Patterns of chronic conditions in older adults: Exploratory spatial findings from the Eldersmile program

Background The increasing prevalence of primary care-sensitive conditions, notably diabetes and hypertension, among older adults presents a challenge to the public health community. Systems science conceptualizations of health, along with considerations of the social and environmental context in which older adults live, are needed before effective interventions can be designed and implemented. Purpose To examine whether spatial patterns exist in hemoglobin A1c and blood pressure measurements among participants in ElderSmile, a community-based oral health and primary care screening program. Methods Two spatial statistical methods, global Moran's I and Cuzick-Edwards tests, were used to determine if there were significant spatial patterns among ElderSmile participants residing in northern Manhattan during 2010-2012. The analyses were conducted in 2013. Results Significant spatial patterns of hemoglobin A1c values and potential diabetes cases, and possibly blood pressure measurements, were found among ElderSmile participants residing in northern Manhattan. Conclusions The presence of spatial patterns allows for the identification of subpopulations in need of additional resources, and can assist in informing advanced spatial and statistical analyses. Screening data collected from an ongoing community-based program can be used to understand broader patterns of urban health.