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      A Bivariate Mapping Tutorial for Cancer Control Resource Allocation Decisions and Interventions

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          Abstract

          Bivariate choropleth mapping is a straightforward but underused method for displaying geographic health information to use in public health decision making. Previous studies have recommended this approach for state comprehensive cancer control planning and similar efforts. In this method, 2 area-level variables of interest are mapped simultaneously, often as overlapping quantiles or by using other classification methods. Variables to be mapped may include area-level (eg, county level) measures of disease burden, health care use, access to health care services, and sociodemographic characteristics. We demonstrate how geographic information systems software, specifically ArcGIS, can be used to develop bivariate choropleth maps to inform resource allocation and public health interventions. We used 2 types of county-level public health data: South Carolina’s Behavioral Risk Factor Surveillance System estimates of ever having received cervical cancer screening, and a measure of availability of cervical cancer screening providers that are part of South Carolina’s Breast and Cervical Cancer Early Detection Program. Identification of counties with low screening rates and low access to care may help inform where additional resources should be allocated to improve access and subsequently improve screening rates. Similarly, identifying counties with low screening rates and high access to care may help inform where educational and behavioral interventions should be targeted to improve screening in areas of high access.

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          Most cited references 19

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          Evaluation of Methods for Classifying Epidemiological Data on Choropleth Maps in Series

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            Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement

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              Geographic information systems (GIS) for Health Promotion and Public Health: a review.

              The purpose of this literature review is to identify how geographic information system (GIS) applications have been used in health-related research and to critically examine the issues, strengths, and challenges inherent to those approaches from the lenses of health promotion and public health. Through the review process, conducted in 2007, it is evident that health promotion and public health applications of GIS can be generally categorized into four predominant themes: disease surveillance (n = 227), risk analysis (n = 189), health access and planning (n = 138), and community health profiling (n = 115). This review explores how GIS approaches have been used to inform decision making and discusses the extent to which GIS can be applied to address health promotion and public health questions. The contribution of this literature review will be to generate a broader understanding of how GIS-related methodological techniques and tools developed in other disciplines can be meaningfully applied to applications in public health policy, promotion, and practice.
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                Author and article information

                Journal
                Prev Chronic Dis
                Prev Chronic Dis
                PCD
                Preventing Chronic Disease
                Centers for Disease Control and Prevention
                1545-1151
                2020
                02 January 2020
                : 17
                Affiliations
                [1 ]Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
                [2 ]Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
                [3 ]Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
                [4 ]College of Nursing, University of South Carolina, Columbia, South Carolina
                Author notes
                Corresponding Author: Whitney E. Zahnd, PhD, Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Dr, Ste 204, Columbia, SC 29210. Telephone: 803-576-6057. Email: zahnd@ 123456mailbox.sc.edu .
                Article
                19_0254
                10.5888/pcd17.190254
                6977777
                31895673

                Preventing Chronic Disease is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.

                Categories
                Tools for Public Health Practice
                Peer Reviewed

                Health & Social care

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