Mapping Heart Disease, Stroke and Other Chronic Diseases: A Program to Enhance GIS Capacity within State and Local Health Departments Highlights from State Health Departments: Iowa; Mississippi; Nebraska; New Hampshire; Texas; Wisconsin; and Local Health departments: Boston, MA; Cambridge, MA; Hennepin, MN; Rockland, NY; and Washington, MN Submitted to the US Centers for Disease Control and Prevention Division for Heart Disease and Stroke Prevention and the National Association of Chronic Disease Directors Prepared by the Children’s Environmental Health Initiative at the School of Natural Resources and Environment, University of Michigan September 2013
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Mapping Heart Disease, Stroke and Other Chronic Diseases: A Program to Enhance GIS Capacity within State and Local Health Departments
Highlights from State Health Departments: Iowa; Mississippi; Nebraska; New Hampshire; Texas; Wisconsin; and Local Health departments: Boston, MA; Cambridge, MA; Hennepin, MN; Rockland, NY; and Washington, MN
Submitted to the US Centers for Disease Control and Prevention Division for Heart Disease and Stroke Prevention and the National Association of Chronic Disease Directors
Prepared by the Children’s Environmental Health Initiative at the School of Natural Resources and Environment, University of Michigan
September 2013
i
Acknowledgements
The following staff from each of the participating agencies provided valuable contributions to the success of this project’s ability to enhance the use of GIS within state and local health departments for the prevention and treatment of heart disease, stroke, and other chronic diseases. In addition, we extend our deep appreciation to Environmental Systems Research Institute (Esri) for their generous provision of software grants to the state and local health departments participating in this project.
Iowa Department of Public HealthJatta Alagie Suning Cao Ousmane Diallo Catherine Lillehoj Terry Y. Meek Joann Muldoon Rob WalkerJohn C. WarmingTim Wickam Kevin Wooddell
Mississippi State Department of HealthSai KurmanaLaTonya Lott Vincent Mendy Amel Mohamed
Nebraska Department of Health and Human ServicesYushiuan Chen Jianping Daniels David DeVries Guangming Han
New Hampshire Department of Health and Human ServicesLia Baroody Jean Cadet Michael Laviolette Tylor Young
Texas Department of State Health ServicesRosemary Ang Nimisha Bhakta Cecily Brea Blaise Mathabela
Wisconsin Department of Health ServicesJulie Baumann Nancy Chudy Randy Glysch Herng-Leh YuanEmily Reynolds
Boston MA Public Health CommissionNeelesh BatraHonglei DaiShannon O’MalleyNelson PidgeonSnehal ShahRashida TaherMegan Young
Cambridge MA Public Health DepartmentSusan Kilroy-AmesLeanne LasherJosefine Wendel
Hennepin County MN Human Services and Public Health DepartmentErica BagstadLinda BrandtJack BrondumMei DingJay MeehlKomal MehrotraMargo SuhrTim Zimmerman
Rockland County NY Department of HealthOscar AlleyneUna DiffeyJeremy ErlichMelissa JacobsonKevin McKay
Washington County MN Department of HealthFred AndersonKim BallChris LeClairAdam SnegoskyJean Streetar
ii
IntroductIon
Geographic Information Systems (GIS) are powerful tools for enhancing the ability of state and local health departments to address the public health burden of heart disease, stroke, and other chronic diseases. In order to build the capacity of state and local health departments to utilize GIS for the surveillance and prevention of chronic diseases, the Division for Heart Disease and Stroke Preven-tion at the National Centers for Disease Control and Prevention (CDC) funds a collaborative training project with the National As-sociation of Chronic Disease Directors and the University of Michigan. The central objective of this GIS Surveillance Training Project is to enhance the ability of state and local health departments to integrate the use of GIS into daily operations that support existing priorities for surveillance and prevention of heart disease, stroke, and other chronic diseases. Staff members from state and local health departments receive training regarding the use of GIS surveillance and mapping to address four major purposes: • documenting geographic disparities, • informing policy and program decisions, • enhancing partnerships with external agencies, and • facilitating collaboration within agencies.
In 2012, the following health departments were competitively selected to participate in this GIS Surveillance Training Project: Iowa; Mississippi; Nebraska; New Hampshire; Texas; Wisconsin; Boston, Massachusetts; Cambridge, Massachusetts; Hennepin County, Min-nesota; Rockland County, New York; and Washington County, Minnesota. The project is intentionally designed to develop a GIS infra-structure that can serve a vast array of chronic disease areas, yet with a focus on heart disease and stroke.
The maps displayed in this document highlight examples of how each participating health department produced maps to support their chronic disease priorities by documenting the burden, informing program and policy development, and enhancing partnerships. The extent of collaboration among chronic disease units within each health department is evident in the diversity of the teams that participated in the training and have continued to work to strengthen GIS infrastructure within their respective health departments.
chronIc dIseAse gIs exchAnge
To see additional maps that address heart disease, stroke and other chronic diseases, visit the Chronic Disease GIS Exchange at www.cdc.gov/dhdsp/maps/gisx. The site includes a map gallery, GIS training modules, and a wide range of GIS resources. Visitors to the site are also invited to submit their own map to the map gallery.
Iowa: Using GIS to Address Existing Priorities
Document the Burden: Stroke Hospitalizations in Iowa Hospitals, Iowa Residents, 2005-2009
The ability of the Iowa Department of Public Health to use data to drive policy ef-forts and program activities is critical to the department’s mission to promote and protect the health of Iowans. The department also has an obligation to share data with Local Public Health Agencies that is useful to them in their health needs and planning efforts. This map displays the age adjusted rate per 1,000 population of stroke hospitalizations of Iowa residents in Iowa hospitals from 2005-2009. In the 37 hatch-marked counties the rates may be a significant underestimate of the true rates, because greater than 5% of resident hospitalizations occur in out of state hospitals, and are not included in the data. Public health planners in those counties should be cautious in using the presented rates as the underestimation could lead to the interpretation that efforts related to prevention and treatment of stroke are less of a priority due to a lower burden of disease in these counties. The pattern of coun-ties where rates may be unreliable is concentrated in the western and north-eastern portions of the state; this pattern is consistent with proximity to major out-of-state health facilities in Nebraska, South Dakota, and Minnesota. This map will be used to communicate messages to two primary audiences:
1. Leadership within the Iowa Department of Public Health to point out the impor-tance of working with the Iowa Hospital Association and its counterparts in neighbor states to facilitate the inclusion of data for hospitalizations of Iowa residents that occur in out-of-state facilities.
2. Local Public Health Agencies to provide information on the limits of hospitalization data currently being shared with them, and assisting them in appropriate interpreta-tion.
1
Iowa
Illinois
Nebraska
Missouri
Wisconsin
Minnesota
South DakotaSioux
Kossuth
Clayton
Page Taylor
ShelbyHarrison
Crawford
O'Brien
Franklin
WorthAllamakee
Fremont
Mitchell HowardWinneshiek
EmmetOsceola Dickinson
Clay
Iowa
Adair
Benton
Fayette
Jones
Cedar
Dallas
Carroll
Warren
Johnson
Pottawattamie
Hancock
Delaware
Ringgold
Chickasaw
Humboldt
Winnebago
Montgomery
Linn
Polk
Story
Jasper
Wright
Webster
Monona
Marion
Greene
Grundy
Decatur
Marshall
Clarke
Hamilton
Palo Alto
Bremer
Monroe
Poweshiek
PocahontasBuena Vista
Cerro Gordo
Lee
Tama
Cass
Clinton
ButlerPlymouth
Scott
Floyd
Boone
Guthrie
Jackson
Keokuk
HenryUnion Lucas
Dubuque
Louisa
Mahaska
Buchanan
Audubon
SacIda
Mills
Davis
WoodburyHardin
Wayne
Calhoun
Madison
Adams
Cherokee
Wapello
Black Hawk
Washington
Jefferson
Van BurenAppanoose
Muscatine
Des Moines
Lyon
age adjusted rateper 1,000 population
1.2 - 3.1
3.2 - 3.7
3.8 - 4.2
4.3 - 4.6
4.7 - 5.8
Interpret rate with caution*
Primary Stroke Center
Stroke Hospitalizations in Iowa HospitalsIowa Residents, 2005-2009
Source: Iowa Department of Public Health Data Warehouse, Iowa Hospital Association, and US Census Mid-Year Population Estimates Vintage 2009.Hospitalization data does not include Iowa residents hospitalized in federal Veterans Adminstration facilities or facilities outside of Iowa.Rates are Age Adjusted to the 2000 US Standard Population. Rates are presented using a quintile distribution.
Stateage adjusted rate:
3.9
*Rates with hatch marks should be interpreted with caution because greater than 5% of hospitalizations for county residents occur in Out-of-State hospitals.5 year annual average number of hospitalizations statewide: 14,100
(2)
Inform Policy and Program:Primary Stroke Center and Stroke Capable Hospital Service Area
This map allows state leadership to see whether the current stroke system of care is capable of providing quality care for the majority of residents and where system improvements may be necessary by showing service areas for the primary stroke centers and stroke capable hospi-tals serving the state. The service area was defined as 30-minute drive times to the facility by analyzing the road network using ESRI ArcGIS 10.0 and the Network Analyst extension. Analy-sis was then conducted to determine the population residing within a 30-minute commute of a primary stroke center or stroke capable hospital using population data from the 2010 US Census.
