Mapping Information Pathways for Breast Cancer Survivors

• In Event: Science and Technological Innovation in the Re-making of Public Policy and Governance Across Global and Local Space

Abstract

Cancer statistics (e.g., incidence and mortality) are frequently presented in map form, and mapping has long been used in public health to identify disease causality and health disparities. Such maps embed tacit assumptions about the meaning of location, boundaries, and spatial units. However, new forms of mapping are needed to address the movement of patients and information across institutional and geographic boundaries, and respond to changing patterns of care and service delivery. I consider an alternative form of mapping based on an extensive ethnography with breast cancer survivors (n=75) in a medically underserved region in southern California. Drawing on in-depth survivor interview and survey data, I traced paths of information transmission and service delivery. These maps indicate where survivors received services, how information pathways connected them from one service provider to another, and where information connections failed within a fragmented and distributed healthcare landscape. Juxtaposing individual maps as a series of small multiples (Tufte 1983) enables analysis of patterns across survivors and service sites, revealing multiple pathways in and through the labyrinth of healthcare services rather than a single standardized pathway. “Location,” then, does not signify geographic coordinates, but instead encompasses historical and material arrangements with regard to information access. This study opens up new considerations about how information can circulate more effectively within a fragmented healthcare landscape. Mapping here serves to form a new knowledge space to explore policy and/or healthcare interventions.
Research supported by the National Cancer Institute of the National Institutes of Health under Award # F31CA192478.

Author

• Deborah Lefkowitz