Tomer Shekel
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Socio-spatial equity analysis of relative wealth index and emergency obstetric care accessibility in urban Nigeria
Kerry L. M. Wong
Aduragbemi Banke-Thomas
Tope Olubodun
Peter M. Macharia
Charlotte Stanton
Narayanan Sundararajan
Yash Shah
Mansi Kansal
Swapnil Vispute
Olakunmi Ogunyemi
Uchenna Gwacham-Anisiobi
Jia Wang
Ibukun-Oluwa Omolade Abejirinde
Prestige Tatenda Makanga
Bosede B. Afolabi
Lenka Beňová
Communications Medicine, 4 (2024), pp. 34
Preview abstract
Background
Better geographical accessibility to comprehensive emergency obstetric care (CEmOC) facilities can significantly improve pregnancy outcomes. However, with other factors, such as affordability critical for care access, it is important to explore accessibility across groups. We assessed CEmOC geographical accessibility by wealth status in the 15 most-populated Nigerian cities.
Methods
We mapped city boundaries, verified and geocoded functional CEmOC facilities, and assembled population distribution for women of childbearing age and Meta’s Relative Wealth Index (RWI). We used the Google Maps Platform’s internal Directions Application Programming Interface to obtain driving times to public and private facilities. City-level median travel time (MTT) and number of CEmOC facilities reachable within 60 min were summarised for peak and non-peak hours per wealth quintile. The correlation between RWI and MTT to the nearest public CEmOC was calculated.
Results
We show that MTT to the nearest public CEmOC facility is lowest in the wealthiest 20% in all cities, with the largest difference in MTT between the wealthiest 20% and least wealthy 20% seen in Onitsha (26 vs 81 min) and the smallest in Warri (20 vs 30 min). Similarly, the average number of public CEmOC facilities reachable within 60 min varies (11 among the wealthiest 20% and six among the least wealthy in Kano). In five cities, zero facilities are reachable under 60 min for the least wealthy 20%. Those who live in the suburbs particularly have poor accessibility to CEmOC facilities.
Conclusions
Our findings show that the least wealthy mostly have poor accessibility to care. Interventions addressing CEmOC geographical accessibility targeting poor people are needed to address inequities in urban settings.
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Geographical accessibility to emergency obstetric care in urban Nigeria using closer-to-reality travel time estimates
Aduragbemi Banke-Thomas
Kerry L. M. Wong
Tope Olubodun
Peter M. Macharia
Narayanan Sundararajan
Yash Shah
Mansi Kansal
Swapnil Vispute
Olakunmi Ogunyemi
Uchenna Gwacham-Anisiobi
Jia Wang
Ibukun-Oluwa Omolade Abejirinde
Prestige Tatenda Makanga
Ngozi Azodoh
Charles Nzelu, PhD
Charlotte Stanton
Bosede B. Afolabi
Lenka Beňová
Lancet Global Health (2024)
Preview abstract
Background
Better accessibility of emergency obstetric care (CEmOC) facilities can significantly reduce maternal and perinatal deaths. However, pregnant women living in urban settings face additional complex challenges travelling to facilities. We estimated geographical accessibility and coverage to the nearest, second nearest, and third nearest public and private CEmOC facilities in the 15 largest Nigerian cities.
Methods
We mapped city boundaries, verified and geocoded functional CEmOC facilities, and assembled population distribution for women of childbearing age (WoCBA). We used Google Maps Platform’s internal Directions Application Programming Interface (API) to derive driving times to public, private, or either facility-type. Median travel time (MTT) and percentage of WoCBA able to reach care were summarised for eight traffic scenarios (peak and non-peak hours on weekdays and weekends) by city and within-city (wards) under different travel time thresholds (<15, <30, <60 min).
Findings
City-level MTT to the nearest CEmOC facility ranged from 18min (Maiduguri) to 46min (Kaduna). Within cities, MTT varied by location, with informal settlements and peripheral areas being the worst off. The percentages of WoCBA within 60min to their nearest public CEmOC were nearly universal; whilst the percentages of WoCBA within 30min reach to their nearest public CEmOC were between 33% in Aba to over 95% in Ilorin and Maiduguri. During peak traffic times, the median number of public CEmOC facilities reachable by WoCBA under 30min was zero in eight of 15 cities.