The map will be used in presentations to the Paul Coverdell National Acute Stroke Registry leadership, hospital stroke managers and emergency medical service leadership to determine where additional training or leadership is needed to encourage the improvement of available stroke systems of care. Iowa’s EMS protocol provides for EMS personnel throughout Iowa to triage and transport stroke patients to the hospital with the highest level of stroke care avail-able within 30-minutes travel time (unless contraindicated by the patient/patient’s family) in order to access the most appropriate level of stroke care.
2
Enhance Partnerships:Prevalence of Obesity Among Adults, 2008-2010
Obesity is a risk factor for most chronic diseases. To document the extent of obesity in the state, Iowans Fit for Life in the Bureau of Nutrition and Health Promotion at the Iowa Depart-ment of Public Health creates and distributes an annual obesity burden report. The report documents the burden of obesity at both the state and county level. This map displays the age-adjusted obesity prevalence for adults in Iowa at the county level for the combined years of 2008 to 2010. The noticeably higher prevalence documented in the more rural counties (e.g., Audubon and Wayne) demonstrates a geographic component to obesity in Iowa.
This and similar maps will be used to provide a visual representation of the burden of obesity in Iowa. To deal with the burden of obesity statewide, the Iowa Department of Public Health (IDPH) collaborates with the Iowa Department of Transportation to assess the built environ-ment in an effort to encourage walking and biking. In addition, the IDPH Community Trans-formation Grant endeavors to implement community strategies to improve access to healthy nutrition and physical activity opportunities across the state.
Sioux 26.3%
Linn 28.1%
Tama 25.7%
Kossuth 28.9%
Jasper 35.1%
Polk 27.5%
Lyon 26.5%
Iowa 28.7%
Sac 29.1%
Story 26.0%
Clay 30.5%
Adair 30.7%
Clayton 29.2%
Cass 35.7%
Fayette 33.5%
Benton 30.3%
Clinton 29.8%
Lee 30.6%
Page 32.6%
Cedar 32.9%
Butler 25.4%
Dallas 30.0%
Jones 30.0%
Plymouth 30.3%
Davis 30.7%
Webster 30.0%
Floyd 29.5%
Monona 27.2%
Wright 30.0%
Boone 33.7%
Woodbury 30.5%
Taylor 30.2%
Shelby 32.1%
Hardin 33.4%
Scott 27.2%
Carroll 30.8%
Marion 31.5%
Harrison 30.9%
Warren 35.0%
Mills 25.7%
Guthrie 30.3%
Greene 29.1%
Crawford 31.4%
Ida 27.3%
Wayne 33.5%
Jackson 31.2%
Keokuk 33.5%
O'Brien 30.1%
Henry 30.1%
Johnson 23.6%
Franklin 32.6%
Lucas 31.3%
Union 30.2%
Pottawattamie 29.9%
Calhoun 30.7%
Dubuque 26.8%
Decatur 29.4%
Marshall 31.6%
Grundy 31.2%
Madison 28.5%
Clarke 29.5%
Hancock 28.6%
Worth 28.7%
Mahaska 28.0%
Hamilton 31.6%
Allamakee 28.9%
Palo Alto 28.5%
Delaware 32.4%
Fremont 32.2%
Howard 28.3%
Cherokee 26.0%
Louisa 33.8%
Winneshiek 24.5%
Adams 32.5%
Mitchell 26.0%
Ringgold 29.4%
Bremer 27.4%
Buchanan 29.3%
Monroe 32.5%
Emmet 31.4%
Poweshiek 30.5%
Wapello 29.1%
BlackHawk 28.8%
Osceola 30.9%
Van Buren 32.3%
Chickasaw 31.1%
Jefferson 29.0%
Appanoose 30.0%
Humboldt 30.6%
Muscatine 31.6%
Dickinson 26.6%
Winnebago 26.1%
Pocahontas 29.6%
Buena Vista 28.5%
Washington 30.6%
Audubon 33.1%
Cerro Gordo 26.5%
Des Moines 33.8%
Montgomery 30.5%
23.6 - 27.5
27.6 - 29.6
29.7 - 31.1
31.2 - 32.9
33.0 - 35.7
Ü
0 40 8020 MilesSource: Iowa Behavioral Risk Factor Surveillance System; age-adjusted average rates from 2008, 2009, and 2010.
Prevalence of Obesity Among Adults, 2008-2010
Age-adjustedPrevalence
_̂_̂
_̂
_̂
_̂
_̂
_̂
_̂
_̂
_̂
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
®v®v®v®v
®v®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v®v
®v
®v®v
Wisconsin
Illinois
Minnesota
Missouri
Nebraska
South Dakota
Drive Time Towards Facility®v Primary Stroke Center - 14 in Iowa; 6 out-of-state# Stroke Capable Hospital - 88 in Iowa
_̂ City population 50,000 and over
30 Minute Drive Time to Any Stroke Center
30 Minute Drive time to a Primary Stroke Center
Iowa: Primary Stroke Center and Stroke Capable Hospital Service Area
Source: Iowa Heart Disease and Stroke Prevention Program; US Census Bureau - Centers of Population by State, by Census Tract
40% of Iowa residents live within
30 minutes of a Primary Stroke Center85% of Iowa residents live within
30 minutes of a Stroke Capable Hospital
This map is based on data from the Behavioral Risk Factor Surveillance System (BRFSS). Since the BRFSS sampling frame is designed to produce valid state-level prevalence estimates only, the county-level estimates
displayed here may not be reliable statistically.
3
Document the Burden:Heart Disease Age-Adjusted Death Rates, 2005-2010
Heart disease was the leading cause of death in Mississippi in 2010, accounting for 26% of all deaths. Geographic disparity in mortality from heart disease exists among different racial and gender groups in Mississippi and examination of the geographic disparities can raise important questions about the underlying social conditions, structures and mechanisms. This map shows age-adjusted heart disease death rates by county for 2005-2010, highlighting a concentration of high-rate counties in the Mississippi Delta Region. Counties with the highest death rates are also noticeable in parts of the southern region. This map can be used to tailor heart disease related programs and policies to the needs of these communities.
Mississippi: Using GIS to Address Existing Priorities
Mississippi: Heart Disease Age-adjusted Death Rates, 2005-2010
Standard population: U.S., 2000Data Source: Mississippi Vital Statistics, 2010 Note: Heart disease is defined from
ICD-10: Codes, I00-I09, I11, I13, I20-I51
0 25 50 7512.5 Miles
Death Rate/100,000Quintiles
201.2 - 246.0
246.1 - 263.9
264.0 - 284.2
284.3 - 305.0
305.1 - 414.5
Mississippi Delta
State Age-adjusted Rate per 100,000: 264.8±
^
Yazoo
Bolivar
Panola
Holmes
Tate
CarrollLeflore
Tunica
DeSoto
Tallahatchie
Warren
Sunflower
Washington
Coahoma
Sharkey
Quitman
Issaquena
Humphreys
Jackson
4
Inform Policy and Program:Obesity, Education and Poverty in Mississippi
Mississippi has the highest obesity rate in the U.S. with 35.3% of state residents having a BMI 30 of more in 2009. Obesity is higher among Mississippians who are below the poverty level and/or less educated. Inequities across poverty and education groups may influence obesity rate, a risk factor for many chronic diseases, including cardiovascular disease, hypertension, and diabetes. This map shows the prevalence of obesity and indicators of socio-economic status by county in Mississippi. Counties in the Mississippi Delta Region and along the Mississippi River experience both health and socioeconomic disparities with high obesity prevalence. More than 30% of the population below poverty level and less than 75% of adults aged 25 years and older having graduated from high school.
This map of obesity and socio-economic status will be compared with maps of chronic disease health disparities to help inform policy decision making. Furthermore, the Mississippi State Department of Health will be able to identify counties with the greatest health inequities and focus their outreach efforts in the counties with the greatest need.
Enhance Partnerships:Mississippi Delta Health Collaborative Initiatives
The Mississippi Delta Health Collaborative (MDHC) is a five-year cooperative collaborative between the Mississippi State Department of Health and the Centers for Disease Control and Prevention designed to prevent heart disease, stroke, and related chronic diseases. This will be achieved through the implementation of the “ABCS” of heart disease and, stroke prevention in the 18-county Missis-sippi Delta Region. MDHC initiatives include: Medication Therapy Management, ABCS Community Screening Program, Mayoral Health Councils, County Planning and Development Councils, Barber-shop Hypertension Reduction Initiative, and Clinical Community Health Worker Initiative. This map highlights current initiatives and clinical sites participating in the ABCS program.
The map has been shared with the Mississippi Task Force on Heart Disease and Stroke Prevention, the Office Health Data and Research, program staff, and MDHC grantees.
