Geography and Health

by

Sarah Curtis

• LAST REVIEWED: 30 June 2014
• LAST MODIFIED: 30 June 2014
• DOI: 10.1093/obo/9780199756797-0121

Introduction

Health geography considers the significance for physical and mental health of interactions between people and their environment. It investigates why space and place are important for health variation in the population. Approaches in health geography are diverse, drawing on different ways of conceptualizing space, place, and health. Some geographers work with positivist concepts of causal processes that can often be researched in Euclidian space by considering patterns of variability across a large number of areas. Others conceptualize place using interactionist or phenomenological perspectives and consider space and place to be socially constructed and highly contingent on individual experience and perception. The idea of scale is often crucial, and geographers are concerned with processes operating from the global to the micro scale. Some geographical research focuses on a specific place (such as a single building, a natural setting, or a local community). Geographers are interested in concepts of embodiment and the physical and social construction of the human body as a “site” where social processes associated with health are expressed. Geographical research concerns processes operating in time as well as space, linking health over the life course with processes of human migration, environmental change, and duration of exposures to different environmental risk factors. Geography considers “health” broadly defined as physical or mental health