2023 Community Mapping Toolkit for D.C. Organizations

Community mapping is the process of creating maps to gain a visual representation of community-specific data organized by geography. It is an important tool for HIV prevention and intervention—and having visually striking proof that your program is truly serving the community lets others easily see the value of your work. Mapping can allow community members and organizations to better plan the management of resources, implement and develop interventions and programs, and resolve resource conflicts. While mapping is a useful tool for organizations, the knowledge gained from it also has the potential to empower community members to respond to problems and communicate their needs,

In this toolkit, we will explore how community mapping can support your work, what goes into creating a community map, and how to use mapping tools that are available online.

Community assessment is the participative process designed to gather insights and information to help identify and evaluate the strengths, assets, needs, and challenges of a specific community. A community assessment can mobilize the different forces in a community to take action, create coalitions, and establish objectives for the program or intervention. Assessments include determining the preferred or desired situation of a community, comparing the actual and desired situation for the purpose of prioritizing concerns, and the best strategies to collect information and to perform the intervention. They are useful for identifying new ideas, partners, and resources that can be used in working toward a common goal.

However, the language we use to frame this work is an important part of establishing a respectful and productive assessment process. The following list provides examples and explanations of keywords and language considerations essential to developing your assessments and mapping projects.

• Asset-Based Language: Asset-based language is strengths-driven and opportunity-focused. It emphasizes the existing resources in a community in order to identify opportunities for additional support.
• Deficit-Based Language: Deficit-based language is needs-driven and problem-focused. It emphasizes what is lacking in communities and therefore has the potential to reinforce the harm it is attempting to describe.
• Community Asset Assessment: Assets refer to the skills, talents, and abilities of individuals as well as the resources that local institutions contribute to the community. Consider conducting an asset assessment in addition to or in place of a needs assessment, which typically focuses on the deficits of a community rather than its strengths. By identifying and mapping available assets, organizations can pinpoint areas that require additional support while avoiding stigmatizing or harmful claims about the ways a community is "lacking".
• Priority Populations: Groups that would benefit most from public health programs and services. Consider using "priority" to describe your focus community instead of the following deficit-based terms...
  • "high-risk"
  • "target"
  • "vulnerable"
  • "underserved"

1. Determine the Purpose and Scope of the Assessment: What is your motivation and what outcomes are you aiming for?
2. Define the community and context of the assessment: What is the broader community you are working with? Within that community, who are the priority populations or groups? There are two general approaches that can help you answer these questions:
   1. Health Equity Approach ¹ — This approach starts with the social determinants of health and considers which populations should be prioritized based on their relative socioeconomic (dis)advantage. For example, food insecurity can make it more difficult for PLWH to remain virally suppressed. People living in D.C. zip codes 20032, 20019, and 20020 are most likely to be experiencing food insecurity and could therefore be identified as a priority population for HIV care organizations. ² 
   2. Burden of Disease Approach — This approach starts with health outcomes and considers which populations should be prioritized based on their relative rates of disease/poor health. For example, in D.C. in 2020 the rate of Black males living with an HIV diagnosis was 3.2 times that of White males, so Black men could be identified as a priority population for HIV prevention organizations. ³ 
3. Define the Goals and Objectives of the Assessment: What will your assessment be used for? Will the resulting materials (e.g. maps) directly benefit the community you are assessing?
   1. Every project should have clear objectives in order to ensure smooth implementation. However, objectives are also important so you can be sure you are not needlessly extracting data from your priority community. You should know exactly what information you need and how you will get it without placing additional burdens on the focus community.
4. Prepare a Timeline and Budget
5. Select or Design Data Collection Methods, Instruments, and Procedures: Where can you find the information you need?
   1. Maybe an online search is all you need—CDC, state health departments, and universities maintain extensive databases of health surveillance data and other relevant information such as income and poverty levels.
   2. If you are seeking data that is not available online or hasn't been collected before, how will you collect that data, and who needs to be involved? How will you include the perspective and expertise of community members?
6. Pilot Test the Instruments and Procedures 
7. Collect the Data 
8. Analyze the Data (Community Mapping) 

Community mapping is a process of creating maps to visually represent data from community assessments, organized by geography. Also called Public Participatory Geographic Information Systems (PPGIS), community mapping can be used to tell a story about what is happening in our communities. It also allows you/your organization to track where your community needs you to be, allowing you to answer, “Where are the resources I can provide most needed?”

The information collected can be interpreted using a range of different statistical analyses to identify relationships with other data, such as socioeconomic trends, or to view changes over time. Community mapping can be used to identify resource gaps which can be extremely useful in targeting interventions.