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
Obesity, Education and Poverty in Mississippi
Obesity Prevalence (%) 200928.5 - 35.335.4 - 37.938.0 - 44.9
High School Graduates(25 years and older)
< 75%# > 75%
Below Poverty Level> 30%
Data Source: Obesity data from CDC: National Diabetes Surveillance System (2009); High School Graduation and Poverty data from : US CensusBureau; State and County Quick Facts (2006-2010)
Adult Obesity Prevalence in Mississippi is 35.3% (2009)
!(
!(
!(
!(
!( !(
!(!(
!(
!(
!(
!(
!(
!(!(
!(
!(
")
")
")
")
")
")")")
")
")
")
")
")
")
")
#*
#*
#*
#*
_
_
_
_
_
$+
$+
$+
$+
$+
$+
$+
$+
$+
$+
$+
$+
$+
$+ $+
$+
$+
$+
$+$+
$+
XX
XX
XXX
X
XX
XX
X
X
XX
X
X
!(
!(
!(
Yazoo
Bolivar
Panola
Holmes
Tate
Carroll
Leflore
Warren
Tunica
Sunflower
DeSoto
Washington
Coahoma
Tallahatchie
Sharkey
Quitman
Issaquena
Humphreys
Vicksburg
Greenwood
Yazoo City
Greenville
Clarksdale
Mississippi Delta Health Collaborative (MDHC) InitiativesInitiatives
#* Medication Therapy Management (MTM) Site*") DACH Church
$+ Clinical Site**
!( Mayoral Health Council
X Barbershop Hypertension Reduction
County Planning & Development Council
Community Health WorkerYes
No
_ Cities
0 20 4010 MilesNote: DACH, Delta Alliance for Congregational Health
±
* Federally Qualified Health Centers (FQHC)** Rural Health Clinics, FQHCs, Private Provider
5
Document the Burden:Heart Disease Hospitalizations Among Nebraska Residents, 2006-2010
Heart disease is the second leading cause of death behind cancer, and the second leading cause of hospitalization in Nebraska, behind pregnancy and childbirth. This county-level map demonstrates the geographic disparities that exist in age-adjusted heart disease hospi-talization rates in Nebraska. There is considerable variation in the rate of hospitalization across the state. The highest concentration occurs toward the central area of the state and the south-central (115.8-146.0 per 10,000 residents). The lowest concentration oc-curs in the north-eastern and north-western sections of the state (13.4-65.1 per 10,000 residents). This map will be helpful in deter-mining the concentration of hospitalizations due to heart disease. It will be helpful to Emergency Medical Services in their planning of how to improve their services and availability to high use areas. It can also be used by the Nebraska Hospital Association to ensure that hospitals in this region have enough resources to treat patients who have heart disease.
Nebraska: Using GIS to Address Existing Priorities
Lincoln
CherryHolt
Custer
Sioux
Lincoln
Sheridan
Morrill
Garden
Knox
Keith
Dawes
RockBrown
Gage
Hall
Dundy
Chase
Buffalo
Grant
Clay
Kimball
York
Frontier
Otoe
Dawson
Cedar
PlatteArthur
Burt
Perkins
Cheyenne
Hayes
Blaine Loup
Box Butte
Cass
Boyd
Boone
Banner
Polk Butler
Furnas
Hooker
Antelope
Saline
Valley
Pierce
Logan
Thomas
Lancaster
Dixon
Harlan
Adams
Thayer
Dodge
Phelps
Saunders
McPherson
DeuelHoward
Cuming
Seward
Greeley
Fillmore
Hitchcock
Garfield
Franklin
Keya Paha
Webster
Nance
MadisonWheeler
Nuckolls
Merrick
Colfax
Gosper
Scotts Bluff
Jefferson
Wayne
Sherman
Red Willow
Kearney
Hamilton
Stanton
Pawnee Richardson
NemahaJohnson
Thurston
Douglas
Sarpy
Dakota
Washington
Age-Adjusted Hospitalizaton Rate per 10,00013.4 - 65.1
65.2 - 88.2
88.3 - 98.6
98.7 - 115.7
115.8 - 146.0
Insufficient Data
Heart Disease Hospitilization Rates Among Nebraska Residents, 2006-2010
Source: Nebraska Hospital Discharge Data
ICD-9 codes: 390-398, 402, 404, 410-429
6
Inform Policy and Program:Twenty and Thirty Minute Drive Times to Hospitals in Nebraska
Timely hospital accessibility is very important for heart disease. This is espe-cially important in a rural state like Nebraska where many communities do not have easy access to a hospital. We used driving times to determine the proportion of the communities where people could reach a hospital within 30 minutes in the State of Nebraska. Almost all regions in the east of state are covered within 30 minutes driving time, but most of regions located in the west and middle of state are not covered within 30 minutes driving time. Those regions in the west are the most rural areas of Nebraska. The maps will be used to provide an overview of access to hospitals in the general popula-tion. This map will be used to understand the policy implications for pre-hos-pital protocols that are being considered by emergency medical systems across the state.
Enhance Partnerships:Smoking Cessation Referrals to the Nebraska Quitline, 2011
The Nebraska Medicaid program provides smoking cessation aides to enroll-ees through the Nebraska Quitline. The Quitline, sponsored by the Tobacco Free Nebraska program, provides tobacco cessation coaching/counseling and has a fax referral program to provide tobacco cessation products. A healthcare provider can fax a referral to the Quitline and then cessation products will be available to the Medicaid enrollee. This map shows the number of Quitline fax referrals from healthcare professionals by county per 10,000 residents. Those counties with high proportions of fax referrals (38.6 – 47.8 per 10,000) occur in multiple areas of the state. Those counties with low referrals, and in par-ticular, those where no referrals were submitted tend to occur in the north central section of the state. Tobacco Free Nebraska has used this map to understand where gaps exist in fax referrals. Using this map they have planned to target those counties where there have been no fax referrals or very few compared to the county population size.
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®v
®
v
®
v
®
v
®
v
®
v
®
v
®
v®
v
®
v
®
v
®
v ®
v
®
v
®
v
®
v
®
v
®
v
®
v®
v®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v ®
v®
v
®
v ®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v ®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
®
v
CherryHolt
Custer
Sioux
Lincoln
Sheridan
GardenMorrill
Knox
Keith
Dawes
RockBrown
Gage
Chase
Hall
Dundy
Grant
Buffalo
Clay
Otoe
Dawson
Cedar
York
Kimball
Frontier
Platte
Hayes
Cheyenne
Perkins
Blaine
Arthur
BurtLoup
Cass
Box Butte
BannerBoone
Boyd
Polk
Hooker
Furnas
Butler
Saline
Valley
AntelopePierce
Logan
Thomas
Harlan
Dixon
Adams
Thayer
Dodge
Phelps
Saunders
Deuel
McPherson
Seward
Howard
Greeley
Cuming
Keya Paha
Garfield
Fillmore
Nance
Hitchcock
Wheeler
Franklin Webster
Madison
Merrick
Wayne
Nuckolls
Colfax
Gosper
Sherman
Red Willow
Kearney
Scotts Bluff
Jefferson
Hamilton
Pawnee
Nemaha
Richardson
Thurston
Douglas
Sarpy
Lancaster
Stanton
Johnson
Dakota
Washington
Twenty and Thirty Minute Drive Times to Hospitals in Nebraska
0 40 80 120 16020Miles±
Source: Nebraska Emergency Medical Services (EMS)
®v Hospital
Within 20 Minutes to Hospital
Within 30 Minutes to Hospital
CherryHolt
Custer
Sioux
Lincoln
Sheridan
MorrillGarden
Knox
Keith
Dawes
RockBrown
Gage
Hall
Dundy
Chase
Buffalo
Grant
Clay
Kimball
York
Frontier
Otoe
Dawson
Cedar
PlatteArthur
Burt
Perkins
Cheyenne
Hayes
Blaine Loup
Box Butte
Cass
Boyd
BooneBanner
Polk Butler
Furnas
Hooker
Antelope
Saline
Valley
Pierce
Logan
Thomas
Lancaster
Dixon
Harlan
Adams
Thayer
Dodge
Phelps
Saunders
McPherson
DeuelHoward
Cuming
Seward
Greeley
Fillmore
Hitchcock
Garfield
Franklin
Keya Paha
Webster
Nance
MadisonWheeler
Nuckolls
Merrick
Colfax
Gosper
Scotts Bluff
Jefferson
Wayne
Sherman
Red Willow
Kearney
Hamilton
Pawnee Richardson
NemahaJohnson
Thurston
Douglas
Sarpy
Stanton
Dakota
Washington
Smoking Cessation Referrals to the Nebraska Quitline, 2011Number of Referrals by Health Care Providers per 10,000 population
Source: Tobacco Free Nebraska Quitline Data 1/1/2011-3/31/2012
Note: The Data shows how many fax referrals per 10,000 population came to the Nebraska Quitline by healthcareprofessionals by county.
