Partnerships to Facilitate Prevention and Recovery:

The Potential of Geographic Information Systems (GIS) to Facilitate Data-Driven Prevention
Partnerships to Facilitate Prevention and Recovery: Transformation Where It Counts! Barbara Seitz de Martinez, PhD, MLS, CPP Desiree Goetze, MPH, CHES, CPP Kaigang Li

What You Will Learn: Components of GIS system
How GIS Helps with Strategic Planning How GIS Can Help You with Program Evaluation Surveillance System Track Change over Time and Space How GIS Plays a Role in Research: Example: Impact of Smoking and Coalitions Morbidity and Mortality Making Sense of the Data How GIS Can Help You with Program Planning Obtain Demographic Background Profile Needs, Resources Locate Problem Area or Target Audience Inform Decisions about Strategy Selection Enhance Cultural Competency Obtain Funding

Data… What is it? It’s up to you! 2018-09-18 www.drugs.indiana.edu
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Use it to enhance quality of life
It’s what you make of it! Limestone detail, IU artists/Rich%20Remsberg.asp House of Parliament, London, England

Data-driven prevention…but you drive
It’s up to you! Little 500 Bike Race, IU page/normal/1450.html

Components of a GIS System
Minimal Equipment and Personnel Skill Requirements

GIS System: Levels of Complexity

Level 1 – Extract Data Equipment: Hardware and Software
Data: Purchased Databases Kinds of Skills (Capacity Building) Basic Computer And Printer (1) MapInfo, PCensus, Maploader (1) Purchased GIS data (1) Objective: GIS to Inform Program Planning Identify Problem Area or Find Target Audience Obtain Demographic Background Inform Decisions about Strategy Selection Enhance Cultural Competency Equipment: Hardware and Software Standard Desktop/Laptop and Printer GIS software: MapInfo and PCensus for MapInfo. Or ArcView equivalent Data: Purchased Databases AGS Core Demographics, Consumer Spending, and MRI Lifestyle Variables or Claritas Equivalent Kinds of Skills (Capacity Building) Computer Literacy and Intro to Microsoft Excel Basic Computer Skills (1)

Level 1 – Extract Data MapInfo, PCensus, Maploader (1) Single Parent Families 2006, Percent (AGS, 2006 est., 2007) County Lake Co. IN U.S. Lone Parent Male (percent) 10.9 6.7 7.4 Lone Parent Female (Percent) 28.9 23.2 25.6 Single Parent Families (M+F) % 39.8 29.9 33 Purchased GIS data (1) Objective: GIS to Inform Program Planning Identify Problem Area or Find Target Audience Obtain Demographic Background Inform Decisions about Strategy Selection Enhance Cultural Competency Equipment: Hardware and Software Standard Desktop/Laptop and Printer GIS software: MapInfo and PCensus for MapInfo. Or ArcView equivalent Data: Purchased Databases AGS Core Demographics, Consumer Spending, and MRI Lifestyle Variables or Claritas Equivalent Kinds of Skills (Capacity Building) Computer Literacy and Intro to Microsoft Excel Basic Computer Skills (1)

Alcohol Spending per Household
Per Household Spending on Alcohol, 2006 est. (AGS, 2007) Adams Indiana U.S. Spending on Alcohol 529.8 664.9 621.7 Beer and ale not at home 73.9 93 87 Wine away from home 36.1 45.4 42.5 Whiskey away from home 60.1 75.6 70.7 Alcohol On Out-Of-Town Trips 65.4 81.7 76.4 Spending on Alcohol for Consumption in the Home 292.9 367.2 343.4 Beer and ale at home 157.2 197.1 184.3 Wine at home 84.7 106.2 99.3 Whiskey at home 20.7 25.9 24.2 Whiskey and other Liquor at Home 51.1 63.9 59.7 Median Household Income 45,791.50 54,272.10 48,276.60 Total Spending Per HH as % of Median HH income 1.155 1.225 1.288 Rank for Spending as % of Median HH Income 67 40th of 51

Adults without a High School Diploma
Educational Attainment, 2006 est. (AGS, 2007) Lake Co. Indiana U.S. Less than 9th grade 3 5 5.8 9th to 12th grade, no diploma 9.5 9.7 8.9 Total, Less Than 9th or less than HS Diploma 12.5 14.6 14.7 High school graduate 40.4 36.5 29.8 Some college, no degree 20.8 19.7 19.9 Associate degree 8.5 6.7 7.4 Bachelor's degree 11.4 14.2 17.9 Graduate or profession degree 6.4 8.2 10.3

Data can seem overwhelming
Too much data can seem overwhelming.

