Obesity is now considered to be the number one chronic health problem in Australia. Among Australians aged 25 years and over, 60% are over-weight or obese. This is forecast to rise to 80% by 2025. It is in epidemic proportions and according to the 2003 Burden of Disease and Injury in Australia study high body mass caused approximately 55% of the burden associated with Diabetes Mellitus.
Health practitioners know that prevention and management of this disease needs to be multi-faceted. Factors in its treatment include; proximity to health services, proximity to open spaces, and the distribution of socio demographic factors including income and housing. All of these are location related.
Our research suggests that no one has yet attempted to employ spatial tools in the management of diabetes mellitus at the level of the GP and their patient.
Spatial tools placed in the hands of health practitioners offer new ways to address this problem. It will help Australia in its shift to a more preventative health regime, a shift that is likely to result in far greater benefits to the Australians than the current regime. The principle benefits are anticipated to be a healthier population and reduced health costs.
The key finding of this research was that a significant proportion of people with a relatively high HbA1c (glycated haemoglobin) served by one general practice were clustered in and around two specific locations. These patients were managed similarly with reference to the guidelines. Likewise, attendance rate at the practice was equivalent to that of other patients with Type 2 Diabetes Mellitus served by the practice.
The locations identified were, in one case, associated with socioeconomic deprivation, and in the other a high proportion of older residents. Patients in these locations were not prescribed more medications, but had a higher prevalence of some comorbidities.
The report concluded that older people with Type 2 Diabetes Mellitus and higher cardiovascular risk have been shown to be clustered in defined geographical locations. If such geographical patterns for chronic diseases such as diabetes are confirmed in other places, the data offers the prospect of more geographically targeted interventions to reduce health risks related to diabetes.
Overlaying spatial approaches (location) to analyse patient records and data is important to the application of patient health and spatial techniques and allows the targeting of scarce resources by adding a spatial lens.
Results from this research were published in the British Medical Journal (open) in January 2016 and can be download from here.