Investigating Geographic Information System integration of health service, community resource, and medical education data for collaboration to improve rural pediatric asthma outcomes




De Arrigunaga, Juan
Allsopp, Leslie C.
Tadesse, Meron


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Purpose: Rural children are at a disadvantage when it comes to health, health care accessibility, education, environmental exposures, and socioeconomic status (SES). These factors contribute to rural-urban disparities in pediatric chronic health conditions such as obesity and asthma. With respect to asthma, emergency department (ED) visits are adverse outcomes that indicate poor control and inadequate preventive care. Community asthma programs are effective at enhancing services to improve asthma outcomes, but evidence suggests there is a lack of such programs in rural areas. Geographic Information Systems (GIS) are recognized as potentially powerful tools to guide the development of community health interventions, but there has been limited application of this method to address pediatric asthma disparities, especially in rural areas. The purpose of this study is to investigate the application of GIS to integrate pediatric asthma ED visit rates, community health resources, and Rural Osteopathic Medicine Clinical Training Sites (ROME) to identify potential sites for collaborative initiatives to improve rural pediatric asthma outcomes. Methods: This study utilized ESRI ArcGIS software for mapping and preliminary spatial analysis. Through the Texas Department of State Health Services and internal resources, we obtained 2020, age-adjusted child and adolescent asthma emergency department visit rates (per 10,000), Rural Osteopathic Medical Education (ROME) Clinical Training and Preceptor Sites, current Community Health Worker (CHW) Training Sites, and location of Texas Critical Access Hospitals (CAHs). Using GIS spatial analysis tools, statistically significant areas with high pediatric asthma ED rates were identified. ROME and CHW within these areas were then located for potential collaboration. Results: Through mapping visualization, the counties of Johnson, Coryell, Bell, McLennan, Lubbock, and Hale were identified as potential sites for collaboration to improve pediatric asthma. Conclusion: Application of GIS can be utilized to identify spatial health inequalities and form coalitions for improvement. This study has identified potential ROME Clinical Training Sites and Community Health Worker Training Sites that are in areas with elevated rates of inadequate pediatric asthma management and adverse outcomes. Visualization of elevated pediatric asthma ED rates (suggesting a prevalence of uncontrolled pediatric asthma) helps to prioritize collaboration to improve rural pediatric asthma outcomes.