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Geospatial analysis for improved understanding of health inequalities
Submission status
Closed
Submission deadline
The achievement of the United Nations Sustainable Development Goal 3, ‘Ensure healthy lives and promote well-being for all at all ages’, requires a better understanding of inequalities in access to and coverage of healthcare interventions, in utilization of health services, in disease infection prevalence and incidence, as well as in determinants of health and disease. When spatial metrics of these indicators are available at high spatial and temporal resolution and can be summarised into actionable units, such as subnational regions, they are a crucial tool for decision- and policy-making. Such metrics at high resolution unmask hidden variation for improved understanding of heterogeneity within countries, enabling effective targeting, prioritization, and allocation of limited resources. This is particularly pressing in the context of low- and middle-income countries (LMICs).
To understand heterogeneity in health outcomes in space and time, and support decision- and policy-making to reduce health inequalities, we welcome submissions of primary research that use geospatial techniques to map coverage of prevalence or incidence of disease, determinants or drivers of disease or health (i.e. social, economic, environmental), vulnerability indices, interventions, healthcare utilization and physical accessibility to healthcare services. Such geospatial techniques may include model-based geostatistics, small area estimation, least-cost-path algorithm and other spatial analysis approaches using routine, household survey, or a combination of routine and survey data, population data and other bespoke data sources. We are particularly interested in submissions focused on LMICs. Other article types, such as Reviews, Perspectives, and Comments that add significant insight leading to improved understanding of spatial and temporal variation of different health outcomes will also be considered for inclusion in the Collection. All submissions will be subject to the same review process and editorial standards as regular Communications Medicine Articles.
Macharia et al. discuss a Communications Medicine article on global healthcare accessibility and the impact of the COVID-19 pandemic. They outline strengths in the comprehensive approach taken to studying revealed versus potential spatial accessibility, plus some limitations and wider context with which the results can be interpreted.
Thomas et al. present a model that integrates household survey and health system data to estimate subnational circumcision coverage in South Africa during scale-up for HIV prevention. Results show considerable, but heterogenous, progress towards increasing circumcision coverage, identifying priority ages and districts to reach national targets.
Gligorić, Kamath, Weiss et al. evaluate revealed versus potential travel times to healthcare facilities in over 100 countries using anonymized smartphone location history data. The authors study the impact of the COVID-19 pandemic on travel times and correlate travel times with key population health indicators.
Hierink et al. assess primary healthcare access in Somali region in Ethiopia using a mixed geospatial analysis. Findings indicate low accessibility (65% lack health center access within 1 h walk), lengthy referral times, and insufficient healthcare worker density; recommendations include upgrading facilities and improving outreach strategies.
Kilpatrick et al. investigate the relationship between neighborhood disadvantage, trans-fatty acid intake, body mass index, stress and cortical microstructure. Results suggest obesogenic aspects of neighborhood disadvantage could disrupt information processing flexibility in regions involved in reward, emotion regulation and cognition.
Song et al. conduct a geospatial analysis of variations in incidence of mood and psychotic disorders and access to care in Caldas, Colombia. They show that many patients requiring only outpatient care live too far away to access it and identify hotspots of more severely ill patients, highlighting the need for targeted interventions.
Morrow et al. evaluate the clinical and social parameters of Scottish patients who were previously admitted to hospital with SARS-CoV-2 infection. They report that socioeconomic deprivation influences illness trajectory after COVID-19.
Wong, Banke-Thomas et al. assess socioeconomic inequality in access to comprehensive emergency obstetric care (CEmOC) facilities in 15 Nigerian cities using closer-to-reality travel time estimates, stratified by wealth status. Findings underscore the need for development of targeted strategies that address geographical accessibility to CEmOC.
Noppert et al. examine how the distribution of COVID-19 cases at the neighborhood-level varies significantly within and between states in the United States. The authors report that correlations between features of the neighborhood social environment and COVID-19 burden vary in magnitude and direction by state.
Ratley, Zeldin et al. implicate xylene in the pathogenesis of atopic dermatitis by combining spatial analysis and patient surveys with prior epidemiological and mechanistic data. They propose that exposure of healthy skin commensals to xylene, benzene and isocyantes in synthetic fabrics disrupts normal lipid metabolism and activates itching.