case study
Picture, if you will, your community facing multiple crises all at once. Your response is constrained due to limited resources. At the same time, your teams are facing issues you have never experienced in your career, like an unprecedented pandemic. The crises are equally critical, and you clearly must respond quickly.
This was the exact scenario the Stark County Health Department was facing. Stark County, a rural community in northeast Ohio, was experiencing the highest number of opioid-related deaths on record. Then the COVID-19 pandemic hit, with both crises now impacting and compounding the other. During the triage, the county officials knew they had to get the pandemic under control but somehow still address the numerous deaths and overdoses caused by opioid misuse. Faced with a shortage of resources and staff, the health department leadership needed to find a way to monitor the crises and make better-informed decisions on where to allocate scarce resources.
For the past 15 years, the Environmental Health Services (EHS) at the Stark Health Department has used geographic information system (GIS) technology. Then the department discovered that GIS technology was being used across the country as a mission-critical tool for communicating information and responding to the pandemic. So Stark County decided to embrace GIS technology to battle the pandemic and opioid crises.
As response times were becoming even more critical due to the pandemic, the health department team partnered with the GIS staff in Stark County's Auditors Office for assistance. The collaboration helped the health team navigate and quickly respond to the pandemic. Leveraging the GIS team's expertise, the health department set up COVID-19 contact tracing protocols and later equitable vaccination distribution that included mobile vaccination clinics to expand access to vulnerable communities. The collaboration also created its first public communication tool, the Business Safety Initiative, which allowed businesses to apply for items needed to improve safety during COVID-19. The team used ArcGIS Hub, an easy-to-configure cloud platform that organizes people, data, and tools, to create its site.
The collaboration also created its first public communication tool, the Business Safety Initiative, which allowed businesses to apply for items needed to improve safety during COVID-19.
The next step in developing an effective emergency response system was to take the lessons learned and apply the knowledge to the county's core health functions. While the department had limited health professionals with GIS knowledge, it did have a growing understanding of the power of how a geographic lens could support activities such as data collection, analysis, decision support, and public engagement.
Seeing how the power of location intelligence created targeted solutions for the pandemic, the health department hired a GIS health specialist to develop GIS solutions to mitigate the effects of the pandemic, including opioid misuse that was still heavily claiming lives in the county.
In November 2020, the health department hired Jorian Krob, MS, a GIS specialist, to bring the necessary geospatial literacy to help the county combat multiple health crises. She joined the drug overdose prevention team, tasked with tackling the opioid epidemic in Stark County. This team had to understand how challenges such as an absence of social support, family history, socioeconomic status, job insecurity, or peer pressure could push someone to drug misuse. And all these challenges were compounded and magnified by the COVID-19 pandemic.
Krob started by mapping overdose deaths using ArcGIS Pro, a desktop GIS application that can analyze data from multiple sources and visualize it in a single project-based workflow. Determining where the overdoses were occurring allowed the health department to localize its efforts and allocate its resources to the most affected areas.
The health department understood that to combat this health crisis, it could not do it alone; it would need to educate the public on the issue, partner with local groups who could provide resources, and create a space where drug-dependent individuals could seek assistance.
Krob utilized the Opioid Epidemic Outreach solution, a set of preconfigured applications and maps that allowed the county to quickly index local prevention and treatment resources. The solution helped launch Save Stark, a public information site created using ArcGIS Hub. The site allowed the health department to communicate the severity of the epidemic in the community; promote resources available to those in need; and share real-time data and resources from local health organizations, emergency management, and local nonprofits.
"The Opioid Epidemic Outreach solution allowed us to combat this issue from all angles, which is exactly what we needed. It was so easy to use that other counties are now reaching out and looking to set up their own hub site," said Krob.
A complex issue like the opioid epidemic requires many efforts for a solution. For example, the health department needs to; educate the public on the many contributing factors that may lead to drug misuse, help break the stigma around substance misuse, and increase transparency regarding the impact of the epidemic on the local community.
To navigate this complexity, the health department brought on its communications specialist, Chris Cugini, MPH, to help craft the hub site messaging using inclusive language that promotes education and provides knowledge about how to seek help without feeling ashamed or judged for struggling with a substance use disorder.
"Most campaigns we came across talked about the people facing addiction instead of to the people facing addiction. So we wanted to tailor this differently to break that stigma we see around substance use disorders," stated Cugini.
GIS allowed Krob and Cugini to work collaboratively and distribute their location-based solutions to their communities via the Save Stark hub site.
The Save Stark hub site provides educational information outlining factors that may push someone to substance misuse.
"It was important that this information be made public and could be found in one central location, as we wanted the community involved and able to provide feedback on the resources we had to offer. The hub site provided just that for us," said Krob.
The public-facing opioid awareness maps dashboard provides full transparency on the local status of the epidemic.
Stark County wanted to provide resources that the public could easily find. Using maps and analysis, the county aligned the hub site around three major areas:
Complex issues like the opioid epidemic do not have easy solutions. But by using GIS, finding solutions is made easier. Stark County was able to inventory prevention and treatment resources, communicate the severity of the epidemic, and promote resources available to those in need all with the Opioid Epidemic Outreach solution. The county also used GIS to find opioid overdose patterns and then tailor its solutions to the trends it was seeing and collaborate internally with other staff to effectively apply these solutions.
Seeing how GIS provides data-driven insight and allows cross-department collaboration, the county is looking to use GIS for many future projects such as their fatality review boards, women's health initiatives, and smoking cessation programs. Currently this data is being manually recorded and updated via spreadsheets. The county has already received community feedback on important issues and has since launched Dear Stark Women, a hub site created using ArcGIS. The site provides resources and maps for affordable care, reproductive care, and many other valuable resources.
Stark County's geographic approach allowed it to effortlessly collaborate between internal teams and develop GIS tools to effectively improve public health. The county hopes to leverage the power of GIS for all future health matters.
The Opioid Epidemic Outreach solution allowed us to combat this issue from all angles, which is exactly what we needed. It was so easy to use that other counties are now reaching out and looking to set up their own hub site.