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Population, Health & Place Notes
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All lecture notes of the course Population, Health & Place (2021/2022). Taught in MSc Spatial Sciences, MSc Population Studies & MSc BA Health, amongst others.
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POPULATION, HEALTH AND PLACELECTURE NOTES
LECTURE 1: INTRODUCTION AND ORGANIZATION
Course Focus
Introduction to link between population, health and place/geography on micro and macro
level + different micro and macro level theories
Interdisciplinary course: Focus from concepts of medical/health geography, medical
demography, epidemiology, medical sociology/anthropology main focus on medical and
geographical perspective
Geographical focus on global North and South (developing + developed world)
On Friday 29th of October: deadline of the Wikipedia article for peer review. There will also
be an exam
- 15 lectures and required readings
- Written + exam both need to be passed
Written assignment: Wikipedia Article
- Write a Wikipedia article on a self-chosen topic or specific topic covered in lectures
o Explain difficult matters for general audience, critical thinking and reflection
your problem to already existing Wikipedia articles by using reliable literature,
linking + get feedback on what you wrote via peer review
o Documentation of what is known (facts), objective writing, presentation of
potential controversy and limited number of meaningful literature or data
sources different writing style than essay writing
o 5/6 references, not more
Structure of a Wikipedia article:
- Lead section, infobox, body of article, images and appendices and footnotes see
slide 10 of lecture 1. Not mandatory but recommended
- 500-800 words
Deadlines:
- Submit chosen topic at Oct 22
- First draft on Oct 29
- Submission of peer review Nov 5
- Submission of final Wikipedia article on November 12
(Grading rubric on slide 13)
Health-related issues
Case 1: Cholera outbreak in Yemen. In the western part of Yemen there was a cholera
outbreak in 2017. Mainly because due to the civil war, 14.5 million people got cut off from
regular access to clean water and sanitation
1
,Case 2: Outbreak and Spread of Zika Virus in Brazil. In end of 2014 there were first reported
cases. End 2015 there was an increasing number of infants with illness. In 2015, estimated
440k-1.3m cases in Brazil. Has spread through whole North + South America
Case 3: Covid-19.
Case 4: Mean Body Mass Index, ages 18+. In certain countries the Mean Body Mass Index is
high (>30). In Africa it is lower. In 2016, 40% of people were overweight (BMI > 25) and 11-
15% were obese. 2 billion overweight adults worldwide, 650 million obese. Increase in the
past 4 decades. Obesity/overweight kill more people than under-nutrition
Case 5: Maternal Health and Child development – Adolescent Pregnancies. This is a problem
in developing regions. Pregnancy/birth complications is cause of death for 15–19-year-old
girls. Every year, 3.9 million girls aged 15-19 years undergo unsafe abortions. Children of
adolescent mothers exhibit higher risks of school underperformance, late life health etc.