Interpretation
This approach provides more context-specific, finer, and policy-relevant evidence to support improving CEmOC service accessibility in urban Africa.
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Quantifying urban park use in the USA at scale: empirical estimates of realised park usage using smartphone location data
Michael T Young
Swapnil Vispute
Stylianos Serghiou
Akim Kumok
Yash Shah
Kevin J. Lane
Flannery Black-Ingersoll
Paige Brochu
Monica Bharel
Sarah Skenazy
Shailesh Bavadekar
Mansi Kansal
Evgeniy Gabrilovich
Gregory A. Wellenius
Lancet Planetary Health (2024)
Preview abstract
Summary
Background A large body of evidence connects access to greenspace with substantial benefits to physical and mental
health. In urban settings where access to greenspace can be limited, park access and use have been associated with
higher levels of physical activity, improved physical health, and lower levels of markers of mental distress. Despite the
potential health benefits of urban parks, little is known about how park usage varies across locations (between or
within cities) or over time.
Methods We estimated park usage among urban residents (identified as residents of urban census tracts) in
498 US cities from 2019 to 2021 from aggregated and anonymised opted-in smartphone location history data. We
used descriptive statistics to quantify differences in park usage over time, between cities, and across census tracts
within cities, and used generalised linear models to estimate the associations between park usage and census tract
level descriptors.
Findings In spring (March 1 to May 31) 2019, 18·9% of urban residents visited a park at least once per week, with
average use higher in northwest and southwest USA, and lowest in the southeast. Park usage varied substantially
both within and between cities; was unequally distributed across census tract-level markers of race, ethnicity, income,
and social vulnerability; and was only moderately correlated with established markers of census tract greenspace. In
spring 2019, a doubling of walking time to parks was associated with a 10·1% (95% CI 5·6–14·3) lower average
weekly park usage, adjusting for city and social vulnerability index. The median decline in park usage from spring
2019 to spring 2020 was 38·0% (IQR 28·4–46·5), coincident with the onset of physical distancing policies across
much of the country. We estimated that the COVID-19-related decline in park usage was more pronounced for those
living further from a park and those living in areas of higher social vulnerability.
Interpretation These estimates provide novel insights into the patterns and correlates of park use and could enable
new studies of the health benefits of urban greenspace. In addition, the availability of an empirical park usage metric
that varies over time could be a useful tool for assessing the effectiveness of policies intended to increase such
activities.
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Revealed versus potential spatial accessibility of healthcare and changing patterns during the COVID-19 pandemic
Kristina Gligoric
Chaitanya Kamath
Daniel Weiss
Shailesh Bavadekar
Kevin Schulman
Evgeniy Gabrilovich
Nature Communications Medicine (2023)
Preview abstract
Background
Timely access to healthcare is essential but measuring access is challenging. Prior research focused on analyzing potential travel times to healthcare under optimal mobility scenarios that do not incorporate direct observations of human mobility, potentially underestimating the barriers to receiving care for many populations.
Methods
We introduce an approach for measuring accessibility by utilizing travel times to healthcare facilities from aggregated and anonymized smartphone Location History data. We measure these revealed travel times to healthcare facilities in over 100 countries and juxtapose our findings with potential (optimal) travel times estimated using Google Maps directions. We then quantify changes in revealed accessibility associated with the COVID-19 pandemic.
Results
We find that revealed travel time differs substantially from potential travel time; in all but 4 countries this difference exceeds 30 minutes, and in 49 countries it exceeds 60 minutes. Substantial variation in revealed healthcare accessibility is observed and correlates with life expectancy (⍴=−0.70) and infant mortality (⍴=0.59), with this association remaining significant after adjusting for potential accessibility and wealth. The COVID-19 pandemic altered the patterns of healthcare access, especially for populations dependent on public transportation.
Conclusions
Our metrics based on empirical data indicate that revealed travel times exceed potential travel times in many regions. During COVID-19, inequitable accessibility was exacerbated. In conjunction with other relevant data, these findings provide a resource to help public health policymakers identify underserved populations and promote health equity by formulating policies and directing resources towards areas and populations most in need.
