The biopsychosocio-spatial disadvantages of declining health: Lived experiences from Pittsburgh

Authors: Zan M Dodson*, American Association of Geographers, Dan Swayze, University of Pittsburgh | Center for Emergency Medicine
Topics: Medical and Health Geography, Transportation Geography, Urban Geography
Keywords: health, transport disadvantage, mixed methods, spatial, social determinants of health
Session Type: Paper
Day: 4/5/2019
Start / End Time: 9:55 AM / 11:35 AM
Room: Marshall West, Marriott, Mezzanine Level
Presentation File: No File Uploaded


Negative health events have a large impact on an individual’s agency. These events are complex and nuanced, and the effects may be disproportionately felt by already marginalized populations, or may create new causal pathways of marginalization. The built environment and social constructs work not only to disrupt daily activity patterns for the affected individual but also create disruptions in their social safety nets. This analysis uses longitudinal data from 2015-2018 for 200 individuals from the CONNECT Community Paramedic Program based in Pittsburgh, Pennsylvania. Mixed methods are used to harmonize contextual data and field notes with spatial patterns of inequitable access to care. Specifically, qualitative methods are employed to thematically code patient and responder data to identify emerging themes and are then merged with spatial modeling of health care accessibility. These data offer a rare and comprehensive account of the disruptive nature of poor health and an opportunity for overcoming disadvantages. Our results demonstrate both a monetary return on investment—saving $1.8 million in healthcare costs, and a human capital one. By drawing directly from lived experiences, this research has both the ability to influence policy and provide agency for the individuals involved.

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