MSI Fellowship Week: Using geographic thinking to understand a wide range of SDOH and identification of at-risk groups in affected communities by Imelda K Moise

Hello!  My name is Imelda K Moise, Assistant Professor in the Departments of Geography and Public Health Sciences at the University of Miami, Florida. Prior to this, I was a GIS /Global Health M&E Advisor, a Research Specialist and spent six years as a Peace Corps technical trainer in Zambia. Because of these experiences, much of my work has primarily focused on utilizing multi-method approaches, community-based participatory research (CBPR) and evidence-informed interventions that are culturally responsive to a specific problem identified for a given context and practice (e.g., in the areas of diffusion and distribution of disease, health care/utilization and geographical targeting). As a 2016-17 MSI Fellow, our cohort examined the Intersection between Social Determinants of Health (SDOH) and Culturally Responsive Evaluation (CRE).

My contribution to the group project focused on how geographic thinking can help us understand a wide range of SDOH and identification of at-risk groups in affected communities to provide tailored interventions and services to the right people, in the right places and in a timely manner. The following example from one of my projects highlights how I have applied geographical thinking to support neighborhood scale interventions.

Lessons Learned: How would you go about identifying the most at-risk populations and neighborhoods to provide tailored interventions and services in a timely manner? This was the issue in post-Katrina New Orleans.  What we found was that although the hurricane itself was a huge trauma, for those who lived in the affected areas, the mental strain did not stop after floodwaters receded. To help identify at-risk areas and populations in need, we examined hospital data from the Louisiana Department of Health and Hospitals in New Orleans from 2004 (pre-Katrina) and 2008 (post-Katrina), looking for a change in the rate of hospitalizations for substance abuse. “What we saw was that geographic patterns of hospitalization for substance abuse disorders shifted in post-Katrina from flood-exposed areas to less exposed areas located in the center of the city, areas used for evacuees displaced by the hurricane.”

The generated information can inform public health officials deploy targeted interventions and treatment for substance use disorders to those affected individuals and neighborhoods in a timely manner. Further, physicians and other health care providers can use these findings as evidence to attend to the patient’s state of mind after such trauma.

As evaluators, we can contribute to research on CRE by teasing out connections between place effects and health disparities by utilizing geographic tools and methodologies to explore these associations. If you do not have expertise in using geographic tools and methodologies, you can leverage local resources in your community such as universities and county health departments. 

Rad Resources:

Hospitalizations for substance abuse disorders before and after Hurricane Katrina: Spatial clustering and area level predictors, New Orleans, 2004 and 2008.  

“A Process Guide to Monitoring and Evaluation for Informed Decision Making” provides evaluators with an overview of geospatial analysis techniques and ways to apply geospatial analysis within the context of M&E, along with additional resources.


The American Evaluation Association is AEA Minority Serving Institution (MSI) Fellowship Experience week. The contributions all this week to aea365 come from AEA’s MSI Fellows. For more information on the MSI fellowship, see this webpage: Do you have questions, concerns, kudos, or content to extend this aea365 contribution? Please add them in the comments section for this post on the aea365 webpage so that we may enrich our community of practice. Would you like to submit an aea365 Tip? Please send a note of interest to aea365 is sponsored by the American Evaluation Association and provides a Tip-a-Day by and for evaluators.

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