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MIDTERM EXAM REVIEW GGRB28 LECTURE 02 – THEORIES AND APPRAOCHES Definitions of Health  Bio-Medical/Western o Absence of disease o All about treatment not prevention o Measured by its absence  Holistic Model o Takes person as a whole o Health is a state of complete mental and social well being o The person as a whole  Wellness Model o Health is a resources for everyday life o Emphasizes social/personal resources and physical capabilities o Health is a resource you draw on to get through things (like a tool kid)  Social Determinants of Health o Social factors that help you in health o Always changing, each society different s.d.o.h Illness/disease  Illness: subjective experience of person – how someone feels o Holistic model  Disease: diagnosis of recognized symptoms o Bio-medical model Measuring Health  Mortality  Morbidity: sickness/illness  Prevalence/Incidence o I: # of new cases w/in given time interval (what we will have) o P: # of people with the disease at one point in time (what we have right now)  Chronic: long-lasting, life long  Acute: starts suddenly, last only a few days  Infectious: cause by organisms that can move between people  Impairment/Disability o I: having a defective or missing body part o D: socially or culturally constructed of exclusion Quantitative vs. Qualitative  Qual : explaining or seeking experiences  Quant: take/make findings and apply it to population Geographical Concepts  Location: fixed point/geographic area, no meaning  Space: absolute space, independent of whatever occupies it  Place: a location w/a specific identity/meaning  Distance: relates one place to another o Distance decay: the further away you are from one place the less likely you are to use it  Scale: micro to the macro – different levels impact our health Geographic Approaches  Positivist o Quantitative and objective o Requires objectivity and truth o Studies adopts a Biomedical perspective: type of questions you’re asking are in the understanding of health in the absence of disease  Humanist/Social Internationalist o Emerged as a challenge of positivism 1 MIDTERM EXAM REVIEW GGRB28 o Emphasize humans as decision makers: they way they perceive their world, land, landscapes and regions o Studies adopt holistic approach: looking at the persons feelings along with the conditions they have o Qualitative  Structuralist o Emphasis on macro political and economic system o Social context matter- not individual level o Agency of individual is lacking  Post-Structuralist/Post Modern o Power relations: who has it and who doesn’t o Difference or “otherness”: what does it mean to be a woman o The body: how its understood socially- how can you manipulate your body to pull into different power bases Kearns  Move form medical geography to health geography  Advocated medical geography to engage with new social theory  Began debate within the field o Where theory comes into place o Health geography you see a variety of approaches 2 MIDTERM EXAM REVIEW GGRB28 LECTURE 03 –GEOGRAPHICAL IMAGINATIONS Geographical Imaginations  Derek Gregor  Spatialized, cultural and historical knowledge that characterize social groups o In an area (space), the things you know in culture like how to use a knife and spoon (type of knowledge), and how that characterizes social groups (how we define that group by cultural or historical knowledge/how its related to people) Doreen Massey  The way we understand a space may not be the same as another person does (map of Toronto) Said’s Orientalism  Argues that there is a group of assumptions that western thinkers had of the east and these stereotypes brought colonialism o West = masculine/rational and it was seen as a duty to help the east o East = feminine/irrational and exotic usually used to represent them  Geographical imaginations can alter our actions and effects of our actions Treichler  Blaming cultural theory – we have to look at other factors  Aids was being framed in academic conferences  People assumed all of Africa was the same and were ignoring the differences/impacts  Argued too much focus on culture as defining reason for Aids affecting Africa  Africans were seen as victims + many stereotypes  African gov’t wasn’t doing much  As a result of stereotypes we only looked at research in one way  Quantitative methods – a lot of early work was number based (skewed pictures)  Teleology: grand narratives: how we understand a place Farmer’s Geographies of Blame  U.S believed Aids came from Haiti to the U.s  3 main stereotypes o Haitian immigrants were seen as dirty, uneducated, living in high poverty areas o Practices voodoo: blood rituals o Descendants of African slaves  Haiti is not in Africa  Farmer argues Aids did not come from Haiti 1. American phase: sex tourism (tourist from outside came inside and had gay relationships in the cities) 