Health geography
Encyclopedia
Health geography is the application of geographical information, perspectives, and methods to the study of health
, disease
, and health care
.
) are combined with traditional medicine
.
This alternative methodological approach means that medical geography is broadened to incorporate philosophies such as structuration
, structuralism
, social interactionism
, feminism
, et cetera. Thus the field of health geography was born.
. Death tolls rang around the clock and the people feared that they were being infected by vapors coming from the ground. John Snow
thought that if he could locate the source of the disease, it could be contained. He drew maps showing the homes of people who had died of cholera and the locations of water pumps. He found that one pump, the public pump on Broad Street, was central to most of the victims. He figured that infected water from the pump was the culprit. He instructed the authorities to remove the handle to the pump, making it unusable. After that the number of new cholera cases decreased.
The field is considered a subdiscipline of human geography
, however, it requires an understanding of other fields such as epidemiology
, climatology
.
available to all individuals. The geography of health care provision has much to do with
this. Demand for public services is continuously distributed across space, broadly in
accordance with the distribution of population, but these services are only provided at
discrete locations. Inevitably therefore, there will be inequalities of access in terms of the
practicality of using services, transport costs, travel times and so on. Geographical or
'locational' factors (e.g. physical proximity, travel time) are not the only aspects which
influence access to health care. Other types (or dimensions) of accessibility to health care except for geographical (or spatial) are social, financial and functional. Social accessibility to health care depends on race (like separate hospitals for white and black people), age, sex and other social characteristics of individuals, important here is also relationship between patient and the doctor. Financial depends upon the price of a particular health care and functional reflects the amount and structure of provided services. This can vary among different countries or regions of the world. Access to health care is influenced also by factors such as opening times and waiting lists that play an important part in determining whether individuals or population sub-groups can access health care – this type of accessibility is termed 'effective accessibility'.
The location of health care facilities depends largely on the nature of the health care
system in operation, and will be heavily influenced by historical factors due to the heavy investment costs in facilities such as hospitals and surgeries. Simple distance will be mediated by organisational factors such as the existence of a referral system by which patients are directed towards particular parts of the hospital sector by their GP
. Access to primary care
is therefore a very significant component of access to the whole system. In a 'planned' health care
system, we would expect the distribution of facilities to fairly closely match the distribution of demand
. By contrast, a market-oriented system might mirror the locational patterns that we find in other business sectors, such as retail
location. We may attempt to measure either potential accessibility or revealed accessibility, but we should note that there is a well-established pattern of utilisation
increasing with access, i.e. people who have easier access to health care
use it more often.
See also, North American Health Geographers Profiles and International Health Geographers Profiles on the Association of American Geographers, Health & Medical Geography Specialty Group web site (http://userpages.umbc.edu/~earickso/Index.html). There were over 200 profiles in this archive as of January 2009.
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
, disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
, and health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
.
Overview
Adopting a socio-ecological rather than the bio-medical model, health geography adopts a more holistic approach, emphasizing treatment of the whole person and not just components of the system. Under this model, new illnesses (e.g., mental ill health) are recognised, and other types of medicine (e.g., complementary or alternative medicineAlternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....
) are combined with traditional medicine
Traditional medicine
Traditional medicine comprises unscientific knowledge systems that developed over generations within various societies before the era of modern medicine...
.
This alternative methodological approach means that medical geography is broadened to incorporate philosophies such as structuration
Structuration
The theory of structuration, proposed by Anthony Giddens in The Constitution of Society , is an attempt to reconcile theoretical dichotomies of social systems such as agency/structure, subjective/objective, and micro/macro perspectives...
, structuralism
Structuralism
Structuralism originated in the structural linguistics of Ferdinand de Saussure and the subsequent Prague and Moscow schools of linguistics. Just as structural linguistics was facing serious challenges from the likes of Noam Chomsky and thus fading in importance in linguistics, structuralism...
, social interactionism
Interactionism
In sociology, interactionism is a theoretical perspective that derives social processes from human interaction. It is the study of individuals and how they act within society. Interactionist theory has grown in the latter half of the twentieth century and has become one of the dominant...
, feminism
Feminism
Feminism is a collection of movements aimed at defining, establishing, and defending equal political, economic, and social rights and equal opportunities for women. Its concepts overlap with those of women's rights...
, et cetera. Thus the field of health geography was born.
History of health geography
A classic piece of research in health geography was done in 1854 as a cholera outbreak gripped a neighborhood in LondonLondon
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...
. Death tolls rang around the clock and the people feared that they were being infected by vapors coming from the ground. John Snow
John Snow (physician)
John Snow was an English physician and a leader in the adoption of anaesthesia and medical hygiene. He is considered to be one of the fathers of epidemiology, because of his work in tracing the source of a cholera outbreak in Soho, England, in 1854.-Early life and education:Snow was born 15 March...
thought that if he could locate the source of the disease, it could be contained. He drew maps showing the homes of people who had died of cholera and the locations of water pumps. He found that one pump, the public pump on Broad Street, was central to most of the victims. He figured that infected water from the pump was the culprit. He instructed the authorities to remove the handle to the pump, making it unusable. After that the number of new cholera cases decreased.
