This guest post is presented by Maximus, sponsor of the APHA Annual Meeting Blog. Its Center for Health Innovation offers programs and services to help governments respond to population health needs and emerging public health threats and improve public health infrastructure. Jonnell Sanciangco, MSc, GISP, a geographic information science manager at Maximus, and Corinna Dan, RN, MPH, Maximus vice president, discuss how GIS tools can support public health work.

The locations where people live and work play a significant role in their health. A Geographic Information System, or GIS, is a location-based tool that can analyze and present data about communities and their attributes that affect health status and health equity. 

GIS capabilities are a powerful tool in a modernized public health ecosystem. By identifying and clarifying data related to health status, GIS offers a proven strategy that can illustrate health inequities and social determinants of health, identifying specific locations where public program support is most needed and will be most impactful. Ultimately, GIS offers indispensable tools to guide decisionmaking and support health equity and outcomes. 

The U.S. Department of Health and Human Services defines health equity as “attaining the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities.”

According to the Centers for Disease Control and Prevention, health equity is achieved when every individual can attain full health potential. Health equity, however, is affected by social factors and is reflected in various data, from differences in the quality of life to access to health care and treatments. Therefore, we must first learn about places and their attributes to understand health equity. GIS can identify patterns by mapping health equity metrics, such as population density, race and ethnicity, poverty and education levels, median home value, and crime rates. By combining this type of information on a map, experts have developed some vulnerability measures and indices that can explain why specific health equities exist. 

By implementing GIS solutions, community leaders and organizations can better understand, visualize and address the health inequities in their respective communities. In addition, these data visualizations can be used to share information with the public to improve transparency and communication and build trust and engagement.

Using risk variables, metrics to advance equity

One way to apply GIS technology to understand health equity is by visualizing community patterns and trends using available datasets. This information comes in various geographic scales, from national to local. Data variables we can use to study and address health equity include:

• Health risk, which encompasses well-being, disability status, health insurance coverage, the CDC Social Vulnerability Index, homelessness and low birthweight.
• Racial and ethnic data, including children in immigrant families, English ability and linguistic isolation and housing tenure by race or ethnicity.
• Socioeconomic risk, such as household income, housing costs, poverty status, monthly unemployment, child eligibility for free or reduced lunch prices, and income.
• Occupational risk, which includes earnings by occupation, travel time to workplace, vehicle availability and the COVID-19 economic vulnerability index.
• Housing risks, including living arrangements, homeownership and housing unit status.
• Location of essential services, encompassing food deserts and children's services, access to transportation and proximity to services, including hospital and grocery locations. 
• Internet accessibility, such as broadband characteristics and internet access, affordability and access to computers that meet employment and education requirements. 

In addition to its data mapping capabilities, GIS provides efficient communication tools such as interactive maps, dashboards and spatial analytics. The metrics and data can be presented as interactive web map applications and story maps to create a more engaging experience. Real-time data can be collected, analyzed and placed on an operational dashboard to help guide resource allocation and other decisionmaking. 

Experts and researchers leverage GIS to examine spatial and statistical relationships between specific health outcomes and health equity metrics. For example, GIS solutions can help answer questions such as: Why do particular communities have lower COVID-19 testing, mortality or vaccination rates compared to others? What other disparities exist among communities with high mental illness and opioid addiction rates? How accessible are fresh produce markets for communities impacted by malnutrition or childhood obesity?

Want to learn more? Visit this story map that describes the integration of social epidemiology and GIS technology in addressing inequalities in health outcomes.

For more information, visit Maximus Public Health and stop by the Maximus booth, G-21, at APHA’s 2022 Annual Meeting and Expo in Boston. Sanciangco will be a presenter at APHA 2022 during Session 4010, “Big Data and Machine Learning for Health Research,” 8:30-10 a.m., and Session 4123, "Epidemiology and Equity: Methods & Measurement," 10:30 a.m.-12 p.m., both Nov. 8.

Photo captions from top: During the COVID-19 pandemic, maps have played a critical role in mounting an effective public health response. Jonnell Sanciangco. Corinna Dan.