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Sociospatial Approaches to Health: A Social Inequality Case Study
Dr. Sheila Lakshmi Steinberg, Ph.D. Professor, Social & Environmental Sciences, School of Arts and SciencesDoug Morales, Gis Manager LA County Public HealthDr. Rachel Choudhury, Associate Dean, School of Nursing, Brandman University
October 24, 2018
Dr. Sheila Lakshmi Steinberg –Who am I?
Professor, Social & Environmental Sciences
Faculty Leader
GIS Discipline Leader
Book author
Champion for Applied Research
Interdisciplinary Scholar
Doug Morales
GIS Manager Los Los Angeles County Public Health
Part-time health lecturer, California State University Northridge, Dominguez Hills, CSU Pomona and Brandman University
Master’s in Public Health, San Diego State University
Bachelor’s of Science, Biology, University of California Berkley
Expert in GIS and Health Equity Issues
Rachel Slide
Associate Dean, Musco School of Nursing and Health Professions
Program Director, BSN
Community Health Specialist
Over 10 years academic and clinical teaching experiences
Presented at various national and international conference
SociospatialAn integrated examination of space, place and social indicators in a holistic fashion. (Steinberg and Steinberg 2009; 2015)
Sociospatial Grounded Theory using GIS
1. Determine a topic of interest.
2. Determine a geographic location of interest.
3. Collect the data (qualitative, spatially linked social data).
4. Geocode the data.
5. Ground truth the data.
6. Analyze the data and look for spatial and social patterns.
7. Generate theory
Source: (Steinberg, S.L. and Steinberg S.J. 2015: 82). GIS Research Methods Incorporating Spatial Perspectives
Sociospatial Grounded Theory
Starts with the Community
Works on the assumption the local people know their surrounding environment
Local people can spot changes and risks to local health of their families
Starts with observations
People Place and Health Media
Brandman Developed Media
▪Decision Making and Policy
▪ Communicating with GIS Story
Maps (Podcast)
▪ People, Place, & Health: A
Sociospatial Story of
Agricultural Workers & Their
Environment
Why this approach?
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Harnesses the power of research to effectively assess a situation
Clearly documents social and environmental issues using empirical data
Communicates a better story of the situation
Indicates where changes need to occur
Sociospatial Thinking
1: Determine topic of interest
What is the risk of pesticide exposure to school kids in agriculture
al communities?
2: Determine geographic location of interest
3. Collect the data
4: Geocode the Data
Using GPS, geocoding of addresses or other spatial information
5: Ground Truth the Data
6: Analyze the data (look for spatial/social patterns)
Doug Morales LA County Public Health Presentation
Application to Public Health Nursing
Identify affected individuals and families allowing for targeted health education and assessments
Anticipate resources needed to implement health care interventions based on community demographics (i.e., older adult, children, child-bearing women, etc.)
Develop social marketing strategy - focus health services based on community demands, not organizational needs
Utilize information to monitor community health status – follow up surveys and health checks
Conduct community health trend analyses based on assessment findings with the aim of decreasing health disparities
Evaluate effectiveness GIS application to develop health programming in improving community health status
Examine the impact of health programs on ongoing basis, using GIS application to analyze trends in target populations
Evaluate processes, specifically application of Sociospatial Grounded Theory as the framework, in successfully designing, developing, and implementing health initiatives
Recommendations for Future Studies
Conclusion
➢ Integrating GIS into education and planning helps to create multiple place-based interdisciplinary views of a situation/problem/issue
➢ Enables one to see the “big picture”
➢ Fosters better decision-making and REACTION to change
➢ Focuses where the geography of action (space, time and place) should occur.
GIS use in the Exide Community Health Outreach
Douglas Morales, MPHPrincipal GIS Analyst/EpidemiologistOffice of Health Assessment and Epidemiology, GIS UnitChildhood Lead Poisoning Prevention Program, Epidemiology Unit
Los Angeles
Long Beach
Pomona
Torrance
Glendale
Santa Clarita
Lancaster
Palmdale
Vernon
Huntington Park
La Mirada
Santa Monica
Pasadena Glendora
Exide Technologies
• Improperly recycled car batteries (Vernon, CA)
• Release of lead and arsenic into the environment
• ~21,000 households in the 1.7 mi. study area
1
Study Area
• The State of California Dept. of Toxic Substances Control (DTSC) hired a consultant to conduct a plume analyses and create the study area
• Communities
– LA City Boyle Heights
– Commerce
– Huntington Park
– Maywood
– Bell
– East LA
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HuntingtonPark
HuntingtonPark
Maywood
Bell
Bell
Vernon Commerce
Los Angeles -Boyle Heights
Unincorporated- East LA
þ60
¦10
¦710
¦5
Study Area• Located in a statistically significant
poor area (“cold spot”)
3
Los Angeles- BoyleHeights
Los Angeles- Central
Los Angeles -Downtown
Los Angeles -Florence-Firestone
Los Angeles- VernonCentral
Los Angeles -Wholesale
District Boyle Heights
Central
Downtown
Florence-Firestone
VernonCentral
WholesaleDistrict
BandiniIslands
BandiniIslands
East LosAngeles
Florence-Firestone
Bell
Bell Gardens
Commerce
HuntingtonPark
Maywood
Montebello
Monterey Park
Vernon
HotSpot: Median Income
Cold Spot - 99% Confidence
Cold Spot - 95% Confidence
Cold Spot - 90% Confidence
Not Significant
Hot Spot - 90% Confidence
Hot Spot - 95% Confidence
Hot Spot - 99% Confidence
!(
!(
!(
!(
!(
HuntingtonPark
HuntingtonPark
Maywood
Bell
Bell
Vernon Commerce
Los Angeles -Boyle Heights
Unincorporated- East LA
þ60
¦10
¦710
¦5
Incident Command Structure
• GIS was used in the planning phase
5
6
7
8
• Results
– 9,902 Residential Parcels
– 4,211 Residential Parcels with lead in soil
Exide Community Survey Results
10
Exide Community Survey Results
11
Exide Community Survey Results
12
Recommendations from the Community
13
