Toronto HIV/AIDS Community Health Information System

Background

Efforts have been made to identify, reduce and ultimately eliminate health disparities, yet inequities in access to healthcare continue to be an important concern. While researchers have continued to identify the under-utilization of health services by minority and economically marginalized groups, our level of understanding of the geographic barriers to accessing healthcare or the neighborhood characteristics associated with access to healthcare is limited. As with large American cities, Toronto has been particularly hard hit by the AIDS epidemic, representing 68% of Ontario’s HIV diagnoses. The accessibility of healthcare in terms of the geographic location and spatial distribution of health services are important factors in healthcare utilization. The geographic gaps in HIV testing and medical interventions may leave many individuals with fewer choices for obtaining care.

Objectives

The goal of this initiative is to examine the location and distribution of HIV service providers across Toronto neighborhoods. Through the application of an Internet-based community health information system the study examines access to primary healthcare and HIV interventions across Toronto.

The major goal of this project is to incorporate data on primary healthcare into an Internet-based Geographic Information System (GIS) that permits the public, service providers, policy makers, and researchers to:

• Generate maps of the location, distribution and accessibility of health services.
• Analyze the neighborhood characteristics that promote or impede the provision of health services.
• Assess whether the supply of healthcare is adequate and/or appropriate for the target population.
• Examine the extent to which health services are equitably distributed in Toronto and, if necessary, identify ways to achieve a more equitable distribution.
• Develop “what if” scenarios to examine the impact of changes in the allocation of health resources.

Methods

The data for the Internet Mapping Website for Toronto includes a list of HIV service providers that drew from contacts at the AIDS Committee of Toronto (ACT), and the Community Research Initiative of Toronto (CRIT). We identified 244 HIV service providers within Toronto’s 477 Census Tract neighborhoods. A large number of HIV service providers were derived from the electronic version of the 2002 AIDS Committee of Toronto (ACT) Living Guide. The ACT directory includes a total of 128 HIV service providers in Toronto.

Principal Investigators: Katie Kaukinen and Chris Fulcher

Project Managers: Tye Parsons

Project Staff: Yan Barnett, Jim Meyer, Ryan Schroeder

Contracting Agency: Canadian Embassy, Bowling Green State University, University of Missouri,

Partnerships: This initiative is a joint effort between the investigators, CARES and the the AIDS Committee of Toronto.  This research is supported in part by NLM’s Biomedical and Health Informatics Research Training grant 2-T15-LM07089-12.