Using geo-spatial analysis for planning targeted chlamydia interventions among high-risk groups

Vance County, NC has a population of 45,000 residents with 28% living below the poverty line.  Despite improvements in teen pregnancy rates and other reproductive health outcomes, Vance County saw a 35% increase in chlamydia rates from 2004-12. Rising rates prompted the Granville-Vance District Health Department (GVDHD) to identify reproductive health and pregnancy outcomes as a priority area in their 2011 Community Health Assessment. In 2013, GVDHD partnered with People Designs and the NC Institute for Public Health (NCIPH) to plan a social marketing campaign aimed at reducing barriers to being tested and increasing awareness of chlamydia risks, prevention, and screening.

To identify target populations, GVDHD staff pulled reports of confirmed chlamydia cases using the North Carolina Electronic Disease Surveillance System, which requires local health departments to report STIs and other communicable diseases. NCIPH conducted a descriptive analysis identifying high-risk groups and mapped cases to Census block groups and blocks. A cluster and hot spot analysis was performed to identify statistically significant spatial clusters of high value (hot spots), cold spots, and spatial outliers. Core mapping was performed to identify core areas with the highest rates of infection. Finally, census blocks identified as core areas, hot spots, and clustered were highlighted as potential target neighborhoods.

This presentation describes the opportunity to use GIS and statewide surveillance systems as a tool for collaborative decision-making. It identifies best practices and lessons learned for engaging partners to use GIS technology for community health improvement initiatives and the challenges and resources needed.