James Martinez, Population Health Analyst and GIS Specialist, Loma Linda University Health
Milton Ospina, Global Business Development Manager, HERE
The mission of Loma Linda University Health (LLUH) is to strengthen community health so individuals and families can enjoy longer, healthier lives. Like other community health institutions, LLUH uses geographic information system (GIS) technology to support community health needs assessments. Using GIS, LLUH combines geography with data to help decision makers understand what affects community health and focus resources in the areas with the greatest need.
An essential component of needs assessments is developing mapping applications that identify the location of community assets, which consists primarily of points of interest (POI) such as hospitals, clinics, and pharmacy locations to which health professionals can refer patients.
In the summer of 2014, LLUH’s Community Health Mapping Program team embarked on a mission to revamp its community asset data collection and vetting process. The existing asset database was incomplete; not only was the information outdated, but it also only included asset information from nonprofit organizations that had voluntarily shared their data. In need of a more robust database, the Southern California institution turned to Esri ArcGIS software to collect and map assets that are critical to community health programs.
LLUH explored StreetMap Premium for ArcGIS as a solution to collect up-to-date community asset information. StreetMap Premium is a street dataset that supplies data for routing, geocoding, and creating high-quality maps in ArcGIS.
Advancing Community Health with Maps
Community health professionals—such as hospital administrators, health care providers, doctors, nurses, and decision makers—use mapping applications to combine community assets with patients’ addresses. With these tools, for example, health professionals can generate heat maps that show the heaviest concentrations of asthma incidence and where these patients can get treatment.
A heat map combined with community assets can also show if there are enough resources in the areas with the highest asthma incidence (see figure 1). By visualizing the distribution of health challenges along with available resources on a map, LLUH can influence strategic allocations of health resources to areas in need. With these maps, leaders can make better decisions about where to allocate assets. Maps depicting both community assets and patients’ medical data can also be a powerful tool to show stakeholders the patients’ proximity to community health assets.
Comprehensive community health mapping programs also require nonclinical resources, such as pharmacies, grocery stores, farmers’ markets, churches, community centers, parks, fire departments, and transportation hubs. These assets often comprise the first layer included on a basemap in order to have a meaningful GIS mapping program that integrates census and patient health data.
From Daunting to Done
To improve LLUH’s understanding of the geographic location of community assets and the populations they serve, the organization turned to ArcGIS for Desktop and StreetMap Premium. With these two resources, the LLUH team built a comprehensive inventory of health-related assets for the County of San Bernardino. Prior to the project, collecting asset information was a daunting task.
“We had to search and scrub websites for weeks to identify and attempt to validate data,” said James Martinez, population health and GIS analyst at LLUH. “In many cases, the data was not geocoded and required a lot of cleansing. Data quality was a major problem.”
With StreetMap Premium for ArcGIS, there was no longer a need to validate or geocode data. Valid POI data from HERE was readily available. The team pulled and plotted the geographic location of community health assets in ArcGIS for Desktop. In addition to mapping the locations of pharmacies, community clinics, schools, and hospitals, the team identified and mapped areas that lack such assets. The team also mapped these resources in areas where there are high concentrations of patients with asthma, diabetes, and heart failure.
Points of interest ranged from clinical assets, such as hospital locations and medical services, to physician and dental offices. Nonclinical assets included pharmacies and local transit systems, bus stations, and commuter rail stations. StreetMap Premium for ArcGIS offered data on additional assets to complete LLUH’s database. These included churches, schools, educational resources, libraries, civic community centers, social services, government offices, recreational facilities, and parks.
Further database enhancements included the availability of grocery and specialty food stores, restaurants, retirement facilities, fitness and health clubs, fire departments, and police stations. Additionally, LLUH located barriers such as the lack of bus stops where high-risk patients reside, and it was able to provide maps to local and regional health care providers, community partners, and decision makers.
Better Insight, Better Support
Today, LLUH’s revamped community asset maps better support community health needs assessments, hospital readiness reduction programs, and school health interventions for preventive care. With the integration of ArcGIS and StreetMap Premium, LLUH enhanced health programs within the county and neighboring communities with more in-depth and accurate asset mapping applications.
With improved community asset maps in hand, LLUH was able to position interventions where the need was greatest. The Community Health Mapping Program team identified regions that lack health resources for addressing obesity, diabetes, mental health issues, and respiratory illnesses. The StreetMap Premium POIs were an essential component to bringing together trusted information on boundaries, roads, and health assets. LLUH also observed gaps for services in neighborhoods where incomes are lower and that are considered medically underserved.
The updated mapping applications also support leadership in determining grant development by demonstrating the need for more health care professionals in medically underserved areas. Leaders also leverage asset data when working with community clinics to target underinsured communities. Together, LLUH and partners are better able to target interventions that promote active lifestyles and lower risks of chronic illnesses.
The GIS project also led LLUH and HERE to identify POIs not included in StreetMap Premium. This collaboration ignited discussions about how HERE can collect these assets and make them available to better serve the needs of organizations that are developing or enhancing community health mapping programs. Assets that HERE intends to collect will include adult day care centers, skilled nursing facilities, home health agencies, and suppliers of durable medical equipment.
If you are interested in learning more about community asset data or would like to provide input about your needs for specific points of interest or assets, contact Milton Ospina, global Esri business development manager at HERE, at firstname.lastname@example.org. To learn more about the HERE products available across the entire Esri platform, visit esri.com/here.
To learn more about the LLUH Community Health Mapping Program, contact James Martinez, population health analyst and GIS specialist at LLUH, at JAMMartinez@llu.edu.
Figure 1: Loma Linda University Health put StreetMap Premium to work to map asthma emergency department visits and community assets, including hospitals, shopping facilities, and schools.
Figure 2: Loma Linda University Health used a comprehensive set of POIs to identify community health assets near clinics located within medically underserved and health professional shortage areas.