Areas of study
Health geography can provide a spatial understanding of a population's health, the distribution of disease in an area, and the environment's effect on health and disease. It deals also with accessibility to health care and spatial distribution of health care providers.The field is considered a subdiscipline of human geography
Human geography
Human geography is one of the two major sub-fields of the discipline of geography. Human geography is the study of the world, its people, communities, and cultures. Human geography differs from physical geography mainly in that it has a greater focus on studying human activities and is more...
, however, it requires an understanding of other fields such as epidemiology
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...
, climatology
Climatology
Climatology is the study of climate, scientifically defined as weather conditions averaged over a period of time, and is a branch of the atmospheric sciences...
.
Geography of Health Care Provision
Although health care is a public good, it is not 'pure'. In other words, it is not equallyavailable to all individuals. The geography of health care provision has much to do with
this. Demand for public services is continuously distributed across space, broadly in
accordance with the distribution of population, but these services are only provided at
discrete locations. Inevitably therefore, there will be inequalities of access in terms of the
practicality of using services, transport costs, travel times and so on. Geographical or
'locational' factors (e.g. physical proximity, travel time) are not the only aspects which
influence access to health care. Other types (or dimensions) of accessibility to health care except for geographical (or spatial) are social, financial and functional. Social accessibility to health care depends on race (like separate hospitals for white and black people), age, sex and other social characteristics of individuals, important here is also relationship between patient and the doctor. Financial depends upon the price of a particular health care and functional reflects the amount and structure of provided services. This can vary among different countries or regions of the world. Access to health care is influenced also by factors such as opening times and waiting lists that play an important part in determining whether individuals or population sub-groups can access health care – this type of accessibility is termed 'effective accessibility'.
The location of health care facilities depends largely on the nature of the health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
system in operation, and will be heavily influenced by historical factors due to the heavy investment costs in facilities such as hospitals and surgeries. Simple distance will be mediated by organisational factors such as the existence of a referral system by which patients are directed towards particular parts of the hospital sector by their GP
General practitioner
A general practitioner is a medical practitioner who treats acute and chronic illnesses and provides preventive care and health education for all ages and both sexes. They have particular skills in treating people with multiple health issues and comorbidities...
. Access to primary care
Primary care
Primary care is the term for the health services by providers who act as the principal point of consultation for patients within a health care system...
is therefore a very significant component of access to the whole system. In a 'planned' health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
system, we would expect the distribution of facilities to fairly closely match the distribution of demand
Demand
- Economics :*Demand , the desire to own something and the ability to pay for it*Demand curve, a graphic representation of a demand schedule*Demand deposit, the money in checking accounts...
. By contrast, a market-oriented system might mirror the locational patterns that we find in other business sectors, such as retail
Retail
Retail consists of the sale of physical goods or merchandise from a fixed location, such as a department store, boutique or kiosk, or by mail, in small or individual lots for direct consumption by the purchaser. Retailing may include subordinated services, such as delivery. Purchasers may be...
location. We may attempt to measure either potential accessibility or revealed accessibility, but we should note that there is a well-established pattern of utilisation
Utilisation
In relation to access to health care services and in the terminology of Aday and Andersen, utilisation reflects the extent to which "potential access" is converted into "realised access" .-References:...
increasing with access, i.e. people who have easier access to health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
use it more often.
Health Geographers
Notable Health Geographers Include:- Jonathan Mayer
- Melinda Meade
- Ellen Cromley
- Anthony C. Gatrell
- Jim Dunn
- Robin Kearns
- Sara McLafferty
- Graham Moon
- Gerard Rushton
- Nancy Ross
- W.F. (Ric) Skinner
See also, North American Health Geographers Profiles and International Health Geographers Profiles on the Association of American Geographers, Health & Medical Geography Specialty Group web site (http://userpages.umbc.edu/~earickso/Index.html). There were over 200 profiles in this archive as of January 2009.
See also
- Cluster (epidemiology)Cluster (epidemiology)A cluster refers to a grouping of health-related events that are related temporally and in proximity. Typically, when clusters are recognized, they are reported to public health departments in the local area. The 1854 cholera outbreak which occurred in London is a classical example of a cluster...
- Complete spatial randomnessComplete spatial randomnessComplete spatial randomness describes a point process whereby point events occur within a given study area in a completely random fashion. Such a process is often modeled using only one parameter, i.e. the density of points, \rho within the defined area...
- Geographic Information SystemGeographic Information SystemA geographic information system, geographical information science, or geospatial information studies is a system designed to capture, store, manipulate, analyze, manage, and present all types of geographically referenced data...
- Modifiable Areal Unit ProblemModifiable Areal Unit ProblemThe modifiable areal unit problem is a source of statistical bias that can radically affect the results of statistical hypothesis tests. It affects results when point-based measures of spatial phenomena are aggregated into districts. The resulting summary values are influenced by the choice of...
- Spatial autocorrelation
- Spatial epidemiologySpatial epidemiologySpatial epidemiology is a subfield of health geography focused on the study of the spatial distribution of disease.-See also:General topics* Cluster * Complete spatial randomness* Geographic information system* Geographic information science...