The association between heart disease mortality and geographic access to hospitals: County level comparisons in Ohio, USA

• Published in: Social science & medicine (1982) 2010-04, Vol.70 (8), p.1211-1218
• Main Authors: Yamashita, Takashi, Kunkel, Suzanne R.
• Format: Article
• Language: English
• Subjects: Access to health care; Biological and medical sciences; Cardiovascular disease; Demographics; Demography; Distance to hospitals; Epidemiology; Female; General aspects; Geographic information system (GIS); Geographic Information Systems; Geographic location; Geographical information systems; Health care access; Health care delivery; Health care service; Health Care Services; Health Care Utilization; Health services; Health Services Accessibility; Health services utilization; Heart disease; Heart Diseases; Heart Diseases - mortality; Hospitals; Humans; Male; Medical sciences; Miscellaneous; Mortality; Mortality Rates; Multivariate Analysis; Ohio; Ohio - epidemiology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Socioeconomic Factors; U.S.A; USA; USA Geographic information system (GIS) Health care access Heart disease Distance to hospitals Health care service
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2009.12.028

Greater distance to health care facilities is associated with poorer health care service utilization, yet little is known about how the ‘decay effect’ of distance influences the outcome of heart disease that requires frequent medical care. Heart disease has been a leading cause of death in the United States for a last few decades, even with significant improvements in treatment and management. In this study, we examined the association between physical distance to hospitals and heart disease mortality. The geographic information system (GIS) approach was taken to integrate, visualize and analyze data from multiple sources. Hospitals in the state of Ohio were geocoded and zonal statistics were computed to quantify geographical access to hospitals at the level of Ohio's 88 counties. Whereas the results of bivariate analysis showed a significant association between distance to hospitals and heart disease mortality, this relationship was not significant when accounting for socioeconomic and socio-demographic factors. This study demonstrates the usefulness of visualized health data and makes a case for further research on associations between disease outcomes and access to health care services.