2. Feminization of the urban: women came to urban cities to work and many were infected 3. Ruralisation: movement from the city to rural areas  People in city who came to look for work went back  Through mobile/truck drivers/ soldiers Simon-Kumar  Asian women and their sexual health in New Zealand o Younger Asian women were having higher abortion rates  Abortions more widely accepted in Asian cultures  Asian women were culturally passive and adhered to cultural understandings  Argument: women went to school/work had relationships w/NZ men b/c they weren’t educated in their culture  Thought as promiscuous  Clash of cultures o Non-critical understanding of worships in NX media o Public discourse affects policy  Conclude: young A women not having more abortions – geographic imaginations are around Asian cultures 3 MIDTERM EXAM REVIEW GGRB28 LECTURE 04 –GLOBALIZATOIN AND INEQUALITIES Globalization  Increase connections between people and places due to o Transportation technology: get farther faster o Advance communication technology: phones, Skype, world seems smaller  Rising global inequalities o Multinational corporations outsource: head office in one place, manufacturer in another o Smaller farmers can’t compete, move to city to look for work, paid less due to amount of people looking for work  Turn towards the market o State is responsible for the population – health, education, wellbeing o Turn towards the market: state is reducing spending, pulling back on services o Focus less on social welfare Packard  Two main points a. Social and economic determinants are important to health b. “Global health’ policy is similar form the colonial period to today  Colonial: health policy came from traditional colonial policies and filtered down o Most concerned with tropical medicine (colonies were located in tropics) o Health was motivated by colonial interest. Only got medical treatment if  Colonial Ministries  Direct contact with ministers o Served western interests o Technocratic: not looking at the cause, just at the vector and finding a cheap solution o Health = urban areas o Racial Segregation: white colonial masters o Traditional healers: anything other than medicine was hearsay o Biomedical/western model  Post-war: death of colonialism, don’t have money/infrastructure to run colonies o Expansion of health to wider population o Rise of global interest o Still technocratic o Internalization o Communism on the rise: division between non and communist states  Power still lies in same countries that were in control in colonial era  Post-colonial: o “Development” and “experts” o Foreign aid  Most colonies became independent (colonial powers left) but some struggled  Helped by foreign aid = link development to health. Had to create healthy population to create need for product  Still needed ex-colonies to be productive need people to buy products o Continued internalization o Still technocratic – still seeing these offers are being offered by developed to developing countries, power is still in those countries and information is still transferring in one way o Some significant health improvements  Childhood mortality rates decrease (b/c of immunization)  Polio illustrates that tech. process work to an extent Colonial Medicine  Countries themselves providing aid to each other Farmer  Travels between US and Haiti  “Appropriate” Technology: population should only be given tech they can use and should be satisfied at that level  Hypocritical to impose universal market models but not “impost standards of care” 4 MIDTERM EXAM REVIEW GGRB28 o Just b/c you’re born living in Haiti does not mean that you’re automatically screwed over. For farmer it’s a universal right and an obligation for those that have that technology to provide it to those countries. If we are going to use them, their resources and bodies to further our countries, we should be giving back to them. Sees social and economic determinants of health very important.  Links between poverty and health o Poverty is underlying social determinant – if you get people out of poverty it improves heath o Look at poverty by looking at social conditions (access to clean water)  Structural violence o Farmer is a structuralist (looks at larger political, econ, social system and how they effects health) o How these systems structure polices through violence on people o Limiting access or not provided resources to people o Using S.V to look at health rights o We have to look at structures and how they limit health care Global Women  Changing and non-changing gender roles o How they affect movement of women globally and position of society globally  Feminization of migration o Women are now the women’s migrating for work – leaving kids behind o Work women traditionally do are in demand in globalized world  Care deficit
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