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Crighton EJ, Ouédraogo AM, Sawada M, Mestre TA. Patterns and determinants of health care utilization among people with Parkinson's disease: A population-based analysis in Ontario, Canada. PLoS One 2024; 19:e0305062. [PMID: 38905210 PMCID: PMC11192415 DOI: 10.1371/journal.pone.0305062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 05/22/2024] [Indexed: 06/23/2024] Open
Abstract
In Ontario, despite the increasing prevalence of Parkinson's disease (PD), barriers to access-to-care for people with Parkinson's disease (PwP) and their caregivers are not well understood. The objective of this study is to examine spatial patterns of health care utilization among PwP and identify factors associated with PD-related health care utilization of individuals in Ontario. We employed a retrospective, population-based study design involving administrative health data to identify PwP as of March 31, 2018 (N = 35,482) using a previously validated case definition. An enhanced 2-step floating catchment area method was used to measure spatial accessibility to PD care and a descriptive spatial analysis was conducted to describe health service utilization by geographic area and specialty type. Negative binomial regression models were then conducted to identify associated geographic, socioeconomic, comorbidity and demographic factors. There was marked spatial variability in PD-related service utilization, with neurology and all provider visits being significantly higher in urban areas (CMF>1.20; p<0.05) and family physician visits being significantly higher (CMF >1.20; p<0.05) in more rural areas and remote areas. More frequent visits to family physicians were associated with living in rural areas, while less frequent visitation was associated with living in areas of low spatial accessibility with high ethnic concentration. Visits to neurologists were positively associated with living in areas of high spatial accessibility and with high ethnic concentration. Visits to all providers were also positively associated with areas of high spatial accessibility. For all outcomes, less frequent visits were found in women, older people, and those living in more deprived areas as years living with PD increased. This study demonstrates the importance of geographic, socioeconomic and individual factors in determining PwP's likelihood of accessing care and type of care provided. Our results can be expected to inform the development of policies and patient care models aimed at improving accessibility among diverse populations of PwP.
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Affiliation(s)
- Eric J. Crighton
- Department of Geography, Environment and Geomatics, University of Ottawa, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
| | | | - M. Sawada
- Department of Geography, Environment and Geomatics, University of Ottawa, Ottawa, Ontario, Canada
- Laboratory for Applied Geomatics and GIS Science (LAGGISS), Department of Geography, Environment and Geomatics, University of Ottawa, Ottawa, Ontario, Canada
| | - Tiago A. Mestre
- Parkinson Disease and Movement Disorder Clinic, Department of Medicine, Division of Neurology, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
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Soukhov A, Tarriño-Ortiz J, Soria-Lara JA, Páez A. Multimodal spatial availability: A singly-constrained measure of accessibility considering multiple modes. PLoS One 2024; 19:e0299077. [PMID: 38394151 PMCID: PMC10889880 DOI: 10.1371/journal.pone.0299077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
Place-based accessibility measures communicate the potential interaction with opportunities at a zone that populations can access. Recent research has explored the implications of how opportunities are counted by different accessibility methods. In conventional measures, opportunities are multiply counted if more than one zone offers access to the same opportunity. This multi-count of opportunities leads to values of accessibility that are difficult to interpret. A possible solution to enhance the meaning-making of accessibility results is by constraining the calculations to match a known quantity. This ensures all zonal values sum up to a predetermined quantity (i.e., the total number of opportunities). In this way, each value can be meaningfully related to this total. A recent effort that implements this solution is spatial availability, a singly-constrained accessibility measure. In this paper, we extend spatial availability for use in the case of multiple modes or more generally, heterogeneous population segments with distinct travel behaviors. After deriving a multimodal version of spatial availability, we proceed to illustrate its features using a synthetic example. We then apply it to an empirical example of low emission zones in Madrid, Spain. We conclude with suggestions for future research and its use in evaluating policy interventions.
