Abstract
Race and class are major predictors of health outcomes in the United States. Health disparities among racial and low-income minorities often have environmental etiologies. Using Rhode Island as a case study, we geocoded and visualized several environmental determinants of health via Geographic Information Systems (GIS) in the entire state and conducted a geospatial analysis to determine whether or not patterns existed along racial and class lines. The variables that we geocoded include elementary schools, fast food restaurants, Superfund sites, and community parks. From a census tract level, we then analyzed the racial and income makeup of each geocoded site. We discovered that, on average, the worst-performing elementary schools, fast food restaurants, and Superfund sites in Rhode Island were clustered in neighborhoods with a larger black population and lower household income. Conversely, community parks and the best elementary schools in Rhode Island tended to be located near neighborhoods with a larger White population and higher household income. Our results provide additional evidence for the pervasiveness of the unequal distribution of environmental health burdens between low-income, minority communities and affluent, predominantly White communities. This summer experiential student project demonstrates the feasibility of incorporating GIS as a practical tool for learning health disparities material at a U.S. medical school. Our study also highlights the value of digital technology and citizen science in helping the public recognize and understand the various environmental factors that perpetuate health disparities.
Highlights
The evidence in the scientific literature documenting the prevalence of racial and ethnic health disparities in the United States is profound
For our first geospatial analysis, we showed that the top-ranked elementary schools were mostly located in affluent and largely White neighborhoods, while the worstranked elementary schools were clustered in low-income and largely Black neighborhoods
The data suggest that the locations of schools, fast food restaurants, Superfund sites, and community parks are associated with the racial and economic makeup of their surrounding census tract neighborhoods
Summary
The evidence in the scientific literature documenting the prevalence of racial and ethnic health disparities in the United States is profound. Between 1999 and 2011, we only saw a modest increase in public awareness on the prevalence of health disparities [1]. Many Americans believe that health disparities that affect low-income and minority communities are borne out primarily by personal choices, as opposed to structural and historical factors [2,3]. Physician awareness and attitudes towards health disparities have been a subject of concern. While the majority of medical schools today include health disparities in their curriculum, many report that they do not feel satisfied with the quality offerings [5]. Health disparities material, if not implemented well into medical school curriculum, can be met with negative attitudes by medical students [6]
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