Referrals per 10,000 population
No referrals submitted1.6 - 10.911.0 - 20.120.2 - 29.329.4 - 38.538.6 - 47.8
7
Document the Burden:Stroke Hospitalization in New Hampshire by County, 2009
Stroke is the fourth leading cause of death in New Hampshire, and it remains a leading cause of serious long-term disability. The State records about 1700 hospitalizations for stroke each year. This map shows the counties in NH where most stroke hospitalizations occurred in 2009. This map may be used to help stakeholders to target counties where the burden is high for interventions aimed at reducing stroke deaths.
New Hampshire: Using GIS to Address Existing Priorities
Coos
Grafton
Carroll
Merrimack
Cheshire Hillsborough
Sullivan
Rockingham
Belknap
Strafford
³
0 10 205
Miles
Source: Bureau of Data and Systems Management (BDSM), Office of Medicaid Business and Policy (OMBP), Office of Health Statistics and Data Management (HSDM), Bureau of Public Health Statistics and Informatics (BPHSI), New Hampshire Department of Health and Human Services (NH DHHS), 2005-2009
Produced by the New Hampshire Department of Health and Human Services, Division of Public Health Services, Bureau of Population Health and Community Services, Chronic Disease Prevention and Control Program. For more information visit: www.dhhs.state.nh.us/dphs/cdpc/index.htm or call (603) 271-4931
Stroke Hospitalization in New Hampshireby County 2009
Hospitialization Counts
2009 Total = 1750
48 - 6364 - 110111 - 180181 - 536
Enhance Partnerships:Manchester, NH Middle and High Schools that have Tobacco Retailers Within 1000 ft.
Tobacco merchant compliance with laws concerning tobacco sales to youth in New Hampshire continues to increase according to the latest Synar tobacco compliance report by the New Hampshire Department of Health and Human Services Bureau of Drug and Alcohol Services (BDAS).
The New Hampshire Liquor Commission and BDAS attempt tobacco buys by supervised youth during random compliance checks. The rate of retailers selling to youth dropped to 7.8% in 2011 in New Hampshire. This number is down from 8.6% in 2010, and a dramatic decline from 14% in 2009. Research demonstrates that lower tobacco use by youth also decreases the chance that they will use drugs or alcohol. This map shows how GIS can be used to locate tobacco retailers that are readily accessible to underage smokers and may assist as a tool to help target specific retailers for compliance checks.
8
Inform Policy and Program:Drive time to PCI-capable Hospitals in New Hampshire, June 2012
As part of the assessment of medical care infrastructure for the treatment of ST-elevation myo-cardial infarction (STEMI), The Heart Disease & Stroke Prevention Program in New Hampshire identified all Percutaneous Coronary Intervention (PCI) capable hospitals in New Hampshire and the surrounding area as of June 2012. These hospitals, also called heart attack receiving centers, have the equipment and expertise to perform Percutaneous Coronary Interventions to qualified heart attack patients, which is the preferred therapy for reducing mortality if administered in a timely manner.
This map shows the geographic areas within 30, 60 and 90 minute drive times to the closest PCI capable hospitals in New Hampshire. Using the 2010 Census data, nearly 75% of New Hamp-shire’s population is within 30 minutes drive time to those hospitals; 92% are within 60 minutes and 99% are within 90 minutes. This map helps to identify gaps in the access to emergency care for New Hampshire heart attack patients and opportunities for collaboration with neighboring states.
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
M a i n eM a i n e
V e r m o n tV e r m o n t
M a s s a c h u s e t t sM a s s a c h u s e t t s
Coos
GraftonCarroll
Merrimack
Cheshire Hillsborough
Sullivan
Rockingham
Belknap
Strafford
N e w H a m p s h i r eN e w H a m p s h i r e
CANADA
Drive Time to PCI-capable Hospitalsin New Hampshire, June 2012
³
0 10 205
Miles
Legend
®v PCI_Capable_Hospitals
Times in Minutes0 - 30
31 - 60
61 - 90
Produced by the New Hampshire Department of Health and Human Services, Division of Public Health Services,Heart Disease and Stroke Prevention Program. For more information visit: http://www.dhhs.nh.gov/dphs/cdpc/hdsp.htm
Data Sourses:NH Bureau of Emergency Medical Services,
The Joint Commission,The U.S. Department of Health & Human Services
Hospital Compare
*PCI capable hospital: a hospital that has the equipment, expertise and facilities to administer Percutaneous Coronary Intervention (PCI), a mechanical means
of treating heart attack patients.
They are also called STEMI-receiving hospitals because they are well equipped to receive and treat STEMI patients
(www.heart.org)
Population Coverage:
- 74.7% of NH population are within 30 minutes drive time to the closest PCI Hospital- 91.9% are within 60 minutes- 92.0% are within 90 minutes - Only 0.005% is beyond 90 minutes drive time
n
n
nn
n
n
n
n
Bartlett St Superette
Manchester West High Schooland Middle School at Parkside
Fritzie's Variety West Side Gulf
Manchester Central High School
WestHigh
Cumberland Farms
N & N Express
7 - 11 Z - J Market
Hillside Middle School
N & K Market
Lowell St
Concord St
Maple St
Belm
ont St
Reser
voir
Rd
I-293
Mai
n St
Granite StDouglas StParkside Ave
Putnam St
Manchester, New Hampshire Middle and High Schools that have Tobacco
Retailers Within 1000 ft
Hall St
Pearl St
0 500 1,000250
Feet
0 500 1,000250
Feet
0 500 1,000250
Feet
³
- Tobacco Retailer
n - School
- 1000 Foot Buffer Zone
Legend
- Manchester Road
9
!(
!(!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
Cardiovascular Disease and Stroke WorkforcePer County
!( 1 - 5!( 6 - 17!( 18 - 27
!( 28 - 77
!( 78 - 160
¢
Data Source: Texas Healthcare Information Council (THCIC), Department of State Health Services, ICD-9 Codes for stroke 430-434 and 436-438
Source: Health Professions Resource Center
0 70 14035 Miles
* Age-Adjusted Death Rate* Workforce: CARDIAC ELECTROPHYSIOLOGY, CARDIO-INTERVENTIONAL RADIOLOGY, CARDIOLOGY, CARDIOTHORACIC ANESTHESIOLOGY, CARDIOTHORACIC RADIOLOGY, CARDIOVASCULAR DISEASES, CARDIOVASCULAR IMAGING, CARDIOVASCULAR SURGERY, INTERVENTIONAL, CARDIOLOGY, and THORACIC CARDIOVASCULAR SURGERY
AADR per 100,00028.3 - 41.8
41.9 - 46.9
47.0 - 52.1
52.2 - 58.0
58.1 - 149.9
Excluded (Deaths<20)
Stroke Age- Adjusted Death Rate by County and Cardiovascular Disease and Stroke Workforce Locations, Texas 2006-2010
Texas: Using GIS to Address Existing Priorities
Document the Burden:Stroke Age-adjusted Death Rate by County and Cardiovascular Disease and Stroke Workforce Locations, Texas 2006-2010
This map of Texas counties displays the age-adjusted stroke mortality rate over a 5 year-period. The purpose of this map is to document the burden of stroke in Texas. This map also displays the total number of health professionals in the cardiovascular disease workforce by county. The highest stroke mortality rates are located primarily in Central and East Texas. The counties containing the largest cardiovascular work-force are located in the metropolitan areas of Dallas, Houston, Austin, and San Antonio. This map also indicates that there are many counties with very high stroke mortality rates but no health professionals that specialize in cardiovascular disease. These counties could be prime locations for chronic disease self-management programs and commu-nity health worker programs.
10
Inform Policy and Program:Age-adjusted Hospitalization Rate per 10,000 due to Asthma by County, Texas 2010 and Hospital-based Asthma Program Locations
This is a map of 2010 age-adjusted asthma hospitalization rates per 10,000 individuals by county. Additionally, it displays the location of 14 hospital-based asthma programs. Asthma related hospitalization is high among some counties in Texas especially in south Texas. This map shows that the counties with hospital-based asthma programs tend to be located in counties with relatively low asthma hospitalization rates. These programs identify patients and families at high risk for poor self-management capabilities and refer them to self-management education inter-ventions. They conduct asthma education and case management interventions to reduce asthma-related dispari-ties and asthma hospitalization rates. Texas Asthma Control Program funds some of these programs and this map gives a good illustration of where the programs are critically needed. This map was presented at the 2012 Asthma Coalition of Texas Annual Conference and shared with the coalition partners.
Enhance Partnerships:Diabetes Prevalence by Public Health Region with Accredited Diabetes Education Program Sites, Texas, 2012
This map displays 2010 diabetes prevalence by public health region (PHR). As diabetes prevalence increases, the color of the map darkens. The PHRs with significantly higher diabetes prevalence than the state as a whole are depicted with crosshatch. In addition to diabetes prevalence, the map shows diabetes self-management training (DSMT) sites in Texas that are accredited by the American Association of Diabetes Educators (AADE). DSMT is a collaborative process through which people with or at risk for diabetes gain the knowledge and skills needed to modify behavior and successfully self-manage diabetes and its related conditions. It is evident from the map that some PHRs with significantly higher diabetes prevalence lack or do not have adequate DSMT sites. This map will be used to advocate for DSMT sites by organizations dedicated to serving persons at-risk or with diabetes in Texas. Since it displays where there are not any DSMT sites along with diabetes prevalence, it states where DSMT sites are needed. It enhances partnerships because it encourages organiza-tions to work together to advocate for persons at risk for or with diabetes. The map will be used by the Texas Diabetes Prevention and Control Program (DPCP) to plan interventions, with the goal of having interventions where they will do the most good.