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Affiliation(s)
- Anastasia Soukhov
- Department of Earth, Environment and Society, McMaster University, Hamilton, Canada
| | - Javier Tarriño-Ortiz
- Centro de Investigación del Transporte (TRANSyT), Universidad Politécnica de Madrid, Madrid, Spain
| | - Julio A. Soria-Lara
- Centro de Investigación del Transporte (TRANSyT), Universidad Politécnica de Madrid, Madrid, Spain
| | - Antonio Páez
- Department of Earth, Environment and Society, McMaster University, Hamilton, Canada
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Stacherl B, Sauzet O. Gravity models for potential spatial healthcare access measurement: a systematic methodological review. Int J Health Geogr 2023; 22:34. [PMID: 38041129 PMCID: PMC10693160 DOI: 10.1186/s12942-023-00358-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Quantifying spatial access to care-the interplay of accessibility and availability-is vital for healthcare planning and understanding implications of services (mal-)distribution. A plethora of methods aims to measure potential spatial access to healthcare services. The current study conducts a systematic review to identify and assess gravity model-type methods for spatial healthcare access measurement and to summarize the use of these measures in empirical research. METHODS A two-step approach was used to identify (1) methodological studies that presented a novel gravity model for measuring spatial access to healthcare and (2) empirical studies that applied one of these methods in a healthcare context. The review was conducted according to the PRISMA guidelines. EMBASE, CINAHL, Web of Science, and Scopus were searched in the first step. Forward citation search was used in the second step. RESULTS We identified 43 studies presenting a methodological development and 346 empirical application cases of those methods in 309 studies. Two major conceptual developments emerged: The Two-Step Floating Catchment Area (2SFCA) method and the Kernel Density (KD) method. Virtually all other methodological developments evolved from the 2SFCA method, forming the 2SFCA method family. Novel methodologies within the 2SFCA family introduced developments regarding distance decay within the catchment area, variable catchment area sizes, outcome unit, provider competition, local and global distance decay, subgroup-specific access, multiple transportation modes, and time-dependent access. Methodological developments aimed to either approximate reality, fit a specific context, or correct methodology. Empirical studies almost exclusively applied methods from the 2SFCA family while other gravity model types were applied rarely. Distance decay within catchment areas was frequently implemented in application studies, however, the initial 2SFCA method remains common in empirical research. Most empirical studies used the spatial access measure for descriptive purposes. Increasingly, gravity model measures also served as potential explanatory factor for health outcomes. CONCLUSIONS Gravity models for measuring potential spatial healthcare access are almost exclusively dominated by the family of 2SFCA methods-both for methodological developments and applications in empirical research. While methodological developments incorporate increasing methodological complexity, research practice largely applies gravity models with straightforward intuition and moderate data and computational requirements.
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Affiliation(s)
- Barbara Stacherl
- Socio-Economic Panel (SOEP), German Institute for Economic Research (DIW Berlin), Mohrenstraße 58, 11017, Berlin, Germany
| | - Odile Sauzet
- School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.
- Department of Business Administration and Economics, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.
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4
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Liu D, Kwan MP, Kan Z, Song Y, Li X. Racial/Ethnic Inequity in Transit-Based Spatial Accessibility to COVID-19 Vaccination Sites. J Racial Ethn Health Disparities 2023; 10:1533-1541. [PMID: 35679013 PMCID: PMC9179220 DOI: 10.1007/s40615-022-01339-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/08/2022] [Accepted: 05/24/2022] [Indexed: 12/18/2022]
Abstract
With the ongoing spread of COVID-19, vaccination stands as an effective measure to control and mitigate the impact of the disease. However, due to the unequal distribution of COVID-19 vaccination sites, people can have different levels of spatial accessibility to COVID-19 vaccination. This study adopts an improved gravity-based model to measure the racial/ethnic inequity in transit-based spatial accessibility to COVID-19 vaccination sites in the Chicago Metropolitan Area. The results show that Black-majority and Hispanic-majority neighborhoods have significantly lower transit-based spatial accessibility to COVID-19 vaccination sites compared to White-majority neighborhoods. This research concludes that minority-dominated inner-city neighborhoods, despite better public transit coverage, are still disadvantaged in terms of transit-based spatial accessibility to COVID-19 vaccination sites. This is probably due to their higher population densities, which increase the competition for the limited supply of COVID-19 vaccination sites within each catchment area.
