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Lecture 11

lecture 11

Course Code

of 3
environment: how people influence and are influenced by their environment, both physical
and human (e.g. cultural, political, social, economic)
space: container, has an objective, spiritual value
how things vary over space, and how spatial variations in one thing influence spatial
variations in other things
place: how the combination of factors found at a place make that place unique - people have
subjective attachment to places (personal perception)
What do we mean when we talk about Medical Geography or Geographies of Health?
What aspects of our lives outside of our genetic composition influence our health?
What role does where we live play on our health?
- follows different diets
- housing and sanitation
- physical environment, temperature, soil conditions, cultural aspects, beliefs
landscape: metaphor for the layers of history, social structure, and built environment that
converge in particular places (plurality of meanings, metaphorical construct)
therapeutic landscapes: places that have achieved lasting reputations for physical, mental,
and spiritual healing
- social/cultural reputations built on physical environment (e.g. spa towns)
- ethnographic vs. experiential studies
health: "a state of complete physical, mental, and social well-being and not merely the
absence of disease or infirmity" (WHO, 1947)
- absence of disease (biological)
- adaptation of an organism to a particular environment (ecological)
- social, political, economic, and spiritual well-being (social, structural, or subjective
traditional and western health systems
medicine as a cultural system
- all human groups have a set of belief, patterns of thought, perceptions of which are
consistent with their cultural systems for defining and conceptualizing disease
- different medical practices/beliefs based on theories of diseases
- internal logic variues by individuals
- the alteration of living cells or tissues that jeopardizes survival of their environment
- malfunction
- diagnosed by a physician
- located in specific organs or systems in the body
- curable through specific biomedical treatments
- the medical perspective -- observable, measurable changes in the body's structure or
* objective; destructive and harmful
* frequently lead to punitive effects on the patient because they exaggerate, simplify, and
stereotype the patient's experience
* stigmatized
* may isolate the person with the disease from the community
illness: the patient's perspective - subjective response to what has happened to the patient,
and those around them, including the meaning that they give to that event
* disease can exist without illness and vice versa
* can have no symptoms of disease but is ill
* induces psychological judgements
- multiple implications e.g. leprosy and sorcery, witchcraft, divine punishment
disease categories
infectious, transmissible, contagious, communicable: can be transmitted from person to
person, usually involves a causal agent or transmission is genetic - defined vector
degenerative, non-transmissible, non-communicable: assumed to be associated with
the aging process, tend to have a geographic component (endemic and epidemic)
epidemiology: the study of disease in populations
geographical epidemiology: the study of disease across space
global distribution of disease shows evidence of causes/determinants of disease
history of disease
- evolved through the development of epidemiology and public health
- early beliefs
-- ancient Greece - Hippocrates - first to pursue rational bases for the presence of disease
-- ancient China - Yin and Yang
-- 1800 - John Snow - identified the source of cholera (first medical geographer)
medical geography
- first applied in the 18th century to describe the relationship between disease and
- applies human geographic methods and approaches to understand spatial influences on
human health e.g. how geographical differences explain variations in disease, how changes
to the physical environment affect rates of disease
- seen to be 'traditional' - naturally occurring, culture-free, and real entity while problems
are assumed to be technical and solvable
- contemporary - notions of health, disease, and illness are problematic, and intimately
linked to complexities in society
* biomedical model of health
* focuses on the physical processes of a disease (pathology and physiology)
* does not take into account the role of social factors or individual subjectivity
health geography
* focuses on place as oppose to space or environment
* subjective aspects, does not account the role of social factors or individual subjectivity
* favours the use of both qualitative and quantitative methodologies
approaches: medical sciences, environmental sciences (ecology), social sciences
(anthropology), demography, economics, political sciences and development studies
social determinant of health: income inequality, social in/exclusion, employment and job
security, working conditions, contribution of the social economy, early childhood care,
education, food security, housing
- poverty, safe water sources
Health Geography
*environment and health *disease ecology *health care delivery
health and the environment
- impacts of high profile environmental disasters
- psycho-social impacts of living near potential or real sources of environmental
- how the environment (we live in) affects particular health behaviours
- climate change research & impacts
disease ecology
- aims to understand the temporal patterns of disease
- considers the system as a whole
- relationship between disease and the environment
practical application of geography of disease
- shows where the highest outbreaks of certain types of disease are
- affects planning of health facilities/distribution of funds
- contributes to reducing or stopping the spread of the worlds disease
* finds patterns of transmission, cures
- data: demography, socioeconomic conditions, environmental factors
- maps [incidence & prevalence]
- morbidity and morality at various geographic scales
- explores how diseases spread & identifies the location of origin
- location-allocation modelling
- determines the optimal location of current facilities
- key concepts: demand, supply, and capacity
- GIS = spatial data Æ spatial analysis Æ information
- predictions
- in health: 1. data visualization and exploration, 2. data integration, 3. monitoring
1. 2D (maps), 3D (surfaces), 4D (temporal)
- enables informed planning for disease management
2. thematic structure; map overlay; computes new information; research
3. surveillence
obstacles in health geography
- recording, accuracy, timely reports