Lake County – Less Than High School Diploma
Source: AGS, 2007 estimates

Source: AGS, 2007 estimates Census Tracts: 30300; 30100; 30200; 31000; 20400; 20600; 10202; 10700; 10500; 11300; 41200

Family Conflict: Divorce
Divorce Rate, 2006 est. (AGS,2007) County Lake Indiana U.S. Divorced (Percent) 10.2 10.7 9.7

Lake County – Divorce Rate
Source: AGS, 2007 estimates

Lake County – Divorce Rate
Source: AGS, 2007 estimates Census Tracts: ; 10203; 10202; 10201; 10900; 11300; 11700; 11600;11900; 41600; 12600

Level 2 – Your Data / Maps Equipment: Data: Skills (Capacity Building)
Geocoding Software Color Printer Data: Local data Addresses Skills (Capacity Building) Patience, precision Microsoft Excel, Microsoft Access Objectives: GIS to Monitor Program Effectiveness Create a Risk/Protection Surveillance System Track Change Additional Equipment: Geocoding Software MapMarker Geocoding Software Color Printer Additional Data: Local program and local geographic location data to be imported Additional Skills (Capacity Building) Patience and precision Microsoft Excel and some Microsoft Access preferable

Mapmarker Geocoding software, Excel & Access
Software Required MapInfo, PCensus, Maploader (1) Mapmarker Geocoding software, Excel & Access (2)

Data Complexity Purchased GIS data (1) Imported data (free or
(2)

Program Data, Address Data, Health Data (public or purchased)
Examples of Data AGS, Claritas™, Map files (1) Program Data, Address Data, Health Data (public or purchased) (2)

Geocoding, Excel and Access
Skills Required Basic Computer (1) Geocoding, Excel and Access (2)

Afternoons R.O.C.K. in Indiana
Afternoons R.O.C.K. Programs, School Year Indiana Prevention Resource Center Afternoons R.O.C.K. in Indiana, 2006

Places of Worship Places of Worship, 2005
Indiana Prevention Resource Center Info USA, American Church List, 2005

Youth Serving Agencies
Indiana Prevention Resource Center Info USA, American Church List, 2005

Public Libraries and Branches
Main Library, 2006 Branch Library, 2006 Indiana Prevention Resource Center Indiana State Library, 2006

Schools School Indiana Prevention Resource Center
Indiana Department of Education, 2005

Marion County Schools, Alcohol Retail Outlets by School District
Marion County Alcohol Retail Outlets by Census Tract Public School Other School Alcohol Retail Outlet Marion County Schools, Alcohol Retail Outlets by School District

Marion County Schools, Alcohol Retail Outlets by School District
Marion County Alcohol Retail Outlets by School District Public School Other School Alcohol Retail Outlet Marion County Schools, Alcohol Retail Outlets by School District

Franklin Township School District
Public School Other School Alcohol Retail Outlet

M S D Perry Township School District

MSD Washington Township Schools

Indianapolis Public Schools
Other School Alcohol Retail Outlet

Marion County Universities and Alcohol Retail Outlets
University Alcohol Retail Outlet Butler Marion College Indianapolis Downtown Campus of Ivy Tech IUPUI U of Indy Marion County Universities and Alcohol Retail Outlets

1 Mile Radius around Butler University

1 Mile around University of Indianapolis

1 Mile around Downtown Campus of IVY TECH

1 Mile around Marion College

1 Mile around IUPUI

1 and 2 Miles around IUPUI

Jefferson County Profile, 6.9
TRIP Inspection Data (using data for 2005 from IN State Excise Police), ATC 2006 Jefferson Indiana Intensity of Inspection 2 1 No. Insp per 1,000 Youth, 10-17 13 12 Population 10-17 3,686 726,218 Total Population 32,343 6,270,352 Total No. of Tobacco Retail Outlets 2005 33 6,401 Total inspections Completed 49 8,503 Total Failed Inspections 10 1,076 Percent, Failed Inspections 20 Percent, Passed Inspections 80 87 Ranking (1-81) for % Failed Inspections 22 Ranking (1-81) for % Passed Inspections 62 Table 6.9: Intensity of TRIP Inspections and Related Statistics, Calculations for 2005 Based on Data from the TRIP Program (ATC, Indiana State Excise Police, 2006)

