case study
Orange County, California, is known for its tourist destinations and is the third-most populous county in the state. This means that the Orange County Health Care Agency (HCA) is responsible for the health of thousands of residents and must analyze social determinants of health (SDOH) to ensure that services and resources reflect each community's needs.
The HCA, a leading health-care provider, has adopted a geographic approach to first analyze the county's health-care needs, find which communities require the most assistance, and then tailor programs and outreach based on its findings. Adopting a geographic approach allows health organizations to apply targeted solutions to make sure they are responding to their communities' most critical health needs. Geographic information system (GIS) technology provides organizations with the tools to execute their targeted location-based solutions. GIS layers community data to locate hot spots, provides organizational transparency, and allows you to target at-risk communities. The HCA leveraged GIS software to enhance its workflows and connect internal departments to holistically address the following:
Average life expectancy has improved since 1990 at the national, state, and county levels. However, this upward trend dramatically reversed during the COVID-19 pandemic. Orange County, California, and the US as a whole all lost roughly a decade of improvements in longevity in just 2 years of the global pandemic. Specifically, the US lost a full 3 years, California lost 2.7 years, and Orange County lost 2.4 years. Leveraging ArcGIS Dashboards, the HCA analyzed life expectancy trends by age; gender; and notably, race. Findings from the HCA identified which groups were largely impacted by COVID-19 and systematically disclosed the leading cause of death within each community.
HCA map highlights the cities in the southern part of the county that have higher life expectancy rates.
To enhance response efforts, the HCA developed a tool to score a city's social determinants of health. The HCA's Social Progress Index (SPI) based scoring on a city's life expectancy, so the higher the life expectancy age, the higher the SPI score.
Social Progress Index (SPI) scores of Orange County cities are measured by social determinants of health.
Location intelligence uncovered that Santa Ana, the second-largest city in Orange County, has the lowest SPI score, while the city of Irvine received the highest SPI score. Santa Ana underperformed in 9 of the 12 SPI measures including basic human needs (e.g., nutrition and basic medical care, housing), foundations of well-being (e.g., health and wellness, access to basic knowledge, access to info and communication), and opportunity (e.g., personal rights, personal freedom and choice, inclusiveness, access to advanced education). This location intelligence allows the HCA to target resources and education to cities with lower SPI scores.
The city with the lowest SPI score is compared next to the city with the highest SPI score.
A social determinant of health that the HCA sought to address was tobacco use in the city of La Habra, a predominantly Hispanic/Latinx community
The HCA layered demographic data, community data, and health data in their GIS to identify where they should target tobacco prevention programs. They identified 20,000 housing units with 33.2% being multiunit complexes and that 93% of La Habra stores sold tobacco products. The Tobacco Use Prevention Program (TUPP) has taken these findings and are analyzing the results and looking to pass regulations that prohibit smoking of any kind in multiunit complexes and limit the sale of tobacco products within the city.
The HCA is currently collecting community feedback and observing whether there is less tobacco product waste and active smoking than what was observed at baseline. Thanks to the GIS informed work of TUPP and its many community and state partners, cigarette use continues to be on the decline in La Habra and Orange County overall. Unfortunately, the same cannot be said of drug and alcohol mortality rates.
Leveraging ArcGIS StoryMaps, a tool that helps you tell remarkable stories with custom maps that inform and inspire, the HCA analyzed drug and alcohol mortality rates to see which communities were impacted the most.
"Geographically, certain cities were hit harder than others, and certain demographic groups were also hit harder than others. GIS technology has been a great way to highlight these disparities and provide departments like social services with this information so they can tailor their response efforts accordingly," said Curtis Condon, PhD, HCA research manager.
Users can swipe the icon on the map to compare mortality rates between 2010–2012 and 2019–2021.
Report findings illustrated that alcohol and drug-related deaths increased from 2019 to 2021. Notably, drug-related deaths consistently occurred in greater numbers compared to alcohol-related deaths. Further analysis found that opioid-related overdoses rose sharply in 2020, with an 86.9 percent increase from 2019. GIS tools like ArcGIS StoryMaps allow organizations to easily share crucial data and findings with other internal departments to ensure health programs and resources directly reflect the needs of their communities. The HCA is now working with OC Navigator, a resource hosted by the HCA's Mental Health and Recovery Services Transformation Innovation Project, which provides a central site to locate health, well-being, and other supportive services within the county.
The HCA research team and stakeholders determined that responding to social determinants of health is far more effective when a geographic approach is applied. Utilizing GIS technology allows you to analyze your communities, identify where greater health disparities are occurring, and tailor response efforts accordingly. Moving forward, the HCA anticipates expanding its GIS use and will be leveraging ArcGIS Insights to explore death rates by homicide and suicide.
Geographically, certain cities were hit harder than others, and certain demographic groups were also hit harder than others. GIS technology has been a great way to highlight these disparities and provide departments like social services with this information so they can tailor their response efforts accordingly.