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Open Access Study protocol

A trans-disciplinary approach to the evaluation of social determinants of health in a hispanic population

Michael F Dulin1, Hazel Tapp1*, Heather A Smith2, Brisa Urquieta de Hernandez1, Maren J Coffman3, Tom Ludden4, Janni Sorensen2 and Owen J Furuseth4

Author Affiliations

1 Department of Family Medicine, Carolinas HealthCare System, 2001 Vail Avenue, Charlotte, NC, 28207, USA

2 Department of Geography and Earth Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA

3 School of Nursing University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA

4 Metropolitan Studies and Extended Academic Programs University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA

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BMC Public Health 2012, 12:769  doi:10.1186/1471-2458-12-769

Published: 11 September 2012

Abstract

Background

Individual and community health are adversely impacted by disparities in health outcomes among disadvantaged and vulnerable populations. Understanding the underlying causes for variations in health outcomes is an essential step towards developing effective interventions to ameliorate inequalities and subsequently improve overall community health. Working at the neighborhood scale, this study examines multiple social determinates that can cause health disparities including low neighborhood wealth, weak social networks, inadequate public infrastructure, the presence of hazardous materials in or near a neighborhood, and the lack of access to primary care services. The goal of this research is to develop innovative and replicable strategies to improve community health in disadvantaged communities such as newly arrived Hispanic immigrants.

Methods/design

This project is taking place within a primary care practice-based research network (PBRN) using key principles of community-based participatory research (CBPR). Associations between social determinants and rates of hospitalizations, emergency department (ED) use, and ED use for primary care treatable or preventable conditions are being examined. Geospatial models are in development using both hospital and community level data to identify local areas where interventions to improve disparities would have the greatest impact. The developed associations between social determinants and health outcomes as well as the geospatial models will be validated using community surveys and qualitative methods. A rapidly growing and underserved Hispanic immigrant population will be the target of an intervention informed by the research process to impact utilization of primary care services and designed, deployed, and evaluated using the geospatial tools and qualitative research findings. The purpose of this intervention will be to reduce health disparities by improving access to, and utilization of, primary care and preventative services.

Discussion

The results of this study will demonstrate the importance of several novel approaches to ameliorating health disparities, including the use of CBPR, the effectiveness of community-based interventions to influence health outcomes by leveraging social networks, and the importance of primary care access in ameliorating health disparities.

Keywords:
Social determinants of health; Community-based participatory research; Geospatial models; Hispanic