Schools in Proximity to Failed Trip Inspections – Close-up
Tobacco Outlets That Failed TRIP Inspections in 2006 Children at School Jefferson County

Schools in Proximity to Failed Trip Inspections – Close-up
Tobacco Outlets That Failed TRIP Inspections in 2006 Children at School Source: ISP, Excise Police, 2007 Grace Baptist School Shawe Memorial High School Pope John XXIII School Madison, Indiana

Vigo County Profile, 6.5 Methamphetamine Laboratory Seizures, (ISP, 2006) Vigo Indiana 1998 (Any Agency) 1 43 1999 (Any Agency) 18 129 2000 (Any Agency) 52 314 2001 (Any Agency) 66 542 2002 (Any Agency) 105 988 2003 (Any Agency) 108 1,278 2004 (Any Agency) 166 1,549 2005 (IPS) 19 989 2005 (Any Agency) 83 1,303 Table 6.5: Clandestine Methamphetamine Lab Seizures, (ISP, 2007)(ATC, Indiana State Excise Police, 2006)

Map: Meth Lab Busts Total lab busts in 2006, 993
Indiana Prevention Resource Center Source: IN State Police, 2007 Total lab busts in 2006, 993

Map: Meth Lab Busts (prism)
Source: IN State Police, 2007 Total lab busts in 2006, 993 Indiana Prevention Resource Center

Level 3 –Data import & analyze
Equipment: Geocoding Software SPSS Data: Local data Public Purchased Skills (Capacity Building) Higher level computer skills Higher level statistical skills Objectives: GIS to Monitor Program Effectiveness Create a Risk/Protection Surveillance System Track Change Additional Equipment: Geocoding Software MapMarker Geocoding Software Color Printer Additional Data: Local program and local geographic location data to be imported Additional Skills (Capacity Building) Patience and precision Microsoft Excel and some Microsoft Access preferable

Mapmarker Geocoding software, Excel & Access
Software Required MapInfo, PCensus, Maploader (1) Mapmarker Geocoding software, Excel & Access (2) SPSS (3)

Levels of Data Complexity
Purchased GIS data (1) Imported data (free or purchased) (2) More complex imported data (free or purchased) (3)

Program Data, Address Data, Health Data (public or purchased)
Examples of Data AGS, Claritas™ (1) Program Data, Address Data, Health Data (public or purchased) (2) Mortality Report Data Morbidity Data (public or purchased) (3)

Geocoding, Excel and Access
Skill Complexity Basic Computer (1) Geocoding, Excel and Access (2) Excel, Access, SPSS (3)

Alcohol Retail Outlets – Density/Map
Alcohol Sales Outlets Per Capita, (IN ATC, 2006) Monroe Co. Indiana Total Population (2006 est.) 121,477 6,310,320 Number of Outlets (March 2006) 251 11,011 Outlets Per Capita 0.0021 0.0017 Outlets Per 1,000 Persons 2.07 1.74 Indiana Prevention Resource Center Indiana Alcohol Tobacco Commission, 2006

Property Crime Indices
Bottom Quarter, Mid Range, Top Quarter (includes over IN & over US) Above US (9), Above IN (12), Top Quarter (23), Mid Range (46), 19-64 Lowest Quarter (23), 4-19 Objectives: GIS to Monitor Program Effectiveness Create a Risk/Protection Surveillance System Track Change Additional Equipment: Geocoding Software MapMarker Geocoding Software Color Printer Additional Data: Local program and local geographic location data to be imported Additional Skills (Capacity Building) Patience and precision Microsoft Excel and some Microsoft Access preferable AGS, Crime Indices 2004 (2005) Indiana Prevention Resource Center

Using local data and GIS to analyze county level comprehensive tobacco prevention in Indiana

Environmental Strategies +
Theoretical bases for environmental approaches to prevention Describe the elements of a comprehensive tobacco prevention program Discuss how local data and GIS software can be used to evaluate the effectiveness of public health efforts Analyze morbidity and mortality to determine public health impact within the community

Indiana Map Source: http://www.in.gov/itpc/Research2.asp?CatID=8

Smoking Rates by Region
Source:

NC & CW Regional Smoking Rates

Source:

Demographics: Education (Source: AGS, 2006 est., 2007)
Educational Attainment, Less Than a High School Diploma Less Than a High School Diploma RANK North West 15% 7 North Central 18% 4 North East 17% 5 Central 14% 8 Central East 19% 2 South West South East 20% 1 Central West 16% 6