Over the past 30 years, prevention efforts have helped dramatically reduce the rate of HIV infections in the United States. At the height of the epidemic in 1985, 130,000 new infections were reported. New infections declined by 8% between 2015 and 2019 to 34,800 new infections, though HIV continues to have a disproportionate impact on certain populations, particularly racial and ethnic minorities and gay, bisexual, and other men who have sex with men (MSM). ⁴ 

While overall HIV infection rates in the United States have stabilized in recent years, they have remained highest among MSM, accounting for 72% of new HIV infections nationwide. 

Black/African American and Hispanic/Latinx populations in the United States are also disproportionately affected by HIV. Black people experience infection rates that are eight times as high as White people, and Hispanic/Latinx populations experience rates nearly four times as high.

Visualizing the HIV epidemic geo-spatially can empower the workforce to identify these disparities in their own communities and implement data-based strategies for solutions. Mapping is an essential process for staging that identification. 

 AIDSVu.org  is an interactive online mapping tool that visualizes the impact of the HIV epidemic in communities across the United  States, and a leader in the HIV mapping field. 

The following AIDSVu maps of D.C. demonstrate how community mapping can be used to better understand the epidemic.

Sometimes it necessary, and even visually powerful, to map socio-economic or health-related disparities—even if that means mapping "deficits" such as food insecurity, poverty, or life expectancy. However, in these cases it is important to also include data on community assets/resources (either as an additional layer on your map or as written context) so the resources, not the "deficits," become the focus of the assessment.

The above map provides an example of how mapping can be used to capture systemic social inequities that impact health by demonstrating the overlapping burdens of food insecurity and distance from HIV care. We know that food insecurity is a social determinant associated with lower viral suppression rates. ⁵  People experiencing food insecurity need easy access to HIV care, but are not able to achieve that in wards 3, 4, 7, and 8, in particular. Community organizations that provide nutritional services could use this map to develop a strategy for meeting the nutritional needs of PLWH in D.C.

This map demonstrates that East and Southeast D.C. (Wards 7 & 8) are most impacted by financial insecurity and have the least access to HIV and housing services. However, can we identify the specific neighborhoods in highest need from this map alone?

It is important to consider additional variables that might be impacting the distribution of resources across the city. Adding a population overlay to our map impacts our interpretation: the neighborhoods in far South D.C. (in particular, Congress Heights, Bellevue, and the naval/defense centers) have some of the lowest population densities in the city.

Combining all of our variables into one map allows us to more accurately identify the centers of population facing the greatest burden of income inequality and HIV/social service scarcity.

Anticipating all possible interpretations of a map is a crucial step in the development process, as mis-interpretation can perpetuate harmful stereotypes about the communities being depicted. However, ensuring visual clarity is just one of many ethical considerations you must make.

Community mapping can be a highly sensitive process. Protecting the privacy and safety of focus communities must be the foundation of every mapping project.

Some ethical questions to consider:

• Was my mapping process community-based and participatory, or was it extractive? Have members of the focus community reviewed the map and provided input?
• Is it possible that my mapping project could endanger or exploit vulnerable communities?
• Is it possible that individuals could be identified by viewing the map?
• What story am I telling with the map? Could the map perpetuate stigma or harmful misrepresentations of the community?
• Can the map be viewed in isolation or does it need to be contextualized to prevent misinterpretation?
• How will the map be used and what are my next steps to make the map actionable?

For further reading on ethical community mapping, consider reviewing the following resources from the The Urban and Regional Information Systems Association (URISA) and the American Association of Geographers (AGG):

Johns Hopkins COVID-19 Dashboard:

During the COVID-19 public health emergency (January 22, 2020 to March 26, 2023), Johns Hopkins University provided a live COVID-19 Dashboard. The dashboard provided digestible visualizations with crucial information including new infections, mortality, and morbidity distributed geographically.

Washington State Environmental Health Mapping:

The Washington State Department of Health has provided an Environmental Health Disparities Map since 2019. This map is a living tool that is intended to display risk for environmental hazard on a community level to inform and support the state's clean energy transition. The department calculated risk for experiencing environmental health disparities by compounding measures for fossil fuel pollution (diesel, ozone, etc.) and other toxic exposures with socioeconomic factors and distributions of sensitive populations. The above images demonstrate how the map can be used to visualize racial disparities: on the left we see a primarily White neighborhood (outlined/highlighted in yellow) with a low environmental risk ranking of 2; on the right we see a primarily Black neighborhood with a high environmental risk ranking of 9. This is an excellent tool to support environmental justice initiatives.

