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The Spatial Analysis of Health Data   Health Disparities and the Development of High Priority Target Areas   September 10, 2009 Virginia Health Equity Conference Virginia Department of Health Office of Minority Health and Public Health Policy Ken Studer, PhD Rexford Anson-Dwamena, MPH
Types of  Spatial   Analysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Surrounded by Clusters! 'Tobler's first law of geography'  "everything is related to everything else, but near things are more related than distant things"
Double Jeopardy describes children (under 18 years old) that live in poor families and in poor neighborhoods. Poor neighborhoods  are defined as census tracts (CTs) with greater than 20.0% poverty. The racial categories include persons of Hispanic and non-Hispanic  origin; 'Other' includes American Indian, Alaska Native, Native Hawaiian and other Pacific Islander, some other race alone, and two or more races. **Total number of children living below the federal poverty level reflects the sum of the four racial categories since Hispanic ethnicity could not be determined for each race.  Source: Census 2000, SF3, P159. Where is the Map?
Abraham Verghese: Urbs in Rure Verghese, A., S. Berk, and F. Sarubbi. 1989.  Urbs in Rure:  HIV infections in rural Tennessee.  Journal of Infectious Diseases 160(6): 1051-1055.
Spatial Analysis of Prostate Cancer    Incidence in Virginia* * Oliver, MN, E Smith, M Siadaty, FR Hauck, LW Pickle, Spatial Analysis of Prostate Cancer Incidence and Race in Virginia, 1990–1999. Am J Prev Med 2006;30(2S):S67–S76. Census Tract Level Analysis County Level Analysis
Source: United States Department of Agriculture: Economic Research Service, 2004 County Typologies; Census 2000, SF3-PCT25. County/Census Tract Low Education in Virginia Census Tract Level County Level
County/Census Tract SMR
Mortality Ratio by Census Tract
Things Change but…. …systems remain highly sensitive to initial conditions
Persistence of Poverty
31
 
50% Infant Mortality in Richmond    Block Groups: 1990-2005
Percentage (yellow) of Richmond Homicides  by Census Tract, 2007 Richmond, Virginia Infant Deaths by Census Block Group, 1990-2005 Thematic Map (Choropleth Map)
Infant Mortality Clustering
NOVA Infant Deaths per Census Block Group Source: VDH Vital Statistics, 1990-2005.
Predictive Kriging Analysis Infant Deaths by Block Group Source: VDH Vital Statistics, 1990-2005. Kernel Density Analysis Low Birth-weight Infants  based on Census Tract Data with Optimum Locations for Clinics Source: VDH Vital Statistics, 1996-2005.
The Pareto Principle   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Health Disparity
Kernel Density Smoothed Surface
SaTScan Cluster Analysis
Cluster #1 Filter Decomposition
Rural Cluster #2
Breast Cancer Residual Analysis
Combined Kernel Density and Kriging   Analysis—State Standard
Combined Kernel Density and Kriging   Analysis—NOVA Standard
Combined Kernel Density and Kriging Analysis— Potentially Underreported Incidence
GeoDa Cluster Analysis
White Breast Cancer Rates
Black Breast Cancer Rates
Black/White Breast Cancer Disparities
Black/White Breast Cancer Disparities
Levels of Clustering Techniques ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Spatial Clustering Algorithms Level of Spatial Analysis B L U E* *best linear unbiased estimators
Contact Information: Ken Studer, PhD [email_address] Rexford Anson-Dwamena, MPH rexford.dwamena @vdh.virginia.gov

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