Guided Search http://factfinder.census.gov/faces/nav/jsf/pages/guided_search.xhtml .... http://www.nyc.gov/html/doh/html
Andrea King, MPH Janette Yung, MPH New York City Department of Health and Mental Hygiene
Use of Geographic Information Systems (GIS) in Hepatitis B Surveillance
Chronic Hepatitis B Chronic Hepatitis B (HBV) is the world’s most common liver infection Typically asymptomatic at first Can lead to cirrhosis, liver cancer, liver failure etc.
Transmission: person to person through infected blood or sexual fluids Sex, needle sharing, or mother to newborn during birth
Populations affected Born (or parents were born) in a highly endemic country, particularly China § In NYC, the prevalence of chronic hepatitis B is 3 to 5 times higher than the national prevalence, mainly due to the large number of immigrants from China
Geographic Distribution of Chronic HBV Infection 2006*
Source: CDC. Travelers’ health; yellow book. Atlanta, GA: US Department of Health and Human Services, CDC; 2008. http://www.cdc.gov/hepatitis/HBV/PDFs/HBV_figure3map_08-27-08.pdf
Geographic Regions with Intermediate and High HBV Prevalence (>2%)
Source: Centers for Disease Control and Prevention. Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection. MMWR 2008;57(No. RR-8):1-20. http://www.cdc.gov/mmwr/pdf/rr/rr5708.pdf
Country of Birth from NYC Enhanced Hep B Surveillance 2010 and 2011 Number 210
Percentage (%) in each group n/a
Country of Birth United States
11
5.2%
China
108
51.4%
Dominican Republic
6
2.9%
Russia
5
2.4%
Haiti
3
1.4%
All other
34
16.2%
Unknown
43
20.5%
Group Overall
Using GIS to Understand Hepatitis B Which areas in NYC have the highest concentration of persons from China or with recent Chinese ancestry? § Use spoken language as a proxy for recent immigration to identify areas that could benefit from public health messaging about HBV
¡ American Community Sur vey (ACS) is an ongoing statistical sur vey by the US Census Bureau that collects demographic, housing, social and economic data which are published yearly. § Data allow you to identify common languages spoken in your jurisdiction.
¡ American Fact Finder provides access to census data § The guided search assists you in finding data at the granularity you need § Filter by County, State, Census Tract, Zip Code, etc. § Format tables and download to Excel
American FactFinder Guided Search http://factfinder.census.gov/faces/nav/jsf/pages/guided_search.xhtml
¡ We’ll use the dataset 201 3 American Community Sur vey 5-year estimates in this example. ¡ We’ll search for § Language Spoken at Home § by 5-Digit ZIP Code Tabulation Area § in New York State
¡ The search returns 30 relevant data sets based on these criteria.
Criteria
Chosen Result
Data Tables ¡ We downloaded table B16001, which contains data on language spoken at home by English speaking ability for persons ≥5 years
Viewing Extracted Data in Excel
Variable codes and descriptions are in top two rows. You can rename variables or use the coded values, but keep only one row of variable names in the dataset.
Limiting Dataset to Key Variables ¡ Create a subset of data relevant to your research question § Include zip code, estimated total for All Languages included in the survey, and estimated totals for each Asian language. We’ll use all speakers of Chinese language in this example.
¡ Rename variables for clarity and expor t to .csv format to ensure compatibility with the ArcMap 10.2 GIS program.
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Adding Data in ArcMap 1.
A d d a l ay e r f i l e o f N YC b y z i p code from our GIS Data Server (shown in beige)
2.
Right-click the m a p l ay e r i n the table of contents, select Joins and Relates>Join
3.
Next, add the .csv file containing the language data. Use zip code as the join field. Ke e p o n l y matching records in the join.
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Displaying Data in ArcMap – Chinese Language Areas
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2
1.
Double-click on the map layer to adjust properties.
2.
Go to Symbology> Quantiles> Graduated colors Select Chinese a s t h e Va l u e a n d All_Languages as the Normalization. This shows Chinese as a proportion of all languages that you can display as a percent.
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4.
Choose a color ramp you like, and right click on a label to format them (decimals, percent, etc).
Adding Legends and Titles 1.
G o to V i e w > L ayo u t V i e w to e d i t yo u r m a p l ayo u t a n d change its size.
2.
Under the L ayo u t m e n u , yo u c a n a d d a legend, titles, e t c . to e n h a n c e yo u r m a p d i s p l ay.
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Pro tip: Right click the l e g e n d to edit, and c o n v e r t to graphics and u n g r o u p to edit individual elements.
HBV Surveillance ¡ This map published in our annual surveillance report shows chronic HBV data from NYC in 2012-2013. ¡ Higher rates mirror the Chinese speaking areas in NYC. ¡ How to target appropriate public health messaging to persons newly diagnosed with HBV?
Public Health Education ¡ We mail booklets containing the facts about HBV for all persons newly reported to NYC DOHMH with HBV ¡ For all persons with Chinese surnames, we mail the Chinese and English versions of a letter and a booklet containing the facts about HBV ¡ The goal is to inform health implications and transmission risks of the virus and to encourage engaging with medical care.
Community Engagement ¡ NYC Hepatitis B Coalition
- http://nyc hepbc.org/nyc- hepatitis-b-coalition
§ City-wide network of community based organizations, health care organizations, providers, and others interested in HBV related issues. § Focus on advancing HBV awareness, screening, access to care, and vaccination through education, outreach, advocacy and support of research
¡ Check Hep B program § DOHMH program to support patient navigation and care coordination services for chronic hepatitis B patients at 4 community heath sites in areas with high HBV prevalence
¡ DOHMH site locator -
www.nyc.gov /he alt h/site locator
Outreach to Medical Providers ¡ Presentation to Chinese- American Medical Society of NYC on areas of high HBV prevalence and the importance of screening and vaccination for HBV. § Hep B Free Clinician Honor Roll http://chineseamericanmedicalsociety.cloverpad.org/hepbhonorroll
¡ Distribution of education materials to providers § Hep B City Health Information http://www.nyc.gov/html/doh/html/data/chi31-2_index.shtml
Resources ¡ American Community Sur vey 2011 Language Mapper: https://www.census.gov/hhes/socdemo/language/data/ language_map.html ¡ Modern Language Association Map: http://arcgis.mla.org/mla/default.aspx ¡ ESRI White Paper on the American Community Sur vey, Oct. 2014: http://www.esri.com/librar y/whitepapers/pdfs/the-americancommunity -sur vey.pdf ¡ ACS Downloadable Data http://www.census.gov/acs/www/data_documentation/ data_main/
Contact Information ¡ Andrea King, MPH Viral Hepatitis Surveillance, Prevention & Control NYC Department of Health and Mental Hygiene
[email protected]
¡ Janette Yung, MPH Viral Hepatitis Surveillance, Prevention & Control NYC Department of Health and Mental Hygiene
[email protected] 
