Using GIS to Facilitate Community-Based Public Health Planning of Diabetes Intervention Efforts
Diabetes is a disease that occurs when blood sugar levels are too high because the body will not produce or efficiently take in the hormone insulin. Unregulated blood sugar levels poses deadly consequences, causing an increased risk of heart disease, stroke, high blood pressure, and narrowing blood vessels. Symptoms of diabetes include increase of urination, thirst, loss of weight, hunger, blurry vision, numbness, and fatigue.
In Genesee county, diabetes is the sixth-leading cause of death with a mortality rate of 29.5 per 100,000 people, which is higher than the rate throughout all of Michigan. This disease affects 7.4 per 100 people 18 years and older, but disparities in diabetes prevalence and mortality exist by race. For instance, the prevalence of diabetes in African Americans is about 1.5 times the rate of Caucasians within the Genesee. It is estimated that there are nearly 10,000 adults living with undiagnosed diabetes in the area. Although these residents might be unaware, they need medical attention before it is too late.
In the Speak to Your Health (STYH) Community Survey, participants self reported information about diet, physical exercise, health status, and other health-related topics and behaviors. Body mass index scores were calculated based on respondents’ self-reported height and weight. 55% of survey respondents aged 45 years and older are at high risk for diabetes. Some risk factors for type 2 diabetes include being overweight, having a family history of diabetes, being African American, having a sedentary lifestyle, being of older age, and for women, having a baby more than 9 pounds. However, 72% of respondents aged 45 years and older reported being screened for diabetes in the past year, which is a higher percentage than expected.
STYH survey data were used to calculate diabetes-risk scores and geographically map them along with diabetes-screening rates. Researchers used a geographic information system (GIS) to create these maps. A GIS is a system that creates, manages, analyzes, and maps all types of data. It is an effective tool for graphically portraying important information about health problems. GIS is increasingly being used in public health settings and used in detecting and monitoring public health issues. For example, GIS has been used in Massachusetts to explore higher levels of breast cancer incidence and the possible relationship with exposure to multiple environmental contaminants on Cape Cod.
Comparison of the proportion of respondents at risk for diabetes with diabetes screening rates across geographic areas shows that zip code areas where diabetes risk rates were high had relatively low to moderate diabetes screening rates. This illustrates the areas where intervention efforts are most needed and most effective. Currently, Genesee County has a Diabetes Task Force organized through a local health coalition, and the local health department’s current strategic plan prioritized diabetes as one of eight impact measures. In addition, Flint was recently chosen as a pilot site for the DHHS’s Diabetes Detection Initiative, which focused on identifying those persons with undiagnosed diabetes. The results from this research was intended to help local diabetes-intervention programs plan their efforts. STYH geographic analyses have been presented and made available to individuals involved in planning community-based diabetes prevention efforts.