Data frustrates …there will be obstacles

Map: Education: Any College Degree (prism map)
CW NC AGS, Core Demographics, 2005 estimates (2006)

Demographics: Race/Ethnicity (AGS, 2005 est.,2006)
Race/Ethnicity as Percent White Black Hispanic Other North West 88% 7% 6% 2% North Central 93% 5% 1% North East 95% 3% Central Central East South West 96% South East 0% Central West State of Indiana 87% 8% 4%

Map: Race/Ethnicity by County (prism)
AGS, Core Demographics, 2005 estimates (2006)

Demographics: Income (Source: AGS, 2006 est., 2007)
Income: Median Household, Median Family and Rankings Median Household Income RANK, Median Household Income Less Than a High School Diploma RANK, High School Diploma or higher North West $58,919 2 15% North Central $53,495 4 18% 5 North East $53,026 17% Central $66,189 1 14% Central East $44,933 8 19% 6 South West $50,541 South East $54,290 3 20% Central West $49,427 7 16% State of Indiana $58,575 Text Text

Demographics: Income (Source: AGS, 2006 est., 2007)
Income: Median Household, Median Family and Rankings RANK, Diversity RANK, Median Household Income RANK, High School Diploma or higher RANK, Tobacco Use North West 1 2 5 North Central 4 8 North East 7 Central 3 Central East 6 South West South East Central West Text Text

Map: Median Family Income (contour map)
CW AGS, Core Demographics, 2005 estimates (2006)

Adult Cigarette Smokers
AGS, Core Demographics, 2003 estimates (2004)

Indiana Adult Smoking Rates

Source:

NC & CW Regional Smoking Rates

Source: Indiana State Department of Health, October 19, 2007
Bronchitis Region Deaths Mean Age-Adj Rate/100,000 CW+CE 8 3.05 Other 6 regions 15 2.0 CW and CE regions Top 2 counties (CW) 3 of the top 5 counties Only 20 counties reported deaths from bronchitis. All reported less than 5 deaths, making the rates “unstable.” But by using 2 regions, CW+CE compared to the rest of the state, the results are more reliable. Source: Indiana State Department of Health, October 19, 2007

Chronic Airway Obstruction
Age-adjusted chronic airway obstruction mortality rate, 2005 CW and CE regions 3 of the top 4 counties 4 of the top 6 counties 5 of the top 9 (=10% of IN counties) 2 more of these 9 border these regions 7 of the top 9 counties in or border Source: Indiana State Department of Health, October 19, 2007

Source: Indiana State Department of Health, October 19, 2007
Emphysema Age-adjusted emphysema mortality rate, 2005 CW region Top county by more than 8 points Source: Indiana State Department of Health, October 19, 2007

Malignant Neoplasm of the Trachea, Lung, Bronchus
Age-adjusted lung cancer mortality rate, 2005 CW and CE regions 4 of the top 10% of counties (9) 4 of the top 6 counties 33.8% 31.8% Source: Indiana State Department of Health, October 19, 2007

Ischemic Heart Disease
Age-adjusted Ischemic Heart Disease mortality rate, 2005 33.8% 31.8% CW and CE regions Top county in CW 3 of the top 4 counties in CW 5 of the top 10 in CW or CE 8 of the top 16 in CW or CE 12 of the top 16 either in or bordering the CW or CE regions. Source: Indiana State Department of Health, October 19, 2007

Malignant Neoplasm of the Esophagus
Age-adjusted malignant neoplasm of the esophagus mortality rate, 2005 Malignant Neoplasm of the Esophagus Does not SEEM REMARKABLE. Source: Indiana State Department of Health, October 19, 2007

CVD Age-adjusted CVD mortality rate, 2005 33.8%
CVD SEEMS NOT REMARKABLE. Source: Indiana State Department of Health, October 19, 2007

Morbidity Data Cancer of Trachea, Lung, Bronchus
Chronic Airway Obstruction Bronchitis/Emphysema Cancer of the Lip Cancer of the Esophagus Cancer of the Larynx Aortic Aneurysm SIDS Source: Indiana State Department of Health, October 19, 2007

Lung Cancer Incidence 25.1%
Rank for rate of lung cancer incidence, 2003 25.1% 33.8% 31.8% CW region – rate of lung cancer incidence top county 2 of the top 5 counties 3 of the top 7counties NE and NC region 2 lowest counties (NE) 3 of the 4 lowest counties 4 of the 6 lowest counties Source: Health Service Demand Estimates 2005. Franking, TN: Planning 2.0, 2006.

