National HIV Testing Day

HIV testing day is June 27. On this day, organizations throughout the U.S. sponsor a wide variety of events, including free testing and education.  As HRSA’s Health Center Program funds 10,000 health center sites, serving over 24 million people, it is uniquely situated to address the HIV crisis. In fact, the health center program focuses on care for underserved and vulnerable populations, the same populations disproportionately affected by HIV.  One way the health center program is leveraging this is by participating in the Department of Human Services’ “Ending the Epidemic: A Plan for America.” This new 10-year initiative aims to virtually eliminate new HIV infections in the U.S. by focusing on early diagnosis, rapid treatment, proven prevention, and rapid outbreak response among areas most at risk. When the initiative begins next year, health centers in target areas will expand outreach as well as both routine and risk-based HIV testing opportunities.

As a geographer, I was curious about the communities targeted by the Ending the Epidemic initiative and the health centers located within them. I wanted to visualize the service areas of these health centers in relation to other community resources and overlay some population health data. To get started, I created a series of maps of Franklin County, Ohio, one of the initiative’s 48 target counties, using the UDS Mapper.

The UDS Mapper is ideal for this type of project as it is an online mapping and decision-support tool driven primarily by patient location data within the Uniform Data System (UDS). It allows easy visualization of health center service areas, along with patient data, population health data, and health related facilities. Within the UDS Mapper, I started by navigating to Franklin County, Ohio, then activating the By Patient Origin mode of the Explore Service Area tool.

UDS Mapper with Explore Service Area tool set to By Patient Origin mode

I could see right away that there are five organizations located within Franklin County. I wanted to see how large their service areas are and where they overlap.

I clicked on each organization which added its core, in this case 75%, patient origin service area to the map. I could see that these organizations serve many Franklin County ZIP Code Tabulation Areas (ZCTAs), especially those in and adjacent to the city of Columbus.

Patient origin service areas

I turned on service access points and saw that they are also mostly concentrated in central Franklin County.

Patient origin service areas with health center service access points

For demonstration purposes, I chose Columbus Neighborhood Health Center (CNHC) to examine further. I de-selected the other health centers so my map only showed CNHC’s patient origin service area, then I opened the Data Table. Studies show that people with health insurance have greater access to HIV testing, and that early knowledge of one’s HIV status reduces HIV-related morbidity and mortality and reduces the risk of transmission (KFF, 2019). To assess population insurance status and access to care for CNHC’s service area, I added uninsurance and no usual source of care data to my table. I could see at a glance that in the ZCTAs that comprise CNHC’s core service area, 9% of the population are uninsured and 19% have no usual source of care.

Data table and summary row

I then used the Population Indicators tool to see which ZCTAs are at or above these service area benchmarks.

ZCTAs with relatively high rates of uninsurance and no usual source of care

Twelve ZCTAs within the health center’s service area have uninsured rates above 9% and more than 19% of the population without a usual source of care. These ZCTAs might be ideal areas in which to focus the initiative’s early outreach efforts.

I also wanted to see what other health resources are nearby. There are four opioid treatment programs which could serve as ideal partners throughout the initiative. This is important as intravenous drug use is a major risk factor for HIV transmission, and drug use in persons with HIV could exacerbate the progression of the virus (NIDA, 2018). Additionally, there are several hospitals and public housing facilities within CNHC’s service area which could serve as potential HIV care collaborators.

Health centers, hospitals and public housing sites added to map

Using the UDS Mapper, I was able to quickly and effectively visualize population health and resource data for a health center located within an Ending the Epidemic target county. If you’re interested in trying the UDS Mapper, go to www.udsmapper.org, and don’t miss the Tutorials page for details on each of the tools I used and more. And finally, take advantage of National HIV Testing Day – attend a HRSA webinar, read up on the CDC website, get tested, or just spread the word using the #DoingItMyWay hashtag on social.

Jessica McCann

User Engagement Specialist, HealthLandscape

References

KFF. June 25, 2019. HIV Testing in the United States. 

NIDA. February 27, 2018. Common Comorbidities with Substance Use Disorders. 

