Lecture 1
Health geography = subdiscipline of human
geography, which deals with the interaction
between people and the environment →
multidisciplinary and undertaking of health and
places.
Health can be conceptualised in many ways →
best definition: health is a dynamic state of
well-being characterised by a physical, mental
and social potential, which satisfies the demands
of a life commensurate with age, culture and personal responsibility. If the potential is
insufficient to satisfy these demands the state is disease.
→ health is relevant in wider social and cultural contexts → measured in objective (diagnosis of
diseases) and subjective (when you are feeling depressed/ill) terms.
→ can be considered in terms of individual condition of a population (FEX. public health).
Geography = study of places and the relationships between people and their environments →
places may be good or bad for health.
Hippocrates: medicine relates to seasons of the year, wind, hot and cold and the location → there
are differences between cities → places are affected differently, which influences medicine.
Medical geography looks at how diseases spread (physical manner) → health geography looks at
the previous condition and social influences (social manner) → technically they look at health
conditions, but they explain it in different ways.
- Illness: is a subjective experience → I feel ill
when I have a cold (headache).
- Disease: related to specific symptoms that are
tested at the doctor that are general.
- Sickness: determines whether a person is
entitled to treatment and economic rights,
exemption from social duties, such as work (sick
leave).
Epidemiology = basic science to public
health → deals with the incidence,
distribution and possible control of
diseases and other factors relating to the health of populations → key focus:
distribution, determinants (causes, risk factors), specified populations
(neighborhood, school, city, state, country, global).
→ incidence = number of new cases occurring within a
given time → prevalence = number of people with the
disease or illness at any point in time.
→ morbidity = sickness (disease and illness) and its causes →
mortality = death and its causes.
→ chronic = often long-lasting (heart disease and diabetes) → acute
= starts abruptly, lasts perhaps only a few days and then settles, but
may develop into a chronic condition (heart attack, stroke).
Location and place: location is fixed, becomes place when it is
charged with meaning → locations and places can refer to small or large areas (a building, city or
even an entire nation) → places can be good and bad.
, → bad: Chernobyl explosion affected people to a larger extent in southeast Europe.
→ good: therapeutic landscape = places that achieved lasting reputations for providing physical,
mental and spiritual healing → can be physical property of the place (such as water, topography)
or socially or culturally constructed → FEX. hot springs, where the water has physical healing
properties, but also has fascinating stories that mentally stimulate people.
Distance = how far are people from facilities delivering healthcare → how far from source of
pollution or infection center → places are located in relation to other places and thus relate one
place to another, allowing comparisons among places → can be a straight line or road network
distance.
Scale = spatial scale can vary from body surrounding, neighborhood,
city, region, country → health data are often aggregated in different
scales and relations observed in one scale may not be observed in other
scales.
Time = locations remain fixed over time, places change → Chernobyl
was vibrant before the explosion, but is inhabitable now → people move
into different places everyday or over the course of life, so changes
their surrounding environment → some effects of places are immediate (seasonal effects), some
are long-term (climate change effects).
Case studies:
Redlining = creating a systematic racist system → neighbourhoods were ranked from A to D with
increasing risk → these areas were marked and systematically affected black people → there was
less investment in these neighbourhoods.
BUT, correlation is not causation → people eating a lot of
cheese cannot be brought into causation of people dying
tangled in their bedsheets.
Complex, intertwined relations among health and place in
urban contexts:
majority of
population
lives in cities → are vulnerable to crises → cities are
complex, so urban health outcomes are dependent on
may interactions → urban advantage concept (urban
population is more advantaged than rural population
in terms of health outcomes).
Need a systemic approach (picture left).
5 key recommendations for healthy cities:
1. Stakeholders working in urban planning and public health should work together.
2. Health inequalities should be a key focus area.