Abstracts

In 1997 the Centers for Disease Control defined epilepsy as a public health issue and specific goals related to access, quality of care, surveillance and public education were developed. These continue to be issues where progress has been slow. A 2005 health disparities report from the Agency for Healthcare Research and Quality revealed that significant gaps still exist in non-Caucasians for many chronic health conditions. The US government report [italic]Healthy People 2010[/italic] recommended that 90% of all major National, State and local health systems promote nationwide use of Geographic Information Systems (GIS) to map health related data. The process of geocoding (assigning map coordinates) allows researchers to examine where people reside in relation to distribution of health, socioeconomic conditions and proximity to environmental hazards. This is the first use of GIS technology to map epilepsy related health data., Three years (2002-2004) of inpatient/outpatient data were obtained from the 5 hospitals within the Temple University Health System (TUHS). The catchment is primarily North and Northeast Philadelphia - an area of significant ethnic diversity and varying socio-economic status. The dataset included 24,406 contacts with the TUHS. Data included demographics, address, up to 5 ICD-9 codes and insurance type., Fifty-four percent of patient contacts were males (mean age=47.4) and 46% were female (mean age=48.9). Thirty-two percent were Caucasian, 47% African American, 20% Unknown and [lt] 1% were Asian/PI/Other. Seventeen percent were listed as Spanish speaking. The catchment area for TUHS reveals highly segregated communities based on the 2000 US Census data. Six zip codes had between 55[ndash]84% Caucasians, 6 zip codes had 44-97% African Americans, and 4 had [gt]33% Latino residents. There were 665 patient contacts within the ICD-9 codes 345 to 345.81 and 817 with a diagnosis of 345.9. There 22,207 patient contacts (91%) coded for seizure NOS code (780.39). The most frequent co-morbidities were hypertension (n=2322), diabetes (n=1158), heart failure (n=794), other urinary problems (n=774), non-compliance with medical treatment (n=707), COPD (n=545), volume depletion (n=522), asthma (n=494) and depression NOS (n=459)., This study adds to the understanding of co-morbidities in persons with seizures/epilepsy. Statistical modeling will be used to explain similarities and differences. Culturally relevant outreach to these populations is critical and GIS technology is useful in demonstrating where educational programs for patients and health professionals should be focused. Materials based on medical terms foreign to the lay public are less effective and tend to be written at a level that exceeds the readability of most patients. Since patients of low socioeconomic status are less likely to access internet resources, other community-based outreach needs to be investigated.,