"u
"u
"u
"u
"u"u"u
"u
"u"u
"u
"u
"u
"u
Age-adjusted Hospitalization Rate per 10,000 due to Asthma by County, Texas 2010And Hospital-based Asthma Program Locations
Data Source: 2010 Inpatient Hospital Discharge Public Use Data File, Texas Health Care Information Collection, center for health Statistics, Texas DSHS
¹
Map Key
Age-adjusted Hospitalization Rate per 10,000, All Ages
Hospital-based Asthma Programs (A total of 14)
2.8 - 8.1
8.2 - 10.0
10.1 - 12.2
12.3 - 15.8
15.9 - 37.2
Excluded Counties, <12 hospitalizations per county
"u
!(
!(
!(
!( !(
!(!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(!( !(
!(
!(
!(
!(
!(
!(
!(!(
!(
!(
!(
!(
!(
!(!(!(!(!(!(!(!(!(!(!(!(!(
9
1
8
2
7
43
65
11
10
Diabetes Prevalence by Public Health Region with Accredited Diabetes Education Program Sites, Texas, 2012
State Prevalence= 9.7% (95% CI: 9.0-10.4%)
Prevalence (%)7.8 - 8.6
8.7 - 10.2
10.3 - 11.0
11.1 - 12.4
12.5 - 15.3
Statistically Higher than State Rate
!( Accredited Diabetes Education Program Sites
0 50 100 150 20025 Miles
Data Source: Texas Behavioral Risk Factor Surveillance System (BRFSS), 2010. Center for Health Statistics, DSHS.
Quantiles were used for breaks.
This map is based on data from the Behavioral Risk Factor Surveillance System (BRFSS). Since the BRFSS sampling frame is designed to produce valid state-level prevalence estimates only, the county-level estimates
displayed here may not be reliable statistically.
11
Document the Burden:Stroke Hospitalization Rates in Wisconsin, All Ages, 2005-2009
Stroke is a leading cause of both death and long-term disability in Wisconsin. In order to address this heavy burden, many hospitals have established themselves as Primary Stroke Centers (PSC). These Centers have formal programs to treat stroke patients effectively and consistently with the goal of improving care and outcomes to prevent future strokes and to restore functioning. The map displays the age-adjusted stroke hospitalization rates by county and the Primary Stroke Center distribution throughout the state. The map illustrates the geo-graphic disparities of resources with the state divided roughly in half. Almost all of the PSCs and higher hospitalization rates are located in the eastern portion. The western portion shows fewer PSCs and lower hospitalization rates due, in part, to persons seeking care in Border States, namely, Minnesota, Michigan Upper Peninsula, and Iowa.
Further expansion of this map will include PSCs located in the border states to document border care patterns. As Wisconsin’s population ages, efforts to track the number and rate of stroke hospitalizations and review resource distribution will be im-portant. Health information mapping will measure the effects of campaigns like Million Hearts (preventing one million heart attacks and strokes) as well as the effectiveness of new health care policies (such as the Patient Protection and Affordable Care Act) that promote preventive care and coordination of care.
Wisconsin: Using GIS to Address Existing Priorities
Stroke Hospitilization Rates in Wisconsin, All Ages2005-2009
^
_̂
MinneapolisSt. Paul, MN
Dubuque, IA
Duluth, MN
®v
®v
®v
®v
®v
®v®v
®v®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v
®v®v ®v
®v®v
POLK
GRANT
IRON
BAYFIELD
SAWYER
DUNN
TAYLOR
ASHLAND
ADAMS
BURNETT
PORTAGE
PIERCE
BUFFALO
SAINT CROIX
FLORENCEWASHBURN
CALUMET
DANE
ONEIDA
MARATHON
JACKSON
BARRON
MONROE
CHIPPEWA
VERNON
LANGLADE
WAUSHARA
OUTAGAMIE
EAU CLAIREPEPIN
CRAWFORD
TREMPEALEAU
JEFFERSON
WINNEBAGOLA CROSSE
PRICE
RUSK
ROCK
WOOD
DODGE
OCONTO
LINCOLN
SHAWANO
GREEN
WAUPACA
DOOR
LAFAYETTE
FOND DU
LAC
WAUKESHA
WALWORTH
SHEBOYGAN
WASHINGTON
CLARK
VILAS
SAUK
IOWA
FOREST
MARINETTE
JUNEAU
COLUMBIA
BROWN
RICHLAND
RACINE
KENOSHA
MANITOWOC
MARQUETTE
KEWAUNEE
GREEN LAKE
MENOMINEE
OZAUKEE
11.83 - 92.80
92.81 - 112.59
112.60 - 129.15
129.16 - 177.48
®v Primary Stroke Centers*
Age-adjusted Rates/10,000
Source: Wisconsin Hospital Discharge Data, 2005-2009.Stroke is defined as ICD-9 code 430-438.Rates are age-adjusted to the 2010 U.S. Census standard population and expressed as 10,000 per population.
Mean: 112.59DOUGLAS
*Wisconsin’s primary stroke centers are certified by the Joint Commission or Det Norske Veritas Certification
Drive Times to Wisconsin Primary Stroke Centers, 2012
Source: American Heart Association: Primary Stroke Centers, 2012 .
Key
30 minute drive
60 minute drive
®v Primary Stroke Centers
0 25 5012.5 Miles
Enhance Partnerships:Nutrition, Physical Activity, and Obesity Prevention Activities
This is a dot density map of obesity prevention programs and/or activities that have occurred in Wisconsin over the last several years. It illustrates the investment and potential infrastructure of obesity prevention programs and activities on the local level. The map does not contain an exhaustive list of all the obesity pre-vention programs and activities occurring in the state, but rather a variety of programs and activities. These include those funded by the US Department Agriculture; US Department of Education; WI Department of Health Services; WI Department of Public Instruction; WI Department of Agriculture, Trade, and Consumer Protection; WI Department of Transportation; WI Governor’s Council on Physical Fitness & Health; and WI Medical Society Foundation.
This map has been used to conceptualize where obesity prevention work has occurred and to show how current and past funding has created a foundation within communities that may be leveraged for future ef-forts. Additionally, it has been used as a communication tool with state and local partners for collaboration. Future uses for the map include assessing if clusters of activities are related to improvement of risk factors in those areas of the state and identifying if high need areas in the state have insufficient investment for ongoing activities aimed at decreasing health risk factors for chronic diseases.
12
Inform Policy and Program:Drive Times to Wisconsin Primary Stroke Centers, 2012
The Wisconsin Stroke Committee (WSC) is in the process of recommending statewide standards for emergency transport and treatment of acute stroke. Timely, quality stroke treatment has been proven to increase stroke survival rates and reduce stroke-related disabilities. In Wisconsin, 30 hospitals have been certified as Primary Stroke Centers, meaning that dedicated teams follow national clinical guidelines for stroke care. Currently, there are no criteria to assess the level of stroke care at other hospitals across the state. This map illustrates areas known to have access to quality stroke treatment within 60 miles or approximately one hour of driving time. The WSC will use this data to inform rec-ommendations for EMS hospital destination plans, telestroke networks, and expanding the network of hospitals identified as providing stroke care.
Price
Clark
Dane
Polk
Vilas
Grant
Iron
Bayfield
Rusk
Sawyer
Oneida
Marathon
Sauk
Forest
Taylor
Douglas
Iowa
Dunn
Marinette
Rock
Oconto
Wood
Dodge
BarronLincoln
Burnett
Jackson
Ashland
Monroe
Vernon
Juneau
Portage
Chippewa
Buffalo
Adams
Shawano
Langlade
Door
Green
Pierce
Washburn
Brown
Columbia
Waupaca
Lafayette
Richland
Saint Croix
Crawford
Jefferson
Waushara
Walworth
Eau Claire
Fond du Lac
Outagamie
Florence
Manitowoc
Waukesha
Winnebago
Racine
Calumet
La Crosse
MarquetteSheboygan
Pepin
Kenosha
Menominee
Trempealeau
Washington
Kewaunee
Green Lake
Ozaukee
Milwaukee
Other
School Districts
Schools
Counties
WI Nutrition, Physical Acitivity, and Obesity Prevention Activities
2011 Active Schools Grant
2011 DPI Childhood Fitness Grant
2011 Fresh Fruit and Vegetable Program
2+yrs Movin and Munchin Program
2006-2011 WI School Health Award2011-2012 Healthier US School Challenge Award
2012 WI Medical Society Foundation School Garden Grant
2011 Farm to School Program2005-2011 US ED Physical Education Program Grant2008-2012 Safe Routes to School Grant
2012 WI Medical Society Foundation School Garden Grant
2011 WIC Fit Families Grant2008-2012 Safe Routes to School Grant
2011 Active Early Site(Childcare Facilities)2011 DPI Childcare Wellness Grant2008-2012 Safe Routesto School Grant (Citites)
WI Governor's Worksite Wellness Award (Businesses)
1 Dot = 1 Program
Sources: US Department Agriculture; US Department of Education; WI Department of Health Services; WI Department of Public Instruction; WI Department of Agriculture, Trade and Consumer Protection; WI Department of Transportation; WI Governor’s Council on Physical Fitness & Health; and WI Medical Society Foundation
NOTE: This map does not include all Nutrition, Physical Activity, and Obesity Prevention Activities in WI.
