Interactive Maps Drive Home Health Care Issues


When you want to explain a complex problem to someone, paint a picture. That’s what the Robert Wood Johnson Foundation (RWJF) does through the use of interactive maps and other kinds of graphical presentation of data to help explain the obesity epidemic, geographic variation in health care, public health preparedness and other pressing health and health care issues.

These interactive maps and features, displayed on the foundation’s own Web site, and increasingly on the sites of its grantees and programs, allow visitors to see for themselves how their own states or locations compare with others on a particular issue as well as to see whether progress is being made over time.

For example, one map shows the magnitude of the nursing shortage over the next 20 years. Based on 2000 statistics and projections, it estimates the depth and progression of the nursing shortage in states. The animated map shows that nearly all states will have a nursing shortage by 2020, even though just over half of the states had a nursing shortage in 2000.

Another is a a map documenting the progression of the obesity epidemic. Using federal survey data, RWJF’s map shows both the increase over time in obesity in the adult population in nearly every state. By clicking on a state, visitors can see historical obesity data about that state.

Most recently, RWJF, working with grantee the Dartmouth Atlas of Health Care, released an interactive map showing the geographic variations in per-patient Medicare spending in hospital regions across the United States. It also showed how those rates have changed annually between 1992 and 2006.

Map uses animation to show rise in obesity across the U.S.

Most of the work on the maps and related interactive features is done by Jeff Meade, a senior web editor, who previously worked for the consumer health Web site Intelihealth, where interactive quizzes and features were one of the Web site’s most popular features.

For Meade, the interactives illustrate problems and challenges far more effectively than charts on a page.

“The childhood obesity interactive probably provides the best illustration—literally and figuratively,” Meade said. “You can thumb through the [federal Behavioral Risk Factor Surveillance System data] tables to see that, in 2004, a cluster of southern states all moved into the 25-29 percent obesity column.”

“[But] reading charts and tables does not have the same visual impact as clicking on the ‘animate’ button and seeing all those southern states suddenly turn bright orange.”

“The impact is striking, surely worth more than 1,000 words,” Meade said.

Although no two interactives are the same, RWJF’s steps usually follow a common path:

Find a good set of data to display interactively. Some maps are based on data collected from RWJF’s research and policy analysis programs. Examples include Trust for America’s Health’s research on public health preparedness issues, or Academy Health’s annual review of state coverage statistics. Others support RWJF’s work but draw from public sources — usually the federal government. Federal government data is attractive for a few reasons, Meade said: for RWJF, it’s important to use data where the research and analysis are rigorous and, if not created by RWJF, are available in the public domain.

“One of the things I look for is data in the public domain that helps explain or makes clear the foundation’s position on an issue—something that framed an issue in the broadest sense,” Meade said.

Find key facts to display. Characteristics of good choices are:

  • Facts or data that show a particular trend over time (such as the obesity or nursing maps).
  • Facts that show variation between states and regions (such as the public health preparedness map)- Facts and data that are cited regularly (such as the rate of uninsured or the percentage of employers who offer insurance coverage).
  • Questions that can be turned into a rating or result (such as the walkability checklist).

Build the interactive. RWJF has built maps in a variety of technologies working with a firm in Pennsylvania, Digital Wave Technologies. To get started, RWJF sends data to Digital Wave in some type of standardized format, such as in an Excel spreadsheet.

In the beginning, each map was built as a one-of-a-kind effort, but RWJF has transitioned to building a single tool that can be varied to show particular maps and where data can be updated without updating the interactive display itself.

Now, RWJF and Digital Wave builds interactives such as the State Health Access Profile so that they can be displayed at the foundation’s Web site and at grantee Web sites, but the underlying data needs only to be updated in one place and then is shared automatically to all places using the data.

The maps are quite popular, Meade said, and a 2008 redesign of the RWJF Web site has made it easier to promote them by making them available on the front page of program areas and as content related to the reports where data originates. The recent launch of the RWJF news Twitter account, which the RWJF Web Team uses to promote new and interesting items posted to its Web site, has encouraged people to pass along both the Dartmouth map and the obesity map.

Meade notes that there are some challenges in this approach:

  • Choosing the right data to display is important, as some data is too dense or complex to be displayed in this manner.
  • Comparing year-to-year data (as RWJF does in its annual Ready or Not? interactive of state public health preparedness, based on Trust for America’s Health data) can be tricky if the data that’s collected changes or the criteria for the data changes.
  • Making sure the numbers are correct requires several reviews. Sometimes numbers can be mixed up, even in the original source material, so it’s important to check the data carefully. “Our developers have discovered mistakes that slipped by the authors,” Meade said.

–Emily Culbertson

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