Surveillance and Prevention of Stroke, Heart Disease, and Other Chronic Diseases: Integrating Geographic Information Systems (GIS) and Increasing Capacity at the Florida Department of Health

BACKGROUND:   The National Association of Chronic Disease Directors (NACDD) awarded a GIS training opportunity to the Florida Department of Health (DOH) in collaboration with the University of Michigan and the Centers for Disease Control and Prevention (CDC).  The Florida DOH selected a core team, consisting of three epidemiologists and one program evaluator, to attend the three training sessions at the University of Michigan.  The goal of the training opportunity was to enhance the ability of the Florida DOH to integrate GIS into daily operations to support existing priorities for surveillance and prevention of heart disease, stroke, and other chronic diseases.  

METHODS:   The initial training consisted of an introduction to the ArcGIS software, including creating thematic and analytical maps to document and assess chronic disease burden.  The second training focused on data management aspects, including editing tables, combining information from different tables using spatial relationships, and various geoprocessing tasks.  The final training provided guidance in utilizing network analysis tools and masking confidential data. During and in between trainings, the core GIS team worked with an extended team that provided on-going support and feedback.  The extended team included staff from the Heart Disease and Stroke Prevention Program (HDSPP), other chronic disease program managers and staff, epidemiologists, bureau leadership, technical specialists, biostatisticians, and GIS experts.  Various maps were created documenting the burden of chronic disease in Florida, which included but were not limited to heart disease, stroke, asthma, obesity, and cancer. 

RESULTS:   The Florida Breast and Cervical Cancer Early Detection Program used county-level GIS maps of late stage breast and cervical cancer stratified by race to decide which community health workers to assign to specific counties.  The Florida Asthma coalition used a county-level GIS map created during the training to identify areas across the state where coalition activity is occurring.  The map displayed membership in the coalition, existence of local asthma coalitions, and areas where the coalitions’ initiatives are being implemented.  Additional maps addressing heart disease and stroke related issues are currently being developed.

CONCLUSIONS:   FDOH developed the capacity to create and utilize GIS maps for program planning and resource allocation purposes.  The maps have assisted Florida chronic disease prevention programs in identifying areas where health disparities exist and provided guidance on how to best utilize limited resources, as well as facilitated collaboration with internal and external agencies.