Patterns of chronic conditions in older adults: exploratory spatial findings from the ElderSmile program

Michael J Widener; Mary E Northridge; Bibhas Chakraborty; Stephen E Marshall; Ira Lamster; Susan Kum; Sara S Metcalf

doi:10.1016/j.amepre.2014.01.013

Patterns of chronic conditions in older adults: exploratory spatial findings from the ElderSmile program

Am J Prev Med. 2014 Jun;46(6):643-8. doi: 10.1016/j.amepre.2014.01.013.

Authors

Michael J Widener¹, Mary E Northridge², Bibhas Chakraborty³, Stephen E Marshall⁴, Ira Lamster⁴, Susan Kum⁵, Sara S Metcalf⁵

Affiliations

¹ Department of Geography, University of Cincinnati, Cincinnati, Ohio. Electronic address: wideneml@uc.edu.
² Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, New York.
³ Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore; Department of Biostatistics, Columbia University, New York, New York.
⁴ College of Dental Medicine and Mailman School of Public Health, Columbia University, New York, New York.
⁵ Department of Geography, State University of New York at Buffalo, Buffalo, New York.

Abstract

Background: The increasing prevalence of primary care-sensitive conditions, notably diabetes and hypertension, among older adults presents a challenge to the public health community. Systems science conceptualizations of health, along with considerations of the social and environmental context in which older adults live, are needed before effective interventions can be designed and implemented.

Purpose: To examine whether spatial patterns exist in hemoglobin A1c and blood pressure measurements among participants in ElderSmile, a community-based oral health and primary care screening program.

Methods: Two spatial statistical methods, global Moran's I and Cuzick-Edwards tests, were used to determine if there were significant spatial patterns among ElderSmile participants residing in northern Manhattan during 2010-2012. The analyses were conducted in 2013.

Results: Significant spatial patterns of hemoglobin A1c values and potential diabetes cases, and possibly blood pressure measurements, were found among ElderSmile participants residing in northern Manhattan.

Conclusions: The presence of spatial patterns allows for the identification of subpopulations in need of additional resources, and can assist in informing advanced spatial and statistical analyses. Screening data collected from an ongoing community-based program can be used to understand broader patterns of urban health.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Blood Pressure Determination / methods
Chronic Disease
Community Health Services / methods
Diabetes Mellitus / diagnosis*
Diabetes Mellitus / epidemiology
Female
Glycated Hemoglobin / analysis
Glycated Hemoglobin / metabolism
Humans
Hypertension / diagnosis*
Hypertension / epidemiology
Male
Mass Screening / methods*
New York City / epidemiology
Primary Health Care / methods*
Urban Health

Substances

Glycated Hemoglobin A

Abstract

Publication types

MeSH terms

Substances

Grants and funding