Hardt Nancy S, Muhamed Shehzad, Das Rajeeb, Estrella Roland, Roth Jeffrey
College of Medicine at the University of Florida in Gainesville, USA.
Perm J. 2013 Winter;17(1):4-9. doi: 10.7812/TPP/12-090.
Challenges to health care access in the US are forcing local policymakers and service delivery systems to find novel ways to address the shortage of primary care clinicians. The uninsured and underinsured face the greatest obstacles in accessing services. Geographic information systems mapping software was used to illustrate health disparities in Alachua County, FL; galvanize a community response; and direct reallocation of resources. The University of Florida Family Data Center created "hot spot" density maps of important health and social indicators to highlight the location of disparities at the neighborhood level. Maps were produced for Medicaid births, teen births, low birth weight, domestic violence incidents, child maltreatment reports, unexcused school absences, and juvenile justice referrals. Maps were widely shared with community partners, including local elected officials, law enforcement, educators, child welfare agencies, health care providers, and service organizations. This data sharing resulted in advocacy efforts to bring resources to the greatest-need neighborhoods in the county. Novel public-private partnerships were forged between the local library district, children and family service providers, and university administrators. Two major changes are detailed: a family resource center built in the neighborhood of greatest need and a mobile clinic staffed by physicians, nurses, physician assistants, health educators, and student and faculty volunteers. Density maps have several advantages. They require minimal explanation. Anyone familiar with local geographic features can quickly identify locations displaying health disparities. Personalizing health disparities by locating them geographically allows a community to translate data to action to improve health care access.
美国医疗保健可及性面临的挑战正促使地方政策制定者和服务提供系统寻找新方法来解决初级保健临床医生短缺的问题。未参保者和参保不足者在获取服务方面面临最大障碍。地理信息系统绘图软件被用于说明佛罗里达州阿拉楚阿县的健康差异；激发社区回应；以及指导资源的重新分配。佛罗里达大学家庭数据中心创建了重要健康和社会指标的“热点”密度图，以突出邻里层面差异的位置。制作了关于医疗补助分娩、青少年分娩、低出生体重、家庭暴力事件、虐待儿童报告、无故缺课和青少年司法转介的地图。这些地图与社区合作伙伴广泛分享，包括当地民选官员、执法部门、教育工作者、儿童福利机构、医疗保健提供者和服务组织。这种数据共享促成了倡导行动，将资源带到该县最需要的社区。当地图书馆区、儿童和家庭服务提供者以及大学管理人员之间建立了新的公私合作伙伴关系。详细介绍了两项重大变化：在最需要的社区建立了一个家庭资源中心，以及一个由医生、护士、医师助理、健康教育工作者以及学生和教师志愿者组成的流动诊所。密度图有几个优点。它们几乎无需解释。任何熟悉当地地理特征的人都能迅速识别显示健康差异的位置。通过在地理上定位健康差异来使其个性化，能让社区将数据转化为行动，以改善医疗保健可及性。