Case 6: Dementia/Alzheimer. Worldwide 55 million people with dementia, additional 10
million cases each year. Can be reduced by having a healthier lifestyle. Number of
cases/deaths differ a lot around the world
Discussion on how the health issues could be related to the characteristics of places and
population dynamics
Case 1: Yemen is a developing country with probably not the best access to water and lower
sanitary conditions. There is a desert to the western part of Yemen has higher population
density, so cholera can spread easier
Case 2: In the tropical climate, there are a lot of insects. The distribution in the city’s, suburbs
and favela’s affects the population density and access to healthcare. Houses are also much
poorer than in Holland, so hard to protect against Zika mosquitos
Case 3: Regulations of the government, access to care, access to knowledge about the virus
Case 4: Culture. A lot of obese people in the US, much of a cultural thing. In Africa there is
under-nutrition, so lower change on obesity poor/rich. In US junk food is cheap and
healthy food is more expensive than in the Netherlands for example
Links between geography and health
› Example cholera: importance of sanitation, housing, health care facilities and trained
medical staff
› Example Zika: housing situation, income, climate change, migration/mobility
› Example COVID 19: age, socioeconomic status, health behaviors, public prevention
› Example Adolescent pregnancies: education, cultural beliefs, poverty
› Example nutrition: health behavior, education, income
› Example Alzheimer: care provision, family arrangements, aging, health behaviors
Place, health and population are interlinked
Place can determine health risks
2
,Population structures/dynamics determine health risks and place characteristics
Health can determine population dynamics and development
Micro and macro level:
Micro: relates to individual level. Specific diseases or disabilities by persons (causes by
characteristics of an individual or his/her behavior). E.g. health of an individual is affected by
an agent that causes a certain condition/disease
Macro: relates to populations (cities, regions, countries), so population level. Aggregated
information of health in a population. E.g. health of a population is affected by physical or
social environment
- Social, economic and cultural environment: health care services, economic conditions
and political structures
- Living and working conditions: housing, sanitation, work environment, education
- Social and community networks: social capital, community organizations
- Individual behavior: diet, exercise, smoking
- Individual factors: age, gender, etc.
Risk factors and determinants can be clustered on the macro and/or micro level
Change in micro and/or macro level determinants can lead to individual and population level
outcomes
Coleman’s Bathtub (foundation of social theory, 1990):
How do macro level conditions relate to micro level outcomes?
How do macro level conditions lead to micro conditions, which lead to micro level outcomes?
These lead to macro level outcomes
(A and D in lecture 2,3,4) / (A and B in lecture 3,4,5) / (B and C in lecture 8,9,10)
Geographical concepts: Environment
Natural environment refers to components of the environment such as soil, air, vegetation
and water
Built environment refers to human-constructed parts of the landscape such as buildings,
dams, and roads
Social environment refers to aspects of human behavior and organization that comprise the
social structures within which we live
(Physical natural: forests, atmosphere, soil) / (Physical built: buildings, roads) / (Social:
politics, economics, culture)
Dual link between geography and health:
3
, - Spatial differences in health
- Global differences in health, e.g. Africa and Europa
- Comparison of disease rates in regions, e.g. western and eastern Europe
- Specifics of locations, slums, suburbs, favela’s, cities
- Urban-rural differences within a country
Also:
- Where you live affects your health, where you live affects the health care you get,
spread of diseases, mobility & migration and health, role of place on health
(therapeutical landscapes) and influence of health on place (e.g. selection, migration,
health behaviors, etc.)
INTERMEDIATE SUMMARY II
› Health, population dynamics and place are interlinked on the macro and/ or the micro level
› Changes on each level can determine micro and/ or macro level outcomes and conditions
› The dual link between geography, health and place refers to mutual influences that
determine macro and micro level conditions and outcomes
Geographical concepts:
- Space/location: primarily spatial definition of area
- Place: meaning and value
- Distance, spatial scale, time and environment
Examples for different approaches:
- Spatial approaches
o Assessing distribution of grocery stores by socioeconomic characteristics of
neighborhoods
o Analyzing the regional availability of medical resources on preventable
mortality
- Ecological approaches
o Impact of insecticide-treated bed nets for malaria
o Role of occupational exposure to particular matter in the development of lung
cancer among miners
- Social approaches:
o Language as a barrier to healthcare access for immigrants
o Influence of wealth disparities on global distribution of healthcare providers
o Role of community gardens as places of healing
o Importance of internet in creating spaces for interaction between physically
impaired and able-bodied teenagers
Health geography is interdisciplinary: microbiology, medicine, epidemiology, ecology,
psychology, economics and sociology all relate to health geography
New geography of health: dissatisfaction with approaches and methods in classic medical
geography. Key characteristics: adoption of socio-cultural theories, more critical perspective,
development of critical geographies, ‘place matters’, subjective experiences, qualitative
approaches and embodiment
- Power and politics of health & health care availability play a role
4
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