Examining Chronic Disease Mortality Rates in Cleveland, Ohio through Geographic Information Systems (GIS) Mapping, 2008-2012

BACKGROUND: Cleveland Department of Public Health (CDPH) recognizes the importance of chronic disease indicators for the City of Cleveland.  Previous data has shown the need to address chronic disease in Cleveland’s largely minority population. 53.3% of Cleveland’s population is Black/African-American (B/AA).  BRFSS data for City of Cleveland showed that in 2005-2007, B/AA adults were more likely to have hypertension than white adults, or adults of other races. From 2005-07 to 2008-09, B/AA residents had the highest number of adults with diabetes.  The purpose of this project was to examine chronic disease indicators through mortality data at the neighborhood level for Cleveland, and present the findings through GIS mapping.

METHODS: CDPH recently participated in the National Association of Chronic Disease Directors (NACDD) Geographic Information Systems (GIS) Training for Surveillance of Heart Disease, Stroke, and Other Chronic Diseases in Local Health Departments, supported by the University of Michigan and the Center for Disease Control and Prevention.  Maps were created under the guidance of the training.  Chronic disease data reflects age-adjusted average mortality rates from 2008-2012.  Data were mapped across 34 statistical planning areas (neighborhoods) in Cleveland.  Data was obtained from Ohio Department of Health and CDPH Office of Biostatistics.  SAS (SAS Institute, Cary, NC) and ArcGIS v.10.1 (Esri, Redlands, CA) software were used in calculating rates and mapping the data, respectively.

RESULTS: The average annual rate of stroke mortality in Cleveland was 46.8 per 100,000.  Among Whites, there were no neighborhoods with significantly higher stroke mortality rates than the city’s average.  However, among B/AA, non-adjacent neighborhoods of Edgewater, Union-Miles, and Glenville had stroke mortality rates that were significantly higher than the city’s average.  The average rate of heart disease mortality in Cleveland was 268.3 per 100,000, higher than state and national averages.  Overall, nine neighborhoods had heart disease mortality rates that were significantly higher than the city’s average; one was higher among White and B/AA, four for White only (three adjoining), and four others for B/AA populations (none-adjoining).

CONCLUSIONS: These findings are important in helping CDPH identify high priority neighborhoods for chronic disease interventions and education.  The use of GIS mapping provides a visual presentation of the findings that appeal to the general public.  Maps will be disseminated to stakeholders and community partners through CDPH’s Minority Health Report.