13
Boston, MA: Using GIS to Address Existing Priorities
Document the Burden:Chronic Disease Hospitalization, Boston, 2005-2011 Average Annual Rates
This map presents chronic disease hospitalization rates for the fifteen neighborhoods in the city of Boston. There are four maps in total, representing heart disease, diabetes, and cerebrovascular disease (including stroke) hospitalization rates, and an overall composite index map. The composite map pres-ents an index which is calculated by tallying the number of times a neighborhood falls into the highest or second highest quartile for hospitalization rates for the each of the three chronic diseases.There are three neighborhoods (North Dorchester, Roxbury, and South Dorchester) where the chronic disease hospitalization index is highest. North Dorchester and Roxbury are also two of the neighborhoods where the overall socioeconomic status index is lowest. SES index data are available upon request.
Inform Policy and Program:Chronic Disease Deaths, Boston, 2005-2010 Average Annual Rates
This map presents deaths rates from cerebrovascular disease and diseases of the heart among the fif-teen neighborhoods in the city of Boston. In addition to maps of disease specific death rates, an overall composite index map is presented. The composite map presents an index which is calculated by tally-ing the number of times a neighborhood falls into the highest or second highest quartile for the two chronic disease death rates.
This map will be included in the Boston Public Health Commission’s report Health of Boston 2012-2013. The report is published and made available online. In addition, it is distributed to Boston’s Mayor, city councilors, hospitals, community health centers, selected community based organizations and partners, and selected academic institutions. This map will be used by both internal programs and external part-ners working to prevent chronic disease and address racial/ethnic health inequities.
Hyde Park
East Boston
West Roxbury
Jamaica Plain
RoslindaleSouth Dorchester
Allston/Brighton
RoxburySouth Boston
Mattapan
North Dorchester
Fenway South End
Charlestown
Backbay/North End/Downtown
Chronic Disease Hospitalization, Boston, 2005-2011 Average Annual Rates
Chronic Disease Hospitalization Rates1.7 - 1.9
2.0 - 2.5
2.6 - 2.8
2.9 - 3.4
Heart Disease Diabetes
Cerebrovascular Disease (Incl. Stroke)
Chronic Disease Hospitalization Index*Low (0 - 1)Medium (2)High (3)
±
DATA SOURCE: Inpatient Hospital Discharge Database, Massachusetts Center for Health Information and AnalysisDATA ANALYSIS: Boston Public Health Commission Research and Evaluation OfficeMAP CREATED BY: Boston Public Health Commission Research and Evaluation OfficeNOTE: Data are presented as age-adjusted rates.The neighborhood definitions are based on zip codes.
*This index are determined by the number of times (shown in parentheses in the legend) the neighborhood falls into the highest or 2nd highest quartile for each of the three chronic diseases shown.
2005-2011 Boston heart disease hospitalization rate (per 1,000 residents): 11.22005-2011 Boston diabetes hospitalization rate (per 1,000 residents): 2.32005-2011 Boston cerebrovascular (Incl. stroke) hospitalization rate (per 1,000 residents): 2.5
0 2 41 Miles
Hyde Park
Roxbury
East Boston
West Roxbury
North Dorchester
Allston/Brighton
Roslindale South Dorchester
South Boston
Back Bay
Jamaica Plain
Mattapan
South EndFenway
Charlestown
Chronic Disease Mortality Index*Low (0)
Medium (1)
High (2)
Chronic Disease Mortality RatesLowest Quartile2nd Lowest Quartile2nd Highest QuartileHighest Quartile
±
Diseases of the HeartCerebrovascular Disease (Incl. Stroke)
Chronic Disease Deaths, Boston, 2005-2010 Average Annual Rates
*This index was determined by the number of times (shown in parentheses in the legend) the neighborhood falls into the highest or 2nd highest quartile for each of the two chronic diseases shown.
DATA SOURCE: Boston Resident Deaths, Massachusetts Department of Public HealthDATA ANALYSIS: Boston Public Health Commission Research and Evaluation OfficeMAP CREATED BY: Boston Public Health Commission Research and Evaluation OfficeNOTE: Death data for 2010 are preliminary and should be interpreted with caution. Until data are final, some changes in data values may occur during data quality processes.Data are presented as age-adjusted rates.The neighborhood definitions are based on census tracts.
2005-2010 Boston cerebrovascular disease (Incl. stroke) deaths rate (per 100,000 residents): 35.32005-2010 Boston diseases of the heart deaths rate (per 100,000 residents): 152.0
0 2 41 Miles
Cambridge, MA: Using GIS to Address Existing Priorities
Data Source: MassCHIPData Pulled: 8/23/2012*Heart Disease ICD-9: 390-398, 402, 404, 410-429^Metro-West Region (60 cities and towns)
±1 inch = 138 miles
Heart Disease Mortality*Massachusetts Metro-West Region^
Age Adjusted Rates by City/Town2005 through 2009
City of Cambridge
Age Adjusted Rate(per 100,000)
<= 119.93
119.94 - 149.87
149.88 - 185.38
>= 185.39
Division of Epidemiology and Data Services119 Windsor Street, Ground FloorCambridge, MA 02139
Massachusetts: 163.75Metrowest: 145.04Cambridge: 131.70
Document the Burden:Heart Disease Mortality, Massachusetts Metro-West Region, Age Adjusted Rates by City/Town 2005-2009
This map shows the age-adjusted heart disease mortality rates from 2005-2009 across the sixty cities and towns that make up the Metrowest region of Massachusetts with a focus on Cambridge. Cam-bridge has an age-adjusted heart disease mortality rate of 131.7 per 100,000 compared to the Mas-sachusetts rate of 163.75 per 100,000 (Metrowest rate is 145 per 100,000). This map will be used to document the burden of heart disease in the Metrowest region and also to identify areas with high heart disease death rates, and to inform current and future program and policy decisions.
Inform Policy and Program:Stroke Mortality, Massachusetts Metro-West Region, Age Adjusted Rates by City/Town 2005-2009
This map shows the age-adjusted stroke mortality rates from 2005-2009 across the sixty cities and towns that make up the Metrowest region of Massachusetts with a focus on Cambridge. Cambridge has an age-adjusted stroke mortality rate of 29.35 per 100,000 compared to the Massachusetts rate of 34.0 per 100,000 (Metrowest rate is 32.54 per 100,000). This map can be used to document the burden of stroke mortality in the Metrowest region and also identify areas with high death rates from stroke. This map will be used for surveillance purposes and to inform current and future program efforts and policy decisions.
Data Source: MassCHIPData Pulled: 8/23/2012*Stroke ICD-9: 430-434, 436-438^Metro-West Region (60 cities and towns)
±1 inch = 138 miles
Stroke Mortality*Massachusetts Metro-West Region^
Age Adjusted Rates by City/Town2005 through 2009
City of Cambridge
Age Adjusted Rate(per 100,000)
<= 27.73
27.74 - 33.47
33.48 - 40.08
>= 40.09
Division of Epidemiology and Data Services119 Windsor Street, Ground FloorCambridge, MA 02139
Massachusetts: 34.90Metrowest: 32.54Cambridge: 29.35
14
Sloatsburg
Stony Point
Pomona
Nyack
New City
SuffernMonsey
Congers
Spring Valley
Nanuet
Tomkins Cove
Pearl River
Blauvelt
Sparkill
Valley Cottage
Haverstraw
West Nyack
Orangeburg
Tappan
Hillburn
Garnerville
Thiells
Bear Mountain
Palisades
Piermont
West Haverstraw
226.79
202.13246.53
260.43
221.99 185.26
275.12
141.85
190.6
239.62
255.64
246.88
222.39
178.29
176.87
328.09
446.3
183.44
218.19
187.77
144.09
173.23
321.69
145.07
240.33
Heart Disease Mortality Ratesby ZIP Code of Residence Within Rockland County, NY2005 - 2009
Map KeyAge-Adjusted Rate per 100,000 Population
141.85 - 176.87
176.88 - 190.60
190.61 - 226.79
226.80 - 255.64
255.65 - 446.30
No Cases or Population Estimate
Unstable Rate (<20 cases)*
Uninhabited Parkland
0 1 2 3 40.5Miles
Total Heart Disease as defined by ICD10 I00-I09, I11, I13, I20-I51Source: New York State Department of Health, Bureau of Chronic Disease Epidemiology & Surveillance
Prepared by: Rockland County Department of Health
Rockland County
Hu
ds
on
Ri v
er
* Fewer than 20 Heart Disease related mortalities occurred within the ZIP Code over the 5 year period, making the calculated rate less reliable
Rockland County, NY: Using GIS to Address Existing Priorities
Document the Burden:Heart Disease Mortality Rates by ZIP Code of Residence within Rockland County, NY 2005-2009
Heart disease is the leading cause of death among residents of Rockland County, NY. The goal of the Rockland County Department of Health is to reduce coronary heart disease deaths to 166 deaths per 100,000 population. ZIP Code level mortality rates had never been calculated before, so this map is the first to highlight the variation in heart disease mortality within Rockland County. This map will be used in an upcoming Community Health Assessment, the Community Input Plan, and the Health Depart-ment Strategic Planning Initiative. It will also be used as a visual tool in the engagement of community partners, outreach staff and other internal programmatic areas in hopes of lowering the total disease burden locally through collaborative efforts.
