利用地理信息系统绘图确定公共卫生干预目标:通过地理信息系统技术研究出生结局

Using GIS Mapping to Target Public Health Interventions: Examining Birth Outcomes Across GIS Techniques.

作者信息

MacQuillan E L, Curtis A B, Baker K M, Paul R, Back Y O

机构信息

Health Data Research, Analysis and Mapping (HDReAM) Center, Western Michigan University, Kalamazoo, MI, USA.

Grand Valley State University, Grand Rapids, MI, USA.

出版信息

J Community Health. 2017 Aug;42(4):633-638. doi: 10.1007/s10900-016-0298-z.

Abstract

With advances in spatial analysis techniques, there has been a trend in recent public health research to assess the contribution of area-level factors to health disparity for a number of outcomes, including births. Although it is widely accepted that health disparity is best addressed by targeted, evidence-based and data-driven community efforts, and despite national and local focus in the U.S. to reduce infant mortality and improve maternal-child health, there is little work exploring how choice of scale and specific GIS visualization technique may alter the perception of analyses focused on health disparity in birth outcomes. Retrospective cohort study. Spatial analysis of individual-level vital records data for low birthweight and preterm births born to black women from 2007 to 2012 in one mid-sized Midwest city using different geographic information systems (GIS) visualization techniques [geocoded address records were aggregated at two levels of scale and additionally mapped using kernel density estimation (KDE)]. GIS analyses in this study support our hypothesis that choice of geographic scale (neighborhood or census tract) for aggregated birth data can alter programmatic decision-making. Results indicate that the relative merits of aggregated visualization or the use of KDE technique depend on the scale of intervention. The KDE map proved useful in targeting specific areas for interventions in cities with smaller populations and larger census tracts, where they allow for greater specificity in identifying intervention areas. When public health programmers seek to inform intervention placement in highly populated areas, however, aggregated data at the census tract level may be preferred, since it requires lower investments in terms of time and cartographic skill and, unlike neighborhood, census tracts are standardized in that they become smaller as the population density of an area increases.

摘要

随着空间分析技术的进步,近年来公共卫生研究呈现出一种趋势,即评估区域层面因素对包括出生在内的多种健康差异结果的影响。尽管人们普遍认为,针对性强、基于证据且以数据为驱动的社区努力是解决健康差异的最佳方式,并且美国在国家和地方层面都致力于降低婴儿死亡率和改善母婴健康,但很少有研究探讨尺度选择和特定地理信息系统(GIS)可视化技术如何改变对出生结果中健康差异分析的认知。回顾性队列研究。利用不同的地理信息系统(GIS)可视化技术,对2007年至2012年在中西部一个中等规模城市出生的黑人女性低体重儿和早产儿的个体层面生命记录数据进行空间分析[地理编码地址记录在两个尺度层面进行汇总,并额外使用核密度估计(KDE)进行制图]。本研究中的GIS分析支持了我们的假设,即汇总出生数据时地理尺度(社区或普查区)的选择会改变规划决策。结果表明,汇总可视化或使用KDE技术的相对优势取决于干预尺度。KDE地图在针对人口较少且普查区较大的城市中的特定区域进行干预时被证明是有用的,因为它在确定干预区域时具有更高的特异性。然而,当公共卫生规划者试图为人口密集地区的干预布局提供信息时,普查区层面的汇总数据可能更受青睐,因为它在时间和制图技能方面所需投入较低,而且与社区不同,普查区是标准化的,随着区域人口密度的增加,普查区会变小。

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