Spatial access to buprenorphine-waivered prescribers in the HEALing communities study: Enhanced 2-step floating catchment area analyses in Massachusetts, Ohio, and Kentucky

Shrestha, Shikhar; Lindstrom, Megan; Harris, Daniel R.; Rock, Peter; Srinivasan, Sumeeta; Pustz, Jennifer; Bayly, Ric; Stopka, Thomas J.

doi:10.1016/j.josat.2023.209077

Cited by 2 publications

(2 citation statements)

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“… 82 For example, 2SFCA methods have been used previously to determine spatial access to substance use disorder treatment services, accessibility to ICU beds during the COVID-19 pandemic, and access to primary care providers. 83-85 Overall, while a variety of methods exist to quantify spatial disparities in CRC screening and care, future investigators may want to consider the use of different, more robust methods of analysis.…”

Section: Discussionmentioning

confidence: 99%

Rural-Urban Disparities in Colorectal Cancer Screening, Diagnosis, Treatment, and Survivorship Care: A Systematic Review and Meta-Analysis

Sepassi,

Li,

A. Zell

et al. 2024

The Oncologist

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Background Rural residents have a higher prevalence of colorectal cancer (CRC) mortality compared to urban individuals. Policies have been aimed at improving access to CRC screening to reduce these outcomes. However, little attention has been paid to other determinants of CRC-related outcomes, such as stage at diagnosis, treatment, or survivorship care. The main objective of this analysis was to evaluate literature describing differences in CRC screening, stage at diagnosis, treatment, and survivorship care between rural and urban individuals. Materials and Methods We conducted a systematic review of electronic databases using a combination of MeSH and free-text search terms related to CRC screening, stage at diagnosis, treatment, survivorship care, and rurality. We identified 921 studies, of which 39 were included. We assessed methodological quality using the ROBINS-E tool and summarized findings descriptively. A meta-analysis was performed of studies evaluating CRC screening using a random-effects model. Results Seventeen studies reported disparities between urban and rural populations in CRC screening, 12 on treatment disparities, and 8 on staging disparities. We found that rural individuals were significantly less likely to report any type of screening at any time period (pooled odds ratio = 0.81, 95% CI, 0.76-0.86). Results were inconclusive for disparities in staging at diagnosis and treatment. One study reported a lower likelihood of use of CRC survivorship care for rural individuals compared to urban individuals. Conclusion There remains an urgent need to evaluate and address CRC disparities in rural areas. Investigators should focus future work on assessing the quality of staging at diagnosis, treatment, and survivorship care in rural areas.

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Section: Discussionmentioning

confidence: 99%

Rural-Urban Disparities in Colorectal Cancer Screening, Diagnosis, Treatment, and Survivorship Care: A Systematic Review and Meta-Analysis

Sepassi,

Li,

A. Zell

et al. 2024

The Oncologist

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“…Geocoding a patient’s address (ie, converting to geographic coordinates) is often an intermediate step in secondary data analyses; it is either used to link the patient to external geographic units (eg, census tracts to obtain neighborhood socioeconomic status from the United States Census Bureau) or to calculate distance from other entities, such as health care providers and facilities. For example, accessibility of buprenorphine, a medication for opioid use disorder, may be determined using addresses of health care providers that are authorized to prescribe the medication [ 15 ]. In these examples, imprecise locations may be sufficient for confident linkage to administrative units or approximate distance measures and preferred for research to preserve privacy.…”

Section: Introductionmentioning

confidence: 99%

Geospatial Imprecision With Constraints for Precision Public Health: Algorithm Development and Validation

Harris,

Delcher

2024

Online J Public Health Inform

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Background Location and environmental social determinants of health are increasingly important factors in both an individual’s health and the monitoring of community-level public health issues. Objective We aimed to measure the extent to which location obfuscation techniques, designed to protect an individual’s privacy, can unintentionally shift geographical coordinates into neighborhoods with significantly different socioeconomic demographics, which limits the precision of findings for public health stakeholders. Methods Point obfuscation techniques intentionally blur geographic coordinates to conceal the original location. The pinwheel obfuscation method is an existing technique in which a point is moved along a pinwheel-like path given a randomly chosen angle and a maximum radius; we evaluate the impact of this technique using 2 data sets by comparing the demographics of the original point and the resulting shifted point by cross-referencing data from the United States Census Bureau. Results Using poverty measures showed that points from regions of low poverty may be shifted to regions of high poverty; similarly, points in regions with high poverty may be shifted into regions of low poverty. We varied the maximum allowable obfuscation radius; the mean difference in poverty rate before and after obfuscation ranged from 6.5% to 11.7%. Additionally, obfuscation inadvertently caused false hot spots for deaths by suicide in Cook County, Illinois. Conclusions Privacy concerns require patient locations to be imprecise to protect against risk of identification; precision public health requires accuracy. We propose a modified obfuscation technique that is constrained to generate a new point within a specified census-designated region to preserve both privacy and analytical accuracy by avoiding demographic shifts.

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Spatial access to buprenorphine-waivered prescribers in the HEALing communities study: Enhanced 2-step floating catchment area analyses in Massachusetts, Ohio, and Kentucky

Cited by 2 publications

References 46 publications

Rural-Urban Disparities in Colorectal Cancer Screening, Diagnosis, Treatment, and Survivorship Care: A Systematic Review and Meta-Analysis

Rural-Urban Disparities in Colorectal Cancer Screening, Diagnosis, Treatment, and Survivorship Care: A Systematic Review and Meta-Analysis

Geospatial Imprecision With Constraints for Precision Public Health: Algorithm Development and Validation

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