Previous GIS approaches tend to concentrate on census tracts or zip codes, which miss both contextual understanding of the problem and make intervention impractical. We show how a spatially encoded video camera can help blood lead level researchers, clinicians and public health planners become more proactive in their prediction and intervention strategies.

Study Questions:  To what degree do hotspots of elevated child blood level extracted from electronic medical records (EMR) overlay with building and street scale environmental variables? Can neighborhood geonarratives conducted in conjunction with spatial video reveal nuances within these hotspots?

Methods:  Locations of children with elevated blood lead levels (EBLL) were extracted from EMR data for Akron Children’s Hospital for the period 2007 to 2014. Fine scale hotspot clusters were identified using several techniques in a GIS and linked spatio-temporally with building scale assessments of eight neighborhoods. Geonarratives, which are community member and professional conversations recorded while driving around the neighborhood, were mapped using novel coding developed at Kent State University to reveal contextual layers both explaining why these hotspots exist, and identified impediments to intervention. 

Results:  Fine-scale clusters of EBLL can be found at varying intensities throughout Akron, Ohio. These hotspots display visual building characteristics that can be used to develop a preemptive diagnostic tool for identifying where children with EBLL are likely living.  Mapped narratives reveal specific challenges of the resident population and add local context to the problem and solutions.

Discussion:  The novel methods employed here demonstrate a vast improvement to mapping age of residence as a way to show where children are at greatest risk for EBLL.  The technology and the method are translatable to other environments and health conditions.

Learning Areas:

Environmental health sciences
Planning of health education strategies, interventions, and programs

Learning Objectives:
Identify geospatial tools used to assess the built environment. Explain how GIS can be used to address challenges inherent to current childhood lead poisoning prevention programs. Discuss the benefit of spatial video to environmental health assessment. List other health conditions and environments which would benefit from these methods.

Keyword(s): Geographic Information Systems (GIS), Built Environment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently funded through Akron Children's Hospital as a Research Assistant conducting research focused on geospatial approaches to childhood lead poisoning. As a PhD Candidate my research focuses on elucidating neighborhood effects on health and well-being. I have a MPH in Environmental Health Sciences and ten years experience in GIS.
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.