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Identifying COVID-19 Vaccine Deserts and Ways to Reduce Them: A Digital Tool to Support Public Health Decision-Making
Rebecca L. Weintraub
Kate Miller
Benjamin Rader
Julie Rosenberg
Shreyas Srinath
Samuel R. Woodbury
Marinanicole Schultheiss
Mansi Kansal
Swapnil Vispute
Stelios Serghiou
Gerardo Flores
Akim Kumok
Evgeniy Gabrilovich
Iman Ahmad
Molly E. Chiang
John S. Brownstein
American Journal of Public Health (2023)
Preview abstract
A private–academic partnership built the Vaccine Equity Planner (VEP) to help decision-makers improve geographic access to COVID-19 vaccinations across the United States by identifying vaccine deserts and facilities that could fill those deserts. The VEP presented complex, updated data in an intuitive form during a rapidly changing pandemic situation. The persistence of vaccine deserts in every state as COVID-19 booster recommendations develop suggests that vaccine delivery can be improved. Underresourced public health systems benefit from tools providing real-time, accurate, actionable data. (Am J Public Health. 2023;113(4):363–367. https://doi.org/10.2105/AJPH.2022.307198)
Public health leaders can make better, more equitable decisions when they can clearly see and understand the problems. Being presented with potential solutions based on evidence further supports their decision-making and can aid in supporting health equity.
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A geospatial database of close to reality travel times to obstetric emergency care in 15 Nigerian conurbations
Peter M. Macharia
Kerry L. M. Wong
Tope Olubodun
Lenka Beňová
Charlotte Stanton
Narayanan Sundararajan
Yash Shah
Mansi Kansal
Swapnil Vispute
Uchenna Gwacham-Anisiobi
Olakunmi Ogunyemi
Jia Wang
Ibukun-Oluwa Omolade Abejirinde
Prestige Tatenda Makanga
Bosede B. Afolabi
Aduragbemi Banke-Thomas
Scientific Data, TBD (2023), TBD
Preview abstract
Travel time estimation accounting for on-the-ground realities between the location where a need for emergency obstetric care (EmOC) arises and the health facility capable of providing such services is essential for improving maternal and neonatal health outcomes. Current understanding of travel time to care is particularly inadequate in urban areas where short distances obscure long travel times, and also in low-resource settings. Here, we describe a database of travel times to facilities that can provide comprehensive EmOC in the 15 most populated extended urban areas (conurbations) in Nigeria. The travel times from cells of approximately 0.6 x 0.6km to facilities were derived based on Google Maps Platform’s internal Directions Application Programming Interface (API). The API incorporates estimates of traffic to provide closer-to-reality estimates of travel time. Computations were done to the first, second and third nearest public or private facilities. Travel time estimates for eight traffic scenarios (including peak and non-peak periods) and number of facilities within specific time thresholds were estimated. The database offers a plethora of opportunities for research and planning towards improving EmOC accessibility.
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Comparing access to urban parks across six OECD countries
Talia Kaufmann
Swapnil Vispute
Mansi Kansal
Daniel T. O'Brien
Evgeniy Gabrilovich
Gregory A. Wellenius
Lewis Dijkstra
Paolo Veneri
OECD Regional Development Papers (2023)
Preview abstract
This work leverages globally consistent data on parks from Google Maps, in combination with the computational power of Google Maps Directions API to quantify accessibility to parks across nearly 500 metropolitan areas in six countries: Estonia, France, Greece, Mexico, Sweden, and the United States. We combined high resolution population data from Worldpop with parks data and navigation estimates to measure: (1) Fraction of the population with access to parks within a 10-minute walk; and (2) the median walking time to the closest park. We find large differences in access to parks between countries, as well as large variability across cities and their respective commuting zones. To demonstrate how this framework can support cross country comparisons and efforts to track progress towards SDG11, we assessed access to parks by income group in selected countries, finding that the median walking time to a park is shorter for residents of low income neighbourhoods both in French and American metropolitan areas.