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Affiliation(s)
- Dong Liu
- Human Environments Analysis Laboratory, The University of Western Ontario, Social Sciences Centre, 1151 Richmond Street, London, ON, N6A 5C2 Canada
- Department of Geography and Environment, The University of Western Ontario, Social Sciences Centre, 1151 Richmond Street, London, ON, N6A 5C2 Canada
| | - Mei-Po Kwan
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Zihan Kan
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Yimeng Song
- School of the Environment, Yale University, 06511 New Haven, CT, USA
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Xuefeng Li
- College of Automobile and Traffic Engineering, Nanjing Forestry University, 210037 Nanjing, Jiangsu, China
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5
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Park J, Michels A, Lyu F, Han SY, Wang S. Daily changes in spatial accessibility to ICU beds and their relationship with the case-fatality ratio of COVID-19 in the state of Texas, USA. APPLIED GEOGRAPHY (SEVENOAKS, ENGLAND) 2023; 154:102929. [PMID: 36960405 PMCID: PMC10011039 DOI: 10.1016/j.apgeog.2023.102929] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/08/2023] [Accepted: 03/12/2023] [Indexed: 06/18/2023]
Abstract
During the COVID-19 pandemic, many patients could not receive timely healthcare services due to limited availability and access to healthcare resources and services. Previous studies found that access to intensive care unit (ICU) beds saves lives, but they overlooked the temporal dynamics in the availability of healthcare resources and COVID-19 cases. To fill this gap, our study investigated daily changes in ICU bed accessibility with an enhanced two-step floating catchment area (E2SFCA) method in the state of Texas. Along with the increased temporal granularity of measurements, we uncovered two phenomena: 1) aggravated spatial inequality of access during the pandemic, and 2) the retrospective relationship between insufficient ICU bed accessibility and the high case-fatality ratio of COVID-19 in rural areas. Our findings suggest that those locations should be supplemented with additional healthcare resources to save lives in future pandemic scenarios.
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Affiliation(s)
- Jinwoo Park
- Department of Geography and Geographic Information Science, University of Illinois Urbana- Champaign, Urbana, IL, USA
- CyberGIS Center for Advanced Digital and Spatial Studies, University of Illinois Urbana- Champaign, Urbana, IL, USA
| | - Alexander Michels
- Department of Geography and Geographic Information Science, University of Illinois Urbana- Champaign, Urbana, IL, USA
- CyberGIS Center for Advanced Digital and Spatial Studies, University of Illinois Urbana- Champaign, Urbana, IL, USA
| | - Fangzheng Lyu
- Department of Geography and Geographic Information Science, University of Illinois Urbana- Champaign, Urbana, IL, USA
- CyberGIS Center for Advanced Digital and Spatial Studies, University of Illinois Urbana- Champaign, Urbana, IL, USA
| | - Su Yeon Han
- Department of Geography and Environmental Studies, Texas State University, San Marcos, TX, USA
| | - Shaowen Wang
- Department of Geography and Geographic Information Science, University of Illinois Urbana- Champaign, Urbana, IL, USA
- CyberGIS Center for Advanced Digital and Spatial Studies, University of Illinois Urbana- Champaign, Urbana, IL, USA
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6
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Soukhov A, Páez A, Higgins CD, Mohamed M. Introducing spatial availability, a singly-constrained measure of competitive accessibility. PLoS One 2023; 18:e0278468. [PMID: 36662779 PMCID: PMC9858359 DOI: 10.1371/journal.pone.0278468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/16/2022] [Indexed: 01/21/2023] Open
Abstract
Accessibility indicators are widely used in transportation, urban and healthcare planning, among many other applications. These measures are weighted sums of reachable opportunities from a given origin, conditional on the cost of movement, and are estimates of the potential for spatial interaction. Over time, various proposals have been forwarded to improve their interpretability: one of those methodological additions have been the introduction of competition. In this paper we focus on competition, but first demonstrate how a widely used measure of accessibility with congestion fails to properly match the opportunity-seeking population. We then propose an alternative formulation of accessibility with competition, a measure we call spatial availability. This measure relies on proportional allocation balancing factors (friction of distance and population competition) that are equivalent to imposing a single constraint on conventional gravity-based accessibility. In other words, the proportional allocation of opportunities results in a spatially available opportunities value which is assigned to each origin that, when all origin values are summed, equals the total number of opportunities in the region. We also demonstrate how Two-Stage Floating Catchment Area (2SFCA) methods are equivalent to spatial availability and can be reconceptualized as singly-constrained accessibility. To illustrate the application of spatial availability and compare it to other relevant measures, we use data from the 2016 Transportation Tomorrow Survey of the Greater Golden Horseshoe area in southern Ontario, Canada. Spatial availability is an important contribution since it clarifies the interpretation of accessibility with competition and paves the way for future applications in equity analysis (e.g., spatial mismatch, opportunity benchmarking, policy intervention scenario analysis).