Perhaps tobacco production is associated with heavier smoking?
Lung Cancer Incidence Region Smoking Mean Rate Tob-PrCos CW 34% 79.7 1/12 CE 31% 70.2 3/11 SE 78.1 13/14 C 29% 73.3 NW 28% 70.1 0/5 SW 27% 7/16 NC 25% 67.6 NE 26% 60 0/9 Perhaps tobacco production is associated with heavier smoking? IN State Department of Health, published in: Indiana Cancer Facts & Figures, American Cancer Society, Great Lakes Division, Inc., 2006.

Cancer of the Trachea, Lung, Bronchus
Rate/100,000 of DRG082 (C33), Cancer, 2005 CW and CE regions 2 of top 3 (CW) 4 of top 9 counties (CW or CE) 6 of top 11 counties (CW or CE) 8 of top 11 counties (in or bordering CW or CE) 33.8% 31.8% Region Counties % IN Cos % T-R CW/CE 24 26% of 92 66% of 3 44% of 9 54% of 11 Source: Health Service Demand Estimates 2005. Franking, TN: Planning 2.0, 2006.

DRG088 Bronchitis, Emphysema and Chronic Airway Obstruction
Rate/100,000 of DRG088, 2005 CW and CE regions 3 of top 9 (top 10% of IN counties) (3 additional counties border CW or CE) 6 of the top 9 are in or border CW or CE 11 of top 18 counties (top 20%) in CW or CE 33.8% 31.8% Region Counties % IN Cos % T-R CW/CE 24 26% of 92 33% of 9 61% of 18 Source: Health Service Demand Estimates 2005. Franking, TN: Planning 2.0, 2006.

DRG172 Malignant Neoplasm of the Esophagus
Rate/100,000 of DRG172, 2005 33.8% 31.8% CW and CE regions 3 of top 9 (top 10% of IN counties) (3 additional counties border CW or CE) 6 of the top 9 are in or border CW or CE 10 of top 18 counties (top 20%) in CW or CE 55.5% of the top 18 counties are in CW/CE. These 2 regions constitute 26% of IN counties. The 2 top smoking regions bear a disproportionate burden of tobacco-related DRG172 morbidity. DRG172 is associated with malignant neoplasm of the esophagus. The counties in the CW and CE regions make up 26% of IN counties but bear 55.5% of the burden for DRG172’s top 18 counties. A proportionate distribution would see about 26% of those counties being from the CW or CE regions, but the reality is over double, showing the severe consequences that can follow high smoking rates. Source: Health Service Demand Estimates 2005. Franking, TN: Planning 2.0, 2006.

Elements Used for this Study
Community Coalition Public Education / Marketing Cessation Programs School – Based Programs Indoor Air Policies Youth Use Law Enforcement High Risk Population Funding Level

Guiding Principles Is it comprehensive? Is it well funded?
Is it sustainable over time? Does it operate free of the tobacco industry? Does it address high risk populations?

Regional Findings COUNTY SMOKING RATE SMOKING RATE RANK (1 = low)
COALITION STRENGTH RANK (1 = high) NORTHWEST 28% 4 8 NORTH CENTRAL 25% 1 3 NORTH EAST 26% 2 6 CENTRAL 29% 5 CENTRAL EAST 32% 7 SOUTH WEST 27% SOUTH EAST 31% CENTRAL WEST 34%

Tobacco Coalition Strength

What You Have Learned: Components of GIS system
How GIS Helps with Strategic Planning Demographics Assessment – Needs and Resources Relationship Identification (where/who) Decision-Making Cultural Competency Obtain Funding How GIS Can Help You with Program Evaluation Surveillance System Track Change over Time and Space How GIS Can Help You with Program Planning Obtain Demographic Background Profile Needs, Resources Locate Problem Area or Target Audience Inform Decisions about Strategy Selection Enhance Cultural Competency Obtain Funding

Don’t let the task get you down.

Without data you won’t get far.

Indiana Prevention Resource Center
Thank You ! Indiana Prevention Resource Center 501 N. Morton, Suite110 Bloomington, IN 47404 Phone: (800) Fax: (812) WWW: A special thanks to: Jennifer Kelley, MPH, Mikyung Jun, PhD, Aaron Jones, MPH, and Erika Pitcher for their assistance.

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