Map Details – Hypertension Control among Federally Qualified Health Centers (FQHCs) and Hypertension Death Rates by County, Florida

Impact Statement

This map shows hypertension control among Federally Qualified Health Centers (FQHCs) and hypertension age-adjusted death rates for all ages at the county level along with the distribution of FQHCs across Florida counties in 2017. During that period, the average hypertension control among Florida FQHCs was 57%. The lowest hypertension control scores were seen among FQHCs located in the northern regions of the state where hypertension death rates tended to be the highest.

This map shows hypertension age-adjusted death rates at the county level and the distribution of 45 out of 47 FQHCs across Florida counties along with their average county-level hypertension control in 2017. A total of 47 FQHCs are listed on the HRSA-funded Health Center Awardees website for Florida for 2017 along with their Uniform Data System (UDS) data. However, during the geocoding process, a match was not found for two of the FQHCs, one in Pinellas County and one in Broward County. For counties with several FQHCs, an average hypertension control score was calculated per county. The average hypertension death rate in Florida in 2017 was 8.5 per 100,000. The counties in the top quintile (death rates 13.2 - 31.4 per 100,000), mostly located in the northern regions of the state, were Bay, Calhoun, Citrus, Franklin, Gadsden, Glades, Gulf, Hardee, Madison, Putnam, Taylor, Union, and Washington Counties. Among them, only Bay, Putnam, and Union Counties have FQHCs located within their respective geographic boundaries. Counties with no county-specific FQHCs however, may be covered by FQHCs located in bordering counties; this is the case, for example, for Madison and Gadsden Counties that rely on neighboring Leon County’s FQHCs. The average hypertension control attained by all FQHCs was 57 percent and the highest scores (i.e., top quintile 63.0 percent - 78.6 percent) were recorded in Brevard, Osceola, and Pinellas Counties.

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A total of 27 of the 67 Florida counties (40.30%) had the main addresses of the 47 FQHCs distributed within their respective geographic limits in 2017. Many counties with the highest rates of hypertension death rely on services from FQHCs located in neighboring counties.

On average, Florida FQHCs achieved 57% hypertension control statewide in 2017.

The lowest hypertension control scores (i.e., bottom tertile 37.8% – 51.4%) were seen primarily among FQHCs located in counties of the northern regions of the state. Often, these counties tended to have high hypertension-related death rates. The lowest hypertension death rates (i.e., bottom quintile 0.0% – 6.4%) were mostly found in counties of the southern regions.

ArcGIS

Hypertension death rates: Florida Department of Health, Bureau of Vital Statistics. Accessed July 24, 2019, from Florida Department of Health, Division of Public Health Statistics & Performance Management (2019). Hypertension deaths. Available at: http://www.flhealthcharts.com/Charts/DataViewer/DeathViewer/DeathViewer.aspx?indNumber=0099.

Hypertension control among FQHCs: Health Resources and Services Administration (HRSA) [2019]. Accessed July 24, 2019, from HRSA Health Center Program. 2017 HRSA-funded Health Center Awardees Data. Available at: https://bphc.hrsa.gov/uds/datacenter.aspx?q=d&year=2018&state=FL#glist

Data for hypertension death rates was gathered from the Florida Department of Health (FDOH), Division of Public Health Statistics & Performance Management website (ICD-10 Codes: I10, I12, I15).

Hypertension control and FQHCs’ location data were collected from the Health Resources and Services Administration (HRSA) website. Hypertension control was gathered in the pool of clinical data.

Shapefile was obtained from files provided by the Rice University GIS training team, available at: https://app.box.com/folder/73935956763. Accessed June 2019.

Graduated Color Scheme was used to display hypertension death rate by quintile.

The United States Census geocoder was used to geocode the main addresses of the FQHCs and Point Markers were used to display the location of the FQHCs across counties.

Graduated Symbols with 50% transparency were used to show the average percent of blood pressure control achieved by FQHCs in a county. Hypertension control was defined as blood pressure < 140/90 among hypertensive patients.

Rodrigue Pierre, Florida Department of Health

Rodrigue Pierre, Florida Department of Health. Accessed from the Centers for Disease Control and Prevention’s Chronic Disease GIS Exchange https://www.cdc.gov/dhdsp/maps/gisx/mapgallery/fl-hypertension-fqhc.html