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Affiliation(s)
- Anastasia Soukhov
- School of Earth, Environment and Society, McMaster University, Hamilton, ON, Canada
| | - Antonio Páez
- School of Earth, Environment and Society, McMaster University, Hamilton, ON, Canada
| | - Christopher D. Higgins
- Department of Geography & Planning, University of Toronto Scarborough, Toronto, ON, Canada
| | - Moataz Mohamed
- Department of Civil Engineering, McMaster University, Hamilton, ON, Canada
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Cromley G, Lin J. Examining the impact of COVID-19 vaccination rates on differential access to critical care. APPLIED GEOGRAPHY (SEVENOAKS, ENGLAND) 2022; 145:102751. [PMID: 35757493 PMCID: PMC9212364 DOI: 10.1016/j.apgeog.2022.102751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/20/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
The measurement of potential access to health care has focused primarily on what might be called "place-based" access or the differential access among geographic locations rather than between different populations. The vaccination program to inoculate the population against the effects of the COVID-19 virus has created two different at-risk populations. This research examines the impact of COVID-19 vaccination rates on access to critical care for persons fully-vaccinated versus those not fully-vaccinated. In this situation, additional tools are necessary to understand: 1) if there is a significant difference in accessibility between different populations, 2) the magnitude of this difference and how it is distributed across accessibility levels, and 3) how the differences between groups are distributed across the state. A study of access to intensive care unit (ICU) beds by these two populations for the state of Illinois found that although there was a statistically significant difference in access, the magnitude of differences was small. A more important difference was being located in the Chicago Area of the state. The not-fully vaccinated in the Chicago Area had higher than expected spatial access due to the lower need for ICU beds by a higher percentage of fully vaccinated people.
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Affiliation(s)
- Gordon Cromley
- Spatial Literacy Center, Dickinson College, Carlisle, PA, USA
| | - Jie Lin
- School of Earth Sciences, Zhejiang University, Hangzhou, Zhejiang, China
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8
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Park J, Goldberg DW. An Examination of the Stochastic Distribution of Spatial Accessibility to Intensive Care Unit Beds during the COVID-19 Pandemic: A Case Study of the Greater Houston Area of Texas. GEOGRAPHICAL ANALYSIS 2022; 55:GEAN12340. [PMID: 35941845 PMCID: PMC9350384 DOI: 10.1111/gean.12340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 05/02/2022] [Accepted: 06/08/2022] [Indexed: 05/10/2023]
Abstract
Sufficient and reliable health care access is necessary for people to be able to maintain good health. Hence, investigating the uncertainty embedded in the temporal changes of inputs would be beneficial for understanding their impact on spatial accessibility. However, previous studies are limited to implementing only the uncertainty of mobility, while health care resource availability is a significant concern during the coronavirus disease (COVID-19) pandemic. Our study examined the stochastic distribution of spatial accessibility under the uncertainties underlying the availability of intensive care unit (ICU) beds and ease of mobility in the Greater Houston area of Texas. Based on the randomized supply and mobility from their historical changes, we employed Monte Carlo simulation to measure ICU bed accessibility with an enhanced two-step floating catchment area (E2SFCA) method. We then conducted hierarchical clustering to classify regions of adequate (sufficient and reliable) accessibility and inadequate (insufficient and unreliable) accessibility. Lastly, we investigated the relationship between the accessibility measures and the case fatality ratio of COVID-19. As result, locations of sufficient access also had reliable accessibility; downtown and outer counties, respectively, had adequate and inadequate accessibility. We also raised the possibility that inadequate health care accessibility may cause higher COVID-19 fatality ratios.