Inform Policy and Program:Rockland County Community Health Assessment Survey 2009-2010, Body Mass Index and Healthy Food Purchasing Habits
The Rockland County Health Department has made Overweight/Obesity & Diabetes one of its 9 Public Health Priorities. Overweight/Obesity & Diabetes is a major public health concern impacting the health of our population. Our goal is to increase the proportion of adults who maintain a healthy weight, reduce the proportion of adults who are obese, reduce the proportion of children and adolescents who are overweight or obese, and improve options for increased physical activity and weight loss throughout the county. This map displays the difference in prevalence of overweight/obese by ZIP code in Rockland County. Some ZIP code areas have a 95% prevalence of overweight or obese, while other ZIP codes have a prevalence around 50%. This map will help target interventions to regions with the highest prevalence of obesity.
Frequency of Healthy Food Choices% Who "Never" Buy Vegetables
6.13 - 21.05
4.85 - 6.12
3.71 - 4.84
1.61 - 3.70
None
<5 Participants
% Who "Always" Buy Vegetables70.01 - 100.00
62.91 - 70.00
57.15 - 62.90
10.53 - 57.14
None
<5 Participants
Sloatsburg
Stony Point
Pomona
Nyack
New City
Suffern
Monsey
Congers
Spring Valley
Nanuet
Tomkins Cove
Pearl River
Blauvelt
Sparkill
Valley Cottage
Haverstraw
West Nyack
Orangeburg
Tappan
Hillburn
Bear Mountain
GarnervilleThiells
Palisades
Piermont
West Haverstraw
Body Mass Index by ZIP Code% Surveyed with BMI >=25 (Overweight and Obese)
71.44 - 95.00
59.39 - 71.43
53.98 - 59.38
42.86 - 53.97
<5 Particpants
Uninhabited Parkland
*Self-reported height and weightwere used to calculate BMI for each participantSurveys Given in RocklandN = 978
Regional CountiesIncluded in Survey
Rockland County Location
Rockland County Community Health Assessment Survey 2009-2010Body Mass Index and Healthy Food Purchasing Habits
As part of a 2009-2010 regional planning assessment,RCDOH conducted a community survey whereparticipants were asked a range of health relatedquestions. Questions included healthy eating habitsand physical characteristics like height and weight.
These three maps display the aggregated results aspercentage of those respondents by county ZIP code ofresidence who had a calculated BMI in the overweightor obese range, and answered that they "always" buy,or "never" buy fresh fruits and vegetables.
15
MINNEAPOLIS
MEDINA
ORONO
PLYMOUTH
CORCORAN
DAYTON
ROGERS
EDINA
BLOOMINGTON
EDEN PRAIRIE
MAPLE GROVE
MINNETRISTA
INDEPENDENCE
MINNETONKA
GREENFIELD
BROOKLYN PARK
CHAMPLIN
MOUND
RICHFIELD
WAYZATA
HOPKINS
ST. LOUISPARK
CRYSTAL
GOLDENVALLEY
SHOREWOOD
NEWHOPE
BROOKLYNCENTER
DEEPHAVEN
HANOVER
ROBBINSDALE
TONKABAY
ST. ANTHONY
OSSEO
WOODLAND
LONGLAKE
MAPLEPLAIN
GREENWOODEXCELSIOR
MINNETONKA BEACH
ST. BONIFACIUS
FT. SNELLING TERR.
SPRINGPARK
LORETTO
ROCKFORD
MEDICINE LAKE
CHANHASSEN
MPLS AIRPORT
HASSAN TWP.
Heart Disease Deaths Kernel Density
Map information is furnished “AS IS” with no representation or warranty expressed or implied.
²0 2 4
Miles
HennepinCounty
Minnesota
Cities within Hennepin County, 2006-2010
Published Date: 11/20/2012Source: Minnesota Dept. of Health death files
Prepared by: Public Health GIS Team, JB
Hennepin CountyHuman Servicesand Public HealthDepartment
Public Health &Clinical Services
Deaths Kernel DensityLow
Medium
High
Hennepin County, MN: Using GIS to Address Existing Priorities
Document the Burden:Heart Disease Deaths Kernel Density: Cities within Hennepin County, 2006-2010
Heart disease deaths are depicted in Hennepin County, Minnesota, for the years 2006 to 2010. The location of each death was determined by geocoding the address of the deceased individual. The kernel density approach compiles deaths into small geographic clusters and reflects the number of people dying in each area. Overall, a kernel density map displays the geographic density of deaths, whereas a choropleth map shows the mortality rates that are adjusted for the size of the population in the geo-graphic area.
Inform Policy and Program:Number of Physical Activity Interventions per SHIP 2.0 (Statewide Health Improvement Program) School
This map displays the seven partnering school districts and the number of physical activity interventions in each school participating in the Statewide Health Improvement Program in 2011-2013 (SHIP 2.0). The interventions include integrating physical activity breaks into classroom lessons (active classroom), creating physical activity options during indoor recess periods (active recess), quality physical education, and Safe Routes to School (SRTS) environmental improvements.
This map has been shared with staff on the Hennepin County SHIP school team to illustrate program distribution and reach. We plan to expand and enhance partnerships with other local health depart-ments and communities to consolidate program information, to better understand programs’ coverage and reach, and to inform policy-making decisions.
!'
OSSEO
ORONO
WAYZATA
HOPKINS
DELANO
ROCKFORD
BUFFALO
BLOOMINGTON
WESTONKA
EDEN PRAIRIE
ELK RIVER
EDINA
ROBBINSDALE
MINNETONKA
ANOKA HENNEPIN 11-3
RICHFIELD
MINNEAPOLIS 1-1
ST. LOUIS PARK
MINNEAPOLIS 1-5
WACONIA
MINNEAPOLIS 1-4
MINNEAPOLIS1-3
MINNEAPOLIS 1-2
WATERTOWN MAYER
MINNEAPOLIS1-6
ANOKA HENNEPIN 11-5
BROOKLYN CENTER
ST. ANTHONY
!'
!'
!'!'!'
!'!'
!'!'
!'
!' !'!'
!'
!'!'
!'!'
!'
!'!'!' !'
!'
!'
!' !'!'
!' !'!'!' !'!'
!'!'!'!'!'!'!'
!'!' !' !'
!'
!'
!'
!'
!'
!'
Physical Activity
Map information is furnished “AS IS” with no representation or warranty expressed or implied.
²0 2 4
Miles
HennepinCounty
Minnesota
Number of Interventions per SHIP 2.0 School
Published Date: 11/20/2012Source: Hennepin County public schools that participate in State Health
Improvement Project (SHIP) 2.0. Data for cities of Minneapolis, Bloomington, Edina and Richfield is not currently available. Some school locations have been slightly modified to show symbol.
Prepared by: Public Health GIS Team, MD & KM.
Hennepin CountyHuman Servicesand Public HealthDepartment
Public Health &Clinical Services
Number of interventions*' 1
' 2
' 3 - 4
School Districts with SHIP 2.0 Intervention selection
Hennepin County School Districts
* Includes Safe Routes to School, Active Classroom, Active Recess, and Quality Physical Education.
16
(!
(!
(!
(!
(!
(!
(!
(!
(!(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!(!(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!(!
(!
(!
(!
(!
(!
(!
(!(!
(!
(!
(!
(!
(!
(!
(!
(!
(!(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
(!
