"Spatial Analytic Methods in Health Utilization and Outcomes Research"

Dr. Lee Rivers Mobley is a senior economist and Research Fellow at RTI, with a Ph.D. in economics and a Master of Fine Arts, both from University of California at Santa Barbara. Her work focuses on analysis of health care markets, women's health, health disparities, health and place, health care utilization and outcomes, behavioral health, multilevel modeling, spatial modeling, spatial econometrics, use of geographic information systems (GIS) in medical cartography, geo-spatial database development, and socio-ecological modeling. She joined RTI in July 2001 and her work has included a geographic analysis of HIV/AIDS prevention services, development of relational databases and market analysis for several Medicare Modernization reform initiatives, analysis of spatial clustering in behavioral risk factors associated with coronary heart disease in low-income women, spatial clustering and regression analysis of access to preventive care services by the elderly, analysis of reasons why the elderly disenroll from their Medicare health maintenance organizations (HMOs), analysis of why insurance firms joined the Medicare preferred provider organization (PPO) demonstration, and analysis of how urban sprawl impacts obesity and cardiac risk in low-income women. As Principal Investigator on a National Cancer Institute (NCI) R21 innovation grant Spatial Impact Factors and Mammography Use, she developed an extensive geo-spatial database and used it to conduct analysis of the many reasons why women don't get regular cancer screening. Contextual and compositional factors in the community are strong predictors of mammography use in multilevel models including person-level and community-level factors.

Dr. Mobley is now the PI on a NCI R01 grant entitled "Geospatial Factors and Impacts: Measurement and Use," which builds on the work begun under the innovation grant and expands the database and ecological modeling to include both breast and colorectal cancer screening behaviors. The database is now available for public use via a website built by Dr. Luc Anselin (Co-PI) at the School of Geographical Sciences, Arizona State University. Dr. Mobley is also a Co-PI on an NIH R01 grant led by Dr. Gloria Bazzoli at Virginia Commonwealth University "Safety Net Hospitals and Minority Access to Health Care." In that work, Drs. Mobley and Bazzoli will utilize the geo-spatial database created under the NCI funding and employ spatial cluster analysis, distance analysis, and an innovative application of multinomial logit analysis to investigate disparities in healthcare among neighbors of different races or ethnicities in low-income neighborhoods, following closure of a nearby public hospital.

Dr. Mobley's areas of continued research interest include spatially-enabled analysis of socio-ecological problems where place and space are important. These interests include: topics in healthcare, criminology, and antitrust; behavioral modeling; health risk or outcomes simulation and prediction; resource-targeting analysis; gap or suitability analysis; and building spatial decision support systems combining databases, knowledge bases, and tools.