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Affiliation(s)
- Jinwoo Park
- Department of GeographyTexas A&M UniversityCollege StationTexasUSA
| | - Daniel W. Goldberg
- Department of GeographyTexas A&M UniversityCollege StationTexasUSA
- Department of Computer Science & EngineeringTexas A&M UniversityCollege StationTexasUSA
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9
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Supply-demand adjusted two-steps floating catchment area (SDA-2SFCA) model for measuring spatial access to health care. Soc Sci Med 2022; 296:114727. [DOI: 10.1016/j.socscimed.2022.114727] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/26/2021] [Accepted: 01/13/2022] [Indexed: 12/22/2022]
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10
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Higgins CD, Páez A, Kim G, Wang J. Changes in accessibility to emergency and community food services during COVID-19 and implications for low income populations in Hamilton, Ontario. Soc Sci Med 2021; 291:114442. [PMID: 34655939 PMCID: PMC8506574 DOI: 10.1016/j.socscimed.2021.114442] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/01/2021] [Accepted: 09/26/2021] [Indexed: 11/30/2022]
Abstract
In this paper we analyze the changes in accessibility to emergency and community food services before and during the COVID-19 pandemic in the City of Hamilton, Ontario. Many of these food services are the last line of support for households facing food insecurity; as such, their relevance cannot be ignored in the midst of the economic upheaval caused by the pandemic. Our analysis is based on the application of balanced floating catchment areas and concentrates on households with lower incomes (<CAD40,000, approximately the Low Income Cutoff Value for a city of Hamilton's size). We find that accessibility was low to begin with in suburban and exurban parts of the city; furthermore, about 14% of locations originally available in Hamilton closed during the pandemic, further reducing accessibility. The impact of closures on the level of service of the remaining facilities, and on accessibility, was disproportionate, with system-wide losses exceeding 39%. Those losses were geographically and demographically uneven. While every part of the city faced a reduction in accessibility, inner suburbs fared worse in terms of loss of accessibility. As well, children (age ≤18) appear to have been impacted the most.
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Affiliation(s)
- Christopher D Higgins
- Department of Geography & Planning, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON, M1C1A4, Canada.
| | - Antonio Páez
- School of Earth, Environment and Society, McMaster University, Hamilton, ON, L8S 4K1, Canada.
| | - Gyoorie Kim
- Department of Geography, Geomatics and Environment, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON, L5L 1C6, Canada.
| | - Jue Wang
- Department of Geography, Geomatics and Environment, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON, L5L 1C6, Canada.
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11
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Pintor AF, Ray N, Longbottom J, Bravo-Vega CA, Yousefi M, Murray KA, Ediriweera DS, Diggle PJ. Addressing the global snakebite crisis with geo-spatial analyses - Recent advances and future direction. Toxicon X 2021; 11:100076. [PMID: 34401744 PMCID: PMC8350508 DOI: 10.1016/j.toxcx.2021.100076] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 02/08/2023] Open
Abstract
Venomous snakebite is a neglected tropical disease that annually leads to hundreds of thousands of deaths or long-term physical and mental ailments across the developing world. Insufficient data on spatial variation in snakebite risk, incidence, human vulnerability, and accessibility of medical treatment contribute substantially to ineffective on-ground management. There is an urgent need to collect data, fill knowledge gaps and address on-ground management problems. The use of novel, and transdisciplinary approaches that take advantage of recent advances in spatio-temporal models, 'big data', high performance computing, and fine-scale spatial information can add value to snakebite management by strategically improving our understanding and mitigation capacity of snakebite. We review the background and recent advances on the topic of snakebite related geospatial analyses and suggest avenues for priority research that will have practical on-ground applications for snakebite management and mitigation. These include streamlined, targeted data collection on snake distributions, snakebites, envenomings, venom composition, health infrastructure, and antivenom accessibility along with fine-scale models of spatio-temporal variation in snakebite risk and incidence, intraspecific venom variation, and environmental change modifying human exposure. These measures could improve and 'future-proof' antivenom production methods, antivenom distribution and stockpiling systems, and human-wildlife conflict management practices, while simultaneously feeding into research on venom evolution, snake taxonomy, ecology, biogeography, and conservation.
