Project lead: Nancy Waite
Project members: Wasem Alsabbagh, Suzanne Cadarette, Martin Cooke, Susan Elliott, Peter Johnson and Emily Milne

Funded by the Chronic Disease Prevention Initiative, Propel Centre for Population Health Impact

Knowledge users: Allan Malek, Ontario Pharmacists Association; Elaine Maloney, Ministry of Health and Long-Term Care

Background

Mapping health geography data and pharmacy access projectCommunity pharmacists are among the most accessible of healthcare professionals. Complementing their traditional role in patient care, community pharmacists today also provide a range of chronic disease prevention services — from influenza immunization and smoking-cessation support to medication reviews and chronic disease medication management.

The accessibility of community pharmacists and the services they provide may be particularly vital for vulnerable populations. People with low income, older adults, Aboriginal people, people with disabilities, newcomers, minorities and those living in rural or remote communities could benefit from the care community pharmacists provide, particularly when access to other healthcare providers is limited.

However, the extent to which geographic distribution of community pharmacies corresponds with the residential concentrations of at-risk groups is unknown. Examining spatial patterns of community pharmacies in relation to vulnerable populations could improve existing pharmacy services as well as identify opportunities for pharmacists to deliver preventive healthcare services to at-risk groups.

Research activities

Literature review
capsuleProject researchers are conducting a scoping review to examine the location of pharmacies relative to vulnerable populations to determine what previous research, particularly in Canada, has revealed and what specific gaps in understanding remain.

Spatial analysis of vulnerable populations and pharmacy locations
Using publicly available geocoded data on pharmacy locations, population characteristics, health conditions and healthcare use, project researchers will explore the relationships between pharmacy location and residential concentrations of vulnerable populations, including measures such as distance and travel time to community pharmacies.

Interactive map investigation and possible Ontario prototyping
Project researchers will investigate the use of interactive mapping applications to provide geospatial data to knowledge users and policymakers. Although providing evidence of the relationships between vulnerability and pharmacy access through statistical relationships and maps is informative, the data sources researchers will use includes thousands of data points and pharmacy locations across the country, making regional summaries difficult.

immunizationNew technologies, using interactive digital maps, would allow users to navigate to a particular location and explore its respective data. This approach could help provincial policymakers and knowledge users, colleges of pharmacy and pharmacy associations better understand the spatial dimensions of pharmacy access, ultimately leading to policy decisions for improved access.

Project researchers will investigate potential interactive mapping approaches to visualize data for specific regions in Ontario. This will include identifying software to create such maps, testing the appropriateness of the data available for this purpose, and providing support to members of an expanded team with expertise in data visualization to apply for additional funding to expand the scope and applicability of this project.

Relevance

This project brings together a new team of researchers whose expertise spans pharmacy practice, pharmacoepidemiology and health services, social science, community psychology and health geography.

The research is expected to inform pharmacy practice, including the expansion of the role of community pharmacists as key healthcare providers and community pharmacies as key sites for chronic disease prevention.

Expected impact

Rx under the magnifying glass

The risk of particular chronic diseases, such as diabetes, asthma and heart disease, are influenced by age, immigrant status and income. The mechanisms that link these dimensions to chronic disease are complex and vary depending on the disease. A focus on the geography of pharmacy service delivery may provide a way to reduce disparities and ensure that those at highest risk have better access to preventive measures.

Coast to coast, Canada has some 25,000 community pharmacists — accessible healthcare professionals who provide their patients with many services, including those that help prevent and control illness and disease. Pharmacies are a crucial community resource for chronic disease prevention, and may be particularly important for those who have difficulties accessing other healthcare professionals.

This research project will help increase our understanding of the location of pharmacies in relation to vulnerable populations, identify areas that potentially have unmet needs, and inform the development of pharmacy services in ways that may reduce health disparities.