Vol. 57, No. 2, Fall/Winter 2019 - "Medical Geography" (pp. 1 - 15) R. Todd Bartee Department of Kinesiology and Sports Sciences University of Nebraska-Kearney Paul R. Burger Department of Geography University of Nebraska-Kearney Kate A. Heelan Department of Kinesiology and Sports Sciences University of Nebraska-Kearney Ava Coughlin Department of Kinesiology and Sports Sciences University of Nebraska-Kearney H. Jason Combs Department of Geography University of Nebraska-Kearney Kearney, Nebraska Abstract This study employs geographic information science (GIScience) to analyze accessibility between cancer survivors and the nearest exercise program and general fitness facility designed for their needs in a metropolitan statistical area (MSA), a micropolitan statistical area (µSA), or rural area. Initial findings indicate that approximately 59 percent, 19 percent, and 22 percent of survivors respectively, reside in counties designated as MSA, µSA, or rural. Survivors living in an MSA had a mean distance of 16.1 ± 28.8 miles from the nearest exercise program and 3.2 ± 5.2 miles from the nearest exercise facility. Survivors living in a µSA had a mean distance of 149.3 ± 113.7 miles to the nearest exercise program for cancer survivors and 6.4 ± 8.4 miles to the nearest exercise facility. Rural survivors had a mean distance of 164.6 ± 115.7 miles from an exercise program and 24.9 ± 19.6 miles from the nearest exercise facility. Using GIScience to spatially evaluate exercise facilities finds that they are accessible to cancer survivors throughout Nebraska, however, for many cancer survivors exercise programs are not located within reasonable distances to rural survivors. Strategies are needed to address rural access to fitness programs and facilities among cancer survivors. MODELING GEOGRAPHIC BARRIERS TO OVARIAN CANCER CLINICAL TRIALS IN PENNSYLVANIA (pp. 16 - 31) Moira Conway Department of Geography Kutztown University of Pennsylvania Kutztown, University Diana Malandruccolo Department of Public Health Arcadia University Glenside, Pennsylvania Jennifer Hinkel Centre for Evidence Based Medicine University of Oxford Oxford, England Abstract Although clinical trials offer the best management of cancer patients according to National Comprehensive Cancer Network, patient participation in trials remains low. Multiple barriers to trial participation exist; one barrier documented in the literature is geographic. This barrier may present a greater hurdle for cancer patients in rural areas. We assess geographic accessibility to oncology treatment trials through a state and county-level lens in one state (Pennsylvania) and one tumor type (ovarian cancer), applying a methodology replicable to other states and disease areas. GIS methods are used to map and rank counties based on four variables. These were combined to determine each county’s overall vulnerability. Results from the suitability analysis show that the most vulnerable counties are rural. Quantifying geographic and socioeconomic hurdles to clinical trial participation may illuminate potential changes to policy or practice that could improve rural access. Counties with vulnerability can be targeted for intervention (pp. 32 - 51) Robert C. Ziegenfus Department of Geography Kutztown University of Pennsylvania Kutztown, Pennsylvania Abstract At the author’s request, the Pennsylvania Department of Health provided blood lead data for the 90 census tracts in Berks County. The 27 tracts in Reading had the largest absolute number and percent of children with elevated blood lead levels. Housing and socioeconomic variables common in the lead literature were examined to determine their relationship to the elevated lead levels. Pennsylvania needs to greatly expand the number of children tested to obtain a more accurate picture of the lead problem POOR SITE SELECTION DECISIONS PUT SUBDIVISION FAMILIES AT RISK (pp. 52 - 67) Mary K. Kilmer Department of Biology and Environmental Health Missouri Southern State University Joplin, Missouri Hubert B. Stroud Department of Criminology, Sociology, and Geography Arkansas State University Justin R. Gibson Department of Criminology, Sociology, and Geography Arkansas State University Jonesboro, Arkansas Abstract This paper examines problems associated with poor site selection decisions that were made years ago by the developers of Cape Coral, Florida. Poor site selection and inadequate environmental planning have created significant problems for a city that now exceeds a population of 180,000. Rapid growth and development have put a large segment of the population at risk of flooding during intense thunderstorms and hurricanes. Although options are limited, the city continues to work to improve its emergency management response and is looking for ways to enhance the protection of its citizens in the future. |