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Affiliation(s)
- Anna F.V. Pintor
- Division of Data, Analytics and Delivery for Impact (DDI), World Health Organization, Geneva, Switzerland
- Australian Institute of Tropical Health and Medicine, Division of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Nicolas Ray
- GeoHealth Group, Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Institute for Environmental Sciences, University of Geneva, Geneva, Switzerland
| | - Joshua Longbottom
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Centre for Health Informatics, Computing and Statistics, Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Carlos A. Bravo-Vega
- Research Group in Mathematical and Computational Biology (BIOMAC), Department of Biomedical Engineering, University of Los Andes, Bogotá, Colombia
| | - Masoud Yousefi
- School of Biology, College of Science, University of Tehran, Iran
| | - Kris A. Murray
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, UK
- MRC Unit the Gambia at London School of Hygiene and Tropical Medicine, Atlantic Blvd, Fajara, Gambia
| | - Dileepa S. Ediriweera
- Health Data Science Unit, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Peter J. Diggle
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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12
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Lin Y, Lippitt C, Beene D, Hoover J. Impact of travel time uncertainties on modeling of spatial accessibility: a comparison of street data sources. CARTOGRAPHY AND GEOGRAPHIC INFORMATION SCIENCE 2021; 48:471-490. [PMID: 38298180 PMCID: PMC10830160 DOI: 10.1080/15230406.2021.1960609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/21/2021] [Indexed: 02/02/2024]
Abstract
GIS-based spatial access measures have been used extensively to monitor social equity and to help develop policy. However, inherent uncertainties in the road datasets used in spatial access estimates remain largely underreported. These uncertainties might result in unrecognized biases within visualization products and decision-making outcomes that strive to improve social equity based on seemingly egalitarian accessibility metrics. To better understand and address these uncertainties, we evaluated variations in travel impedance for car and bus transportation using proprietary, volunteer-information-based, and free (non-volunteer-information-based) street networks. We then interpreted the measured variations through the lens of street data uncertainty and its propagation in a common E2SFCA model of spatial accessibility. Results indicated that travel impedance disagreement propagates through the modeling process to effect agreement of spatial access index (SPAI) estimates among different street sources, with larger uncertainties observed for bus travel than car travel. Higher impedance coefficients (β), a model parameter, reduced the impact of street-source variations on estimates. Less urbanized regions were found to experience higher street-source variations when compared with the core-metropolitan area. We also demonstrated that a relative spatial access measure - the spatial access ratio (SPAR) - reduced uncertainties introduced by the choice of street datasets. Careful selection of reliable street sources and model parameters (e.g., higher β), as well as consideration of the potential for bias, particularly for less urbanized areas and areas reliant on public transportation, is warranted when leveraging SPAI to inform policy. When reliable/accurate road network data is not accessible or data quality information is not available, the SPAR is a suitable alternative or supplement to SPAI for visualization and analyses.
