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Readiness for an Increase in Congenital Zika Virus Infections in the United States: Geographic Distance to Pediatric Subspecialist Care

Published online by Cambridge University Press:  24 August 2018

Jeanne Bertolli ,
Joseph Holbrook ,
Nina D. Dutton ,
Bryant Jones ,
Nicole F. Dowling  and
Georgina Peacock
Jeanne Bertolli*
Affiliation:
National Center for Birth Defects and Developmental Disabilities, Atlanta, GA
Joseph Holbrook
Affiliation:
National Center for Birth Defects and Developmental Disabilities, Atlanta, GA
Nina D. Dutton
Affiliation:
Oak Ridge Institute for Science and Education (ORISE) Research Participation Program; Geospatial Research, Analysis, and Services Program, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA
Bryant Jones
Affiliation:
Oak Ridge Institute for Science and Education (ORISE) Research Participation Program; Geospatial Research, Analysis, and Services Program, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA
Nicole F. Dowling
Affiliation:
National Center for Birth Defects and Developmental Disabilities, Atlanta, GA
Georgina Peacock
Affiliation:
National Center for Birth Defects and Developmental Disabilities, Atlanta, GA
*
Correspondence and reprint requests to Dr Jeanne Bertolli, 1600 Clifton Road, MS E-88, Atlanta, GA 30329 (e-mail: [email protected]).
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Abstract

Objective

The study’s purpose was to investigate readiness for an increase in the congenital Zika infection (CZI) by describing the distribution of pediatric subspecialists needed for the care of children with CZI.

Methods

We applied county-level subspecialist counts to US maps, overlaying the geocoded locations of children’s hospitals to assess the correlation of hospital and subspecialist locations. We calculated travel distance from census tract centroids to the nearest in-state children’s hospital by state (with/without > 100 reported adult Zika virus cases) and by regions corresponding to the likely local Zika virus transmission area and to the full range of the mosquito vector. Travel distance percentiles reflect the population of children < 5 years old.

Results

Overall, 95% of pediatric subspecialists across the United States are located in the same county or neighboring county as a children’s hospital. In the states where Zika virus transmission is likely, 25% of children must travel more than 50 miles for subspecialty care; in one state, 50% of children must travel > 100 miles.

Conclusion

The travel distance to pediatric subspecialty care varies widely by state and is likely to be an access barrier in some areas, particularly states bordering the Gulf of Mexico, which may have increasing numbers of CZI cases. (Disaster Med Public Health Preparedness. 2019;13:476-486)

Keywords

disease outbreakshealth care facilitiesworkforceservicessurge capacity
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 13 , Issue 3 , June 2019 , pp. 476 - 486
Copyright
Copyright © 2018 Society for Disaster Medicine and Public Health, Inc. 

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