title: Using GIS and secondary data to target diabetes-related public health efforts.
abstract: OBJECTIVE
  To efficiently help communities prevent and manage diabetes, health departments need to be able to target populations with high risk but low resources. To aid in this process, we mapped county-level diabetes-related rates and resources/use using publicly available secondary data to identify Michigan counties with high diabetes prevalence and low or no medical and/or community resources.
  
  
  METHODS
  We collected county-level diabetes-related rates and resources from Web-based sources and mapped them using geographic information systems (GIS) software. Data included age-adjusted county diabetes rates, diabetes-related medical resource and resource use (i.e., the number of endocrinologists and percentage of Medicare patients with diabetes who received hemoglobin A1c testing in the past year), community resources (i.e., the number of certified diabetes self-management education and diabetes support groups), as well as population estimates and demographics (e.g., rural residence, education, poverty, and race/ethnicity). We created GIS maps highlighting areas that had higher-than-median rates of disease and lower-than-median resources. We also conducted linear, logistic, and Poisson regression analyses to confirm GIS findings.
  
  
  RESULTS
  There were clear regional trends in resource distribution across Michigan. The 15 counties in the Upper Peninsula were lacking in medical resources but higher in community resources compared with the 68 counties in the Lower Peninsula. There was little apparent association between need (diabetes prevalence) and diabetes-related resources/use. Specific counties with high diabetes prevalence and low resources were easily identified using GIS mapping.
  
  
  CONCLUSIONS
  Using public data and mapping tools identified diabetes health-service shortage areas for targeted public health programming.
authors: Western Michigan University, College of Health & Human Services, Interdisciplinary Health Sciences, Kalamazoo, MI 49008, USA. amy.curtis@wmich.edu
authors: Amy B
authors: AB
authors: Curtis
authors: Catherine
authors: C
authors: Kothari
authors: Rajib
authors: R
authors: Paul
authors: Elyse
authors: E
authors: Connors
mesh_terms: D000328:Adult; D003153:Community Health Services / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D040362:Geographic Information Systems; D062305:Geographic Mapping; D006266:Health Education; D006293:Health Promotion / Q000379:methods*; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D008824:Michigan / Q000453:epidemiology; D015995:Prevalence; D011634:Public Health; D012044:Regression Analysis; D012648:Self Care
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