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Affiliation(s)
- Yan Lin
- Department of Geography and Environmental Studies, UNM Center for the Advancement of Spatial Informatics Research and Education (ASPIRE), University of New Mexico, Albuquerque, NM, USA
| | - Christopher Lippitt
- Department of Geography and Environmental Studies, UNM Center for the Advancement of Spatial Informatics Research and Education (ASPIRE), University of New Mexico, Albuquerque, NM, USA
| | - Daniel Beene
- Department of Geography and Environmental Studies, UNM Center for the Advancement of Spatial Informatics Research and Education (ASPIRE), University of New Mexico, Albuquerque, NM, USA
- Community Environmental Health Program, College of Pharmacy, Health Sciences Center, University of New Mexico, Albuquerque, NM, USA
| | - Joseph Hoover
- Department of Social Sciences and Cultural Studies, Montana State University Billings, Billings, MT, USA
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Assessing Health Resources Equipped with Hemodynamic Rooms in the Portuguese-Spanish Borderland: Cross-Border Cooperation Strategies as a Possible Solution. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2021. [DOI: 10.3390/ijgi10080514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Portugal and Spain share one of the greatest European borderland areas. This fact has direct impacts on a large territory and consequently on the communities’ living in it. Still, even if the border areas represent an essential fraction of the territory, planning policies have not resulted in specific cooperation programs that could enable sharing general leisure and recreation assets and infrastructures and collaboration in critical domains—i.e., the case of the health sector. The present study aims to assess the territorial accessibility to the hemodynamic rooms by the potential population of the Spanish-Portuguese transition areas that may suffer an acute myocardial infarction. Contextually, this study employed a spatial interaction model based on the three-step floating catchment area method (method-3SFCA). By applying these methods, it was possible to develop a map of accessibility to health infrastructures equipped with hemodynamics rooms on both sides of the border that may answer the Spanish-Portuguese border populations’ needs. Besides, while granting valuable information for decision-makers regarding the need to develop new infrastructures to guarantee that even considering cross border cooperation, everyone gets access to a hemodynamics room within the critical intervention period.
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Pereira RHM, Braga CKV, Servo LM, Serra B, Amaral P, Gouveia N, Paez A. Geographic access to COVID-19 healthcare in Brazil using a balanced float catchment area approach. Soc Sci Med 2021; 273:113773. [PMID: 33609968 PMCID: PMC7879934 DOI: 10.1016/j.socscimed.2021.113773] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/02/2021] [Accepted: 02/09/2021] [Indexed: 12/26/2022]
Abstract
The rapid spread of COVID-19 across the world has raised concerns about the responsiveness of cities and healthcare systems during pandemics. Recent studies try to model how the number of COVID-19 infections will likely grow and impact the demand for hospitalization services at national and regional levels. However, less attention has been paid to the geographic access to COVID-19 healthcare services and to hospitals' response capacity at the local level, particularly in urban areas in the Global South. This paper shows how transport accessibility analysis can provide actionable information to help improve healthcare coverage and responsiveness. It analyzes accessibility to COVID-19 healthcare at high spatial resolution in the 20 largest cities of Brazil. Using network-distance metrics, we estimate the vulnerable population living in areas with poor access to healthcare facilities that could either screen or hospitalize COVID-19 patients. We then use a new balanced floating catchment area (BFCA) indicator to estimate spatial, income, and racial inequalities in access to hospitals with intensive care unit (ICU) beds and mechanical ventilators while taking into account congestion effects. Based on this analysis, we identify substantial social and spatial inequalities in access to health services during the pandemic. The availability of ICU equipment varies considerably between cities, and it is substantially lower among black and poor communities. The study maps territorial inequalities in healthcare access and reflects on different policy lessons that can be learned for other countries based on the Brazilian case.
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Affiliation(s)
| | | | | | - Bernardo Serra
- Institute for Transport Policy & Development - ITDP Brazil, Brazil
| | - Pedro Amaral
- Centre for Development and Regional Planning (CEDEPLAR) at Universidade Federal de Minas Gerais (UFMG), Brazil
| | - Nelson Gouveia
- Department of Preventive Medicine, University of São Paulo Medical School (FMUSP), Brazil
| | - Antonio Paez
- School of Earth, Environment, and Society, McMaster University, Canada
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15
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Bates JE, Parekh AD, Chowdhary M, Amdur RJ. Geographic Distribution of Radiation Oncologists in the United States. Pract Radiat Oncol 2020; 10:e436-e443. [DOI: 10.1016/j.prro.2020.04.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/31/2020] [Accepted: 04/22/2020] [Indexed: 11/16/2022]
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