Exploring the Context of Chronic Illness Self-Care Using Geospatial Analyses

Abstract

Chronic illnesses are managed across clinical settings as well as in homes and communities. Chronic illness self-care is also pervasive because it often involves diet, physical activity, and other lifestyle modifications. Patients' context (i.e., the environments where their self-care occurs and those environments' properties) is related to the success of patients' self-care for chronic illness. Applying geographic sciences can extend the scope and value of human factors investigations and interventions in the domain of health and healthcare. This study used qualitative content analyses and geospatial analyses to examine where elderly, chronically ill patients report performing self-care and ways in which “place matters” for their health and self-care. We identified fifteen common places such as home, clinic, community meeting place, and place of work. In those we identified three key geographic dimensions—physical-spatial, social-cultural, and organizational—and five major themes of how place effected health and self-care. We also created two geographic information system techniques to plot patients' addresses, local fast food restaurants, and air pollution in 95 Tennessee counties. We urge further geospatial analyses as part of the human factors toolkit in research on health and healthcare.