Leveraging Location Analytics to Address the Opioid Epidemic

December 19, 2022 - Addressing the opioid crisis has become a top public and population health priority in recent years, and big data analytics solutions to address the issue have been proposed and implemented by healthcare organizations across the country. Many of these solutions leverage risk prediction, machine learning, or cloud-based EMR ‘technology accelerators’ to combat the epidemic and improve patient outcomes for substance use disorders, but researchers have highlighted gaps that prevent these approaches from being effective.

In an opinion piece published in the June issue of Addiction, researchers from the National Institute of Drug Abuse at the National Institutes of Health (NIH) argued that issues around opioid use data, such as timeliness, quality, sharing, and access, prevent public health officials from getting a clear picture of the crisis and targeting interventions at the local level.

Data from the Centers for Disease Control and Prevention (CDC) indicate that 75 percent of the 91,799 US drug overdose deaths in 2020 involved an opioid and that over 82 percent of those deaths involved synthetic opioids. A key aspect of the CDC’s five-priority framework to address the opioid crisis is building state, local, and tribal capacity with programs and strategies designed to help public health officials respond to opioid-related harms and overdoses.

Many of these strategies don’t rely heavily on tech or advanced analytics, which makes them more accessible in areas with fewer resources, but some health departments have committed to leveraging these tools.

One of these is the Stark County Health Department (SCHD) in Ohio, where officials have turned to geospatial mapping and location analytics to bolster opioid epidemic outreach. Jorian Krob, geographic information system (GIS) specialist at SCHD, shared how the department is using a GIS platform to combat stigma about opioid addiction and raise awareness of community resources in an email interview with HealthITAnalytics.

THE BENEFITS OF GEOSPATIAL MAPPING

The US Geological Survey defines a GIS as “a computer system that analyzes and displays geographically referenced information. It uses data that is attached to a unique location.” These geospatial data can then be combined with descriptive data, which provides information on that location to support location analytics and geospatial mapping.

This type of analytics is often used in earth sciences and resource management, but Krob noted that it is also a powerful tool for combatting the opioid crisis.

“Geospatial mapping is about adding context to data by showing where it is located on a map. For the SCHD Drug Overdose Prevention grant, we use Esri’s ArcGIS Pro to map the locations of fatal overdoses to look at the distribution across the county and then aggregate the overdoses by census tract or a hexbin grid for our public reports. By knowing where overdoses are occurring in the county and looking at multi-year trends as well as recent hot spots, we are able to better target specific areas with outreach and education,” she explained.

As part of SCHD’s strategy to address the opioid crisis, overdose data from three sources and time periods are compiled from a combination of coroner reports, decedent family surveys, and Overdose Fatality Review (OFR) partner agency data. The partner agency data comprises Canton City Police Department data from 2012-2017, SCHD data from 2018-2021, and Ohio Public Health Information Warehouse Mortality Data from 2022.

Currently, SCHD is updating the 2012-2021 data to match the Ohio Public Health Information Warehouse Mortality Dataset and working on incorporating automation into its data processing through ArcGIS Pro. This will allow the department to update the data more frequently, potentially monthly, to move from a more reactive to proactive outreach approach and provide more timely surveillance, Krob stated.

Combining these data sources helps provide a complete view of the county, Krob explained. SCHD has also formed data-sharing agreements with other organizations to help address challenges such as siloed interventions, incomplete data, and limited access to data.

COMBATTING STIGMA AND PROVIDING COMMUNITY RESOURCES

In addition to addressing these data challenges, SCHD has also been working to overcome obstacles related to substance use disorder stigma and workforce issues.

Krob noted that peer support and harm reduction staff are key tools for addressing the opioid crisis. Applying for grants to help hire for these roles is part of SCHD’s strategy.

In addition, SCHD is working to curb stigma by providing resources and education to its staff.

“We have been working on education for first responders and healthcare workers to combat stigma,” said Krob. “Our resource platform, Save Stark, was developed with specific language that focuses on education of substance use disorder to combat stigma in the community.”

The platform, a website that includes a dashboard with countywide aggregate data, also provides access to education and resources for community members who may benefit from them.

The initiative has seen some early successes.

“For the Save Stark platform, we looked at how many people were visiting the [web]site (view numbers) as a main performance indicator,” Krob explained. “Since the site launched in April 2022, we have had around 450 views per month. We take away from those numbers that people in our community are visiting the site and looking at the resources provided.”

While site views are an important metric for community outreach and engagement, Krob noted that SCHD is also already seeing some data patterns that indicate Save Stark may be helping address overdose deaths.

“We were also able to send out mailers advertising the site to the geographic areas at increased risk of overdose in Stark County using the maps [we] created. As of October this year, overdose deaths are trending down in Stark County, and although this is based on preliminary data, we take that as a positive sign,” she said.

Krob noted that collaboration between healthcare organizations, technology companies, and community members was critical for building platforms like Save Stark, which has made an impact on the opioid crisis in Stark County.

“The Save Stark landing page has been a great tool for us in bringing together education and resources to a single location where people can go for information,” Krob stated. “The Opioid Epidemic Outreach Solution from Esri gave us a great starting point with the preconfigured maps, apps, and Hub site. We were able to input our local information and launch the program much faster than if we had built something from scratch. We have been able to update and add to the resources provided as local organizations reach out. The site also offers a way for community members to give feedback about the site. We wanted to make sure that the site was a collaboration with the community, working with them and talking to them, instead of just about them.” 

APPLYING GIS TO OTHER POPULATION HEALTH INITIATIVES

The health department has also leveraged GIS for other population health programs and projects outside of combatting the opioid epidemic and substance use disorder.

One such program is Dear Stark Women, which Krob described as “an ‘open letter’ to the women of Stark County that communicates resources available [within the county] for them and their health.”

She further explained that the initiative originally began with a survey, a meeting with the women in the community to get their opinions and views on the current state of healthcare for women in the county, and a health grant.

The program has six areas of focus formulated from the survey and meeting feedback: after-hours care, affordable care, reproductive care, healthy relationships, mental health, and transportation. Each focus area provides women with locators to find relevant services and countywide resources to help reduce barriers to care.

SCHD also uses GIS to support the Creating Healthy Communities program, which promotes local farmer’s markets throughout the summer; the Cribs for Kids program, which provides classes for sleep education, a cribette, and a sleep sack to families in need of a safe sleep environment for their child; and other projects, such as fatality review boards and soil and sewage inspections.

Improving access to resources and services is just one aspect of any population health initiative, but it is crucial for addressing a national crisis like the opioid epidemic. Geospatial mapping and location analytics can support the larger strategy to address this challenge. Real-world implementations of these tactics, as undertaken by SCHD, show that they can be effective.