Patrick T S Lai1, Jeffrey Wilson2, Huanmei Wu1,3, Josette Jones1, Brian E Dixon4,5. 1. School of Informatics and Computing, Indiana University, Indianapolis, IN. 2. School of Liberal Arts, Department of Geography, Indiana University, Indianapolis, IN. 3. Purdue School of Engineering and Technology, Purdue University, Indianapolis, IN. 4. Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN. 5. Regenstrief Institute, Inc., Center for Biomedical Informatics, Indianapolis, IN, USA.
Abstract
BACKGROUND: Health inequality measurements are vital in understanding disease patterns in identifying high-risk patients and implementing effective intervention programs to treat and manage sexually transmitted diseases. OBJECTIVES: To measure and identify inequalities among chlamydia and gonorrhea rates using Gini coefficient measurements and spatial visualization mapping from geographical information systems. Additionally, we seek to examine trends of disease rate distribution longitudinally over a ten-year period for an urbanized county. METHODS: Chlamydia and gonorrhea data from January 2005 to December 2014 were collected from the Indiana Network for Patient Care, a health information exchange system that gathers patient data from electronic health records. The Gini coefficient was used to calculate the magnitude of inequality in disease rates. Spatial visualization mapping and decile categorization of disease rates were conducted to identify locations where high and low rates of disease persisted and to visualize differences in inequality. A multiple comparisons ANOVA test was conducted to determine if Gini coefficient values were statistically different between townships and time periods during the study. RESULTS: Our analyses show that chlamydia and gonorrhea rates are not evenly distributed. Inequalities in disease rates existed for different areas of the county with higher disease rates occurring near the center of the county. Inequality in gonorrhea rates were higher than chlamydia rates. Disease rates were statistically different when geographical locations or townships were compared to each other (p < 0.0001) but not for different years or time periods (p = 0.5152). CONCLUSION: The ability to use Gini coefficients combined with spatial visualization techniques presented a valuable opportunity to analyze information from health information systems in investigating health inequalities. Knowledge from this study can benefit and improve health quality, delivery of services, and intervention programs while managing healthcare costs. This is an Open Access article. Authors own copyright of their articles appearing in the Journal of Public Health Informatics. Readers may copy articles without permission of the copyright owner(s), as long as the author and OJPHI are acknowledged in the copy and the copy is used for educational, not-for-profit purposes.
BACKGROUND: Health inequality measurements are vital in understanding disease patterns in identifying high-risk patients and implementing effective intervention programs to treat and manage sexually transmitted diseases. OBJECTIVES: To measure and identify inequalities among chlamydia and gonorrhea rates using Gini coefficient measurements and spatial visualization mapping from geographical information systems. Additionally, we seek to examine trends of disease rate distribution longitudinally over a ten-year period for an urbanized county. METHODS: Chlamydia and gonorrhea data from January 2005 to December 2014 were collected from the Indiana Network for Patient Care, a health information exchange system that gathers patient data from electronic health records. The Gini coefficient was used to calculate the magnitude of inequality in disease rates. Spatial visualization mapping and decile categorization of disease rates were conducted to identify locations where high and low rates of disease persisted and to visualize differences in inequality. A multiple comparisons ANOVA test was conducted to determine if Gini coefficient values were statistically different between townships and time periods during the study. RESULTS: Our analyses show that chlamydia and gonorrhea rates are not evenly distributed. Inequalities in disease rates existed for different areas of the county with higher disease rates occurring near the center of the county. Inequality in gonorrhea rates were higher than chlamydia rates. Disease rates were statistically different when geographical locations or townships were compared to each other (p < 0.0001) but not for different years or time periods (p = 0.5152). CONCLUSION: The ability to use Gini coefficients combined with spatial visualization techniques presented a valuable opportunity to analyze information from health information systems in investigating health inequalities. Knowledge from this study can benefit and improve health quality, delivery of services, and intervention programs while managing healthcare costs. This is an Open Access article. Authors own copyright of their articles appearing in the Journal of Public Health Informatics. Readers may copy articles without permission of the copyright owner(s), as long as the author and OJPHI are acknowledged in the copy and the copy is used for educational, not-for-profit purposes.
Entities:
Keywords:
Data analysis; Data visualization; Gini coefficient; Health inequalities; Sexually transmitted diseases
Authors: Junhee Han; Li Zhu; Martin Kulldorff; Scott Hostovich; David G Stinchcomb; Zaria Tatalovich; Denise Riedel Lewis; Eric J Feuer Journal: Int J Health Geogr Date: 2016-08-03 Impact factor: 3.918