DENMARKTOWNSHIP
WOODBURY
WEST LAKELANDTOWNSHIP
WILLERNIE
WHITEBEAR LAKE
ST MARYSPOINT
STILLWATERTOWNSHIP
STILLWATER
PINESPRINGS
OAK PARKHEIGHTS
OAKDALE
SCANDIA
NEWPORT
MAY TOWNSHIP
MARINE ONST CROIX
MAHTOMEDI
LAKELANDSHORES
LAKEELMO
LAKE STCROIX BEACH
LANDFALL LAKELAND
HUGO
HASTINGS
GREY CLOUDISLAND TOWNSHIP
GRANT
FORESTLAKE
DELLWOOD
COTTAGEGROVE
BIRCHWOODVILLAGE
BAYTOWNTOWNSHIP
BAYPORT
AFTON
ST PAULPARK
Living Healthy Nutrition Resources!( Community Gardens
!( Cooking Classes
!( Farm Fresh Produce
!( Farmers Markets
!( Grocer Education and Specialty Foods
!( Nutrition Education and Counseling
!( Nutrition Support Resources
!( Weight Management
Data Source: Living Healthy Washington County Resource Guide, Prepared By: Washington County Department of Public Health and Environment November 2012
This map should be used for reference purposes only. Washington County is not responsible for any inaccuracies.
0 1 2 3 4 5Miles
µ
Washington County, MinnesotaNutrition Resources
State of Minnesota
!(!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!( !(
!(!(
!(
!(
!(
!(
!(
!(
!(
!(!(
!( !(
!(
!( !(
!(
!(
!(
!( !(
!(
!(
!(
!(
!(
!(!(
!(
!(
!(
!(
!(
!(
!(
!(
!(
!(!(
!(!(
!(!(
!(
!(
!(!(!(
!(
!(
!(
!(
!(!(!(
!(
!(!(
!(!(
!(
!(
!(!(
!(!(
!(
!(
!(!(
!(
!(
!(
!(
!(
!(
!(
!(
")
")
")
")
")
")
")
")
")
")
")
")
")
")
")
")
")
")
")
")
")")
")
")
")
")
")
")
")
")
")
")
")")
")
")
")
")
")
")
")
")")")
")
")
")
")
")
")
")
")
")
$+
$+
$+
$+
$+
$+
$+
$+
$+$+
$+
$+$+
$+
$+
$+
$+
$+
$+
$+
$+
$+ $+$+
$+
$+
$+
$+
$+
$+
_̂
_̂
_̂
_̂̂__̂
_̂
_̂
_̂
_̂
_̂
_̂
_̂
_̂_̂
#*
#*
#*
#*#*
#*#*
#*#*#*
#*
#*
#*
#*
#*
#*
#*
#*
#*
#*
#*
#*
#*
#*
#*
#*
#*
#*#*
#*
WHITEBEAR LAKE
BIRCHWOODVILLAGE
DENMARKTOWNSHIP
WOODBURY
WEST LAKELANDTOWNSHIP
WILLERNIE
ST MARYSPOINT
STILLWATERTOWNSHIP
STILLWATERPINESPRINGS
OAK PARKHEIGHTS
OAKDALE
SCANDIA
NEWPORT
MAY TOWNSHIP
MARINE ONST CROIX
MAHTOMEDI
LAKELANDSHORES
LAKEELMO
LAKE STCROIX BEACH
LANDFALLLAKELAND
HUGO
HASTINGS
GREY CLOUDISLAND TOWNSHIP
GRANT
FORESTLAKE
DELLWOOD
COTTAGEGROVE
BAYTOWNTOWNSHIP
BAYPORT
AFTON
ST PAULPARK
Living Healthy Physical Activity Resources#* Community Centers and Clubs (31)!( Dance and Fitness Centers (92)_̂ Fitness Classes and Information (19)") Other Recreational Resources (53)$+ Parks and Trails (32)
Washington County, MinnesotaPhysical Activity Resources
Data Source: Living Healthy Washington County Resource Guide, Prepared By: Washington County Department of Public Health and Environment 12/12/2012This map should be used for reference purposes only. Washington County is not responsible for any inaccuracies.
0 1 2 3 4 5Miles
µ
17
Washington County, MN: Using GIS to Address Existing Priorities
Enhance Partnerships:Nutrition Resources
This map illustrates many nutrition resources available in Washington County, MN. Nutrition educa-tion programs include cooking classes and nutrition counseling. Fresh produce is available at farmers’ markets, from community supported agriculture, and from community gardens. Nutrition Support Re-sources include food banks, home delivered meals, Women, Infants and Children (WIC), and the Supple-mental Nutrition Assistance Program (SNAP). The map shows that there are fewer places to purchase fresh produce in the southwest corner of the county which is also a more densely populated and lower income area in Washington County. The absence of cooking classes in the northern part of the county is noted. Updates to the list and map will focus on these two categories to confirm gaps in services or identify new resources in these areas.
Enhance Partnerships:Physical Activity Resources
This map illustrates the variety of fitness related resources available in Washington County, MN, in-cluding community centers, clubs, fitness centers, classes, and parks and recreation departments. More resources are located in areas of greater population density. The points located to the north and west of the county lines represent strong partnerships with multicounty school and healthcare partners. The northeast and southeast areas of the county are primarily rural or farming communities and have fewer physical activity resources. Future updates to the map and resource list will include major trails as con-nections are completed at the municipal and county level.
18
Facilitating CollaborationThe GIS State & Local Surveillance Training Program was intentionally designed to develop a GIS infrastructure that would facilitate collaboration among an array of chronic disease units within each state health department, yet with a focus on heart disease and stroke. To that end, the four staff members from each state and local health department that participated in the training represented different chronic disease units. Each state & local health department was led by a member of the heart disease and stroke unit; here are the chronic disease units that were represented in each of the participating state and local health departments:
Iowa Department of Public HealthName Chronic Disease Unit Suning Cao Division of Health Promotion and Chronic Disease PreventionOusmane Diallo Division of Behavioral HealthTerry Y. Meek Division of Health Promotion and Chronic Disease PreventionJoann Muldoon Division of Tobacco Use Prevention and ControlRob Walker Division of Environmental HealthJohn C. Warming Division of Administration and LicensureTim Wickam Division of Environmental HealthKevin Wooddell Division of Health Promotion and Chronic Disease Prevention
Mississippi State Department of Health Name Chronic Disease Unit Sai Kurmana Chronic Disease BureauLaTonya Lott Vincent Mendy Amel Mohamed
Office of Health Data and ResearchMississippi Delta Health CollaborativeDiabetes
Nebraska Department of Health and Human Services Name Chronic Disease Unit Yushiuan Chen Cancer Registry Jianping Daniels Office of Women’s and Men’s Health David DeVries Heart Disease and Stroke Prevention ProgramGuangming Han Department of Public Health
19
New Hampshire Department of Health and Human ServicesName Chronic Disease Unit Lia Baroody Heart Disease Stroke Prevention ProgramJean Cadet Public Health Prevention ServiceMichael Laviolette Health Statistics and Data ManagementTylor Young Chronic Disease Prevention and Screening Section
Texas Department of State Health Services Name Chronic Disease Unit Rosemary Ang Nimisha Bhakta
Cardiovascular Disease and Stroke ProgramHealth Promotion and Chronic Disease Prevention
Cecily Brea Blaise Mathabela
Cardiovascular Disease and Stroke Program Texas Diabetes Program
Wisconsin Department of Health ServicesName Chronic Disease Unit Julie Baumann Heart Disease and Stroke Prevention Program Nancy Chudy Chronic DiseaseRandy Glysch Tobacco Prevention & Control ProgramMelissa Olson Oral Health ProgramEmily Reynolds Cancer Control ProgramMark Wegner Chronic DiseaseHerng-Leh Yuan Heart Disease and Stroke Prevention Program
Boston MA Public Health CommissionName Chronic Disease Unit Neelesh Batra Research and Evaluation OfficeHonglei Dai Information and TechnologyShannon O’Malley Research and Evaluation OfficeNelson Pidgeon Information and TechnologySnehal Shah Research and Evaluation OfficeRashida Taher Research and Evaluation Office Megan Young Research and Evaluation Office
Washington County MN Department of Public Health and EnvironmentName Chronic Disease Unit Fred Anderson Epidemiology Kim Ball Healthy CommunitiesChris LeClair Environmental HealthAdam Snegosky GIS Support UnitJean Streetar Public Health Program
20
Hennepin County MN Human Services and Public Health DepartmentName Chronic Disease Unit Erica Bagstad HSPHD EpidemiologyLinda Brandt HSPHD Public Health PromotionJack Brondum HSPHD Epidemiology & Environmental HealthMei Ding HSPHD-Assessment TeamJay Meehl Hennepin County GIS Office Komal Mehrotra HSPHD-Assessment TeamMargo Suhr HSPHD Operation Resources & SupportTim Zimmerman HSPHD
Rockland County NY Department of Health Name Chronic Disease Unit Oscar Alleyne Division of Epidemiology and Public Health PlanningUna Diffey Division of Chronic Disease Prevention and Health PromotionJeremy Erlich Division of Environmental HealthMelissa Jacobson Division of Chronic Disease Prevention and Health PromotionKevin McKay Division of Disease Control
Cambridge MA Public Health DepartmentName Chronic Disease Unit Susan Kilroy-Ames Division of Epidemiology and Data ServicesLeanne Lasher Division of Epidemiology and Data ServicesJosefine Wendel School Nutrition and Let’s Move
E-mail: [email protected]://cehi.snre.umich.edu
Related Documents