HealthLandscape and Men’s Health Week

Since 1994, the week leading up to Father’s Day has been officially recognized as Men’s Health Week. This advocacy campaign, hosted by Men's Health Network, promotes men’s health improvement measures during the entire month of June. During Men’s Health Week and throughout the month, men in the United States are encouraged to schedule appointments with their primary care physician (PCP), get more exercise, get screened for prostate health, eat healthy foods, and consider prevention as a way of life.

Outreach conducted by local and national groups focuses on disseminating statistics to bolster awareness related to men’s health. For example, according to Men’s Health Month, women are 100% more likely than men to seek out an annual visit to their PCP. Data from Health.gov show that men live shorter lives, die at higher rates from the top 10 causes of death in the U.S., and are less likely to have health insurance. According to the Men’s Health Network, men are much more likely than women to die by homicide with some variation by race (1 in 30 for black males versus 1 in 132 for black females; 1 in 179 for white males versus 1 in 495 for white females). Equally alarming is the risk for suicide among men. In 2015, the CDC reported that men are four times more likely to commit suicide than women and that the rate of suicide among men 65 and over is 31.5% compared to 5% for women.

In honor of Men’s Health Week, HealthLandscape has added some exciting new county-level data related to men’s health to the Community HealthView data library. From the National Cancer Institute, we’ve added three datasets describing annual prostate cancer incidence, average prostate cancer cases per year, and prostate cancer incidence five-year trends from 2010 to 2014. From the U.S. Census American Community Survey, users can turn on a layer showing the percent of the population that are male for 2011-2015. Lastly, from the Centers for Disease Control and Prevention’s Diabetes Surveillance System, we’ve added measures on diabetes and obesity prevalence among men, as well as the percentage of physical inactivity among men. All three of these measures are from 2015, the most recent year for which data are available.

During Men’s Health Week and beyond, advocacy groups like the Men’s Health Network and local and state health departments can use tools like HealthLandscape’s Community HealthView to explore data on men’s health, identify geographic variation or overlap, and/or target resources to improve men’s health.

Dave Grolling

GIS Strategist, HealthLandscape

Family Health and Fitness Day and Park Exploration

Family Health and Fitness Day, created by the National Recreation and Park Association (NRPA), is celebrated annually on the second Saturday of June. Intended to show how important parks and recreation are to keeping their communities active and healthy, people are encouraged to visit their local parks to explore the recreational options available in their backyards. According to the Department of Health and Human Services, only one in three children are physically active every day and only one in three adults receive the recommended amount of physical activity each week. Parks can serve as local outlets for individual and community activities.

NRPA’s vision is that everyone has easy access to park and recreation opportunities in sustainable communities. To that end, they’ve partnered with the Trust for Public Land (TPL) in a nationwide movement called The 10-Minute Walk Campaign - ensuring that every person has a great park within a 10-minute walk. 

By visiting their site, www.tpl.org/10minutewalk, you can learn more about park access in your community. Seattle, for example, has a ParkScore ranking of 11. The TPL ParkScore rating is based on the following measures; access - the portion of residents within a 10-minute walk to a park, acreage - the median park size and percent of area dedicated to parks, community investment - park spending per resident, and available amenities - features like basketball hoops, playgrounds, and dog parks. 

In the interest of exploring issues of equity in access to parks and recreation, TPL takes their analysis even further by delving into park access by age, income, and race/ethnicity. All of these data points are available at the aggregate level, by city, and for each individual park.

Further, they use the data collected to make recommendations about where new parks might be best located, based on how many additional residents could be covered by the 10-minute walk radius, highlighting areas highest in need of funding and attention.

Clicking on an individual park polygon on the map will give you information about the service area within a 10-minute walk as well as a detailed report on the population being served by that location.

Want to quickly find the parks in your neighborhood? Check out the ParkServe webmap, created using TPL’s database of collected and user-added park locations, to find public parks near you. Click on any park location to find information about the name, owner, and address, where available. 

Jene Grandmont

Senior Manager, Application Development and Data Services, HealthLandscape