 AtlasPlus  - From the CDC's National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), this is an interactive tool that allows users to create tables, maps, and charts using CDC surveillance data on HIV, viral hepatitis, STD, and TB in conjunction with social and economic data.

 Open Data DC  - A rich database of socio-economic, environmental, political, and health-related data from the District of Columbia, maintained by D.C. government agencies.

 Data.gov  - The U.S. government's open data system—a searchable database of 240,143 datasets.

 HealthData.gov  - A healthcare version of data.gov, collected and curated by the U.S. Department of Health and Human Services.

ArcGIS Online - With an ArcGIS license, users can access extensive dataset lists through their account. ArcGIS Online makes it quick and easy to search for data on a large range of topics. However, GIS licenses can be expensive, and the majority of datasets available through ArcGIS Online can be found elsewhere on government websites and virtual libraries.

TOOLS: GIS, Tableau, Excel, Google maps, Mapbox, Mapline, eSpatial, etc.

ArcGIS - ArcGIS is the gold standard for mapping and data visualization, especially in the healthcare and research fields. The software is useful for a wide range of purposes— use the following resources to get started with ArcGIS mapping:

•  ArcGIS Tutorials 
•  Working with Data in ArcGIS 

However, an ArcGIS license can be expensive. If only one person is doing mapping work at your organization they can purchase an individual license for $100/year, but business licenses start at $550/year.

If ArcGIS is the best option for your organization, there are several ways to secure a license at reduced cost:

There is a non-profit package you can apply for to secure reduced costs  here,  and grants can be obtained to further fund your GIS program. Select the button below to access a GIS funding guide.

Mapbox - Mapbox is a powerful mapping software used by companies like AccuWeather, CNN, Lonely Planet, and T-Mobile. It is also useful for mapping healthcare data—as demonstrated by AIDSVu which uses Mapbox to develop all their interactive maps and dashboards.

The visuals and interactions available through Mapbox are phenomenal, but it is expensive and has more corporate applications than ArcGIS, which is more research focused.

Tableau - Tableau is another license-based software with mapping capabilities. However, Tableau is a general data analysis and visualization tool with some mapping powers, and not geo-spatial technology. Accordingly, it might be more challenging to manipulate location data and create interactive maps that serve your needs.

Excel Maps - Excel Maps is a fast, easy, and affordable mapping tool that anyone with access to Microsoft Excel can use. Excel is best used for creating simple choropleth maps. Use the following resources to get started:

•  Microsoft mapping guide 
•  Excel Map Chart Full Tutorial 

 OpenStreetMap  - OpenStreetMap is an open source mapping tool designed to make community mapping and data accessible. OpenStreetMap is operated by community members and the interface is less user-friendly than other more expensive softwares—but it's free to use! The  OpenStreet Wiki  will provide comprehensive guides to mapping in OpenStreetMap.

Mapline - Mapline is an online mapping tool with moderately advance geo-spatial capabilities. Mapline can create more advanced maps than Excel, and the standard version is free to use! However, be aware that Mapline operates on a credit-based system, and once you go through your initial free credits, you will have to purchase supplemental packages in order to keep mapping.

1.  https://www.publichealthontario.ca/-/media/documents/F/2015/focus-on-priority-populations.pdf 
2. DC Health Matters: SocioNeeds Index® Suite : 2022 Food Insecurity Index. Retrieved August 18, 2023, from  https://www.dchealthmatters.org/indexsuite/index/foodinsecurity?localeType=3&parentLocale=130951&locale=9419 
3. AIDSVu. (n.d.). Local Data: Washington DC. Retrieved August 18, 2023, from  https://aidsvu.org/local-data/united-states/south/washington-dc/ 
4. HIV & AIDS Trends and U.S. Statistics Overview. (n.d.). HIV.Gov. Retrieved August 18, 2023, from  https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics 
5. Aibibula, W., Cox, J., Hamelin, A.-M., McLinden, T., Klein, M. B., & Brassard, P. (2017). Association Between Food Insecurity and HIV Viral Suppression: A Systematic Review and Meta-Analysis. AIDS and Behavior, 21(3), 754–765.  https://doi.org/10.1007/s10461-016-1605-5 
6. COVID-19 United States Cases by County. (2023, March 10). Johns Hopkins Coronavirus Resource Center.  https://coronavirus.jhu.edu/us-map 
7. Washington Tracking Network (WTN). (n.d.). Environmental Health Disparities Map. Washington State Department of Health. Retrieved August 18, 2023, from  https://fortress.wa.gov/doh/wtnibl/WTNIBL/