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High Resolution Building and Road Segmentation from Sentinel-2 Imagery
Abdoulaye Diack
Abel Tesfaye Korme
Emmanuel Asiedu Brempong
Jason Hickey
Juliana Marcos
Krishna Sapkota
Mohammed Alewi Hassen
Wojciech Sirko
arXiv, https://arxiv.org/abs/2310.11622 (2023)
Preview abstract
Mapping buildings and roads automatically with remote sensing typically requires imagery of at least 50 cm resolution, which is expensive to obtain and often sparsely available. In this work we demonstrate how public, worldwide imagery from the Sentinel-2 Earth observation mission can be used to carry out this task at a much higher level of detail than the 10 m raw pixel resolution would suggest. To do this, we employ a teacher-student method in which a model with access to a temporal stack of Sentinel-2 images is trained to make the same predictions as a high-resolution model with access to corresponding 50 cm imagery. Evaluating at 50cm resolution, we achieve mIOU of 0.78, equivalent in accuracy to applying a single-frame high resolution model with imagery of 4m resolution.
This work opens up new possibilities for using freely available Sentinel-2 imagery for a range of downstream tasks that previously could only be done with high resolution satellite imagery.
The model will be made available soon to non-commercial, non-governmental entities at https://sites.research.google/open-buildings/ upon request.
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An evaluation of Internet searches as a marker of trends in population mental health in the US
Uma Vaidyanathan
Yuantong Sun
Katherine Chou
Sandro Galea
Evgeniy Gabrilovich
Gregory A. Wellenius
Scientific Reports (2022)
Preview abstract
The absence of continuous, real-time mental health assessment has made it challenging to quantify the impacts of the COVID-19 pandemic on population mental health. We examined publicly available, anonymized, aggregated data on weekly trends in Google searches related to anxiety, depression, and suicidal ideation from 2018 to 2020 in the US. We correlated these trends with (1) emergency department (ED) visits for mental health problems and suicide attempts, and (2) surveys of self-reported symptoms of anxiety, depression, and mental health care use. Search queries related to anxiety, depression, and suicidal ideation decreased sharply around March 2020, returning to pre-pandemic levels by summer 2020. Searches related to depression were correlated with the proportion of individuals reporting receiving therapy (r = 0.73), taking medication (r = 0.62) and having unmet mental healthcare needs (r = 0.57) on US Census Household Pulse Survey and modestly correlated with rates of ED visits for mental health conditions. Results were similar when considering instead searches for anxiety. Searches for suicidal ideation did not correlate with external variables. These results suggest aggregated data on Internet searches can provide timely and continuous insights into population mental health and complement other existing tools in this domain.
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Vaccine Search Patterns Provide Insights into Vaccination Intent
Sean Malahy
Keith Spangler
Jessica Leibler
Kevin J. Lane
Shailesh Bavadekar
Chaitanya Kamath
Akim Kumok
Yuantong Sun
Tague Griffith
Adam Boulanger
Mark Young
Charlotte Stanton
Yael Mayer
Karen Lee Smith
Kat Chou
Jonathan I. Levy
Adam A.Szpiro
Evgeniy Gabrilovich
Gregory A. Wellenius
arXiv (2021), TBD
Preview abstract
Despite ample supply of COVID-19 vaccines, the proportion of fully vaccinated individuals remains suboptimal across much of the US. Rapid vaccination of additional people will prevent new infections among both the unvaccinated and the vaccinated, thus saving lives. With the rapid rollout of vaccination efforts this year, the internet has become a dominant source of information about COVID-19 vaccines, their safety and efficacy, and their availability. We sought to evaluate whether trends in internet searches related to COVID-19 vaccination - as reflected by Google's Vaccine Search Insights (VSI) index - could be used as a marker of population-level interest in receiving a vaccination. We found that between January and August of 2021: 1) Google's weekly VSI index was associated with the number of new vaccinations administered in the subsequent three weeks, and 2) the average VSI index in earlier months was strongly correlated (up to r = 0.89) with vaccination rates many months later. Given these results, we illustrate an approach by which data on search interest may be combined with other available data to inform local public health outreach and vaccination efforts. These results suggest that the VSI index may be useful as a leading indicator of population-level interest in or intent to obtain a COVID-19 vaccine, especially early in the vaccine deployment efforts. These results may be relevant to current efforts to administer COVID-19 vaccines to unvaccinated individuals, to newly eligible children, and to those eligible to receive a booster shot. More broadly, these results highlight the opportunities for anonymized and aggregated internet search data, available in near real-time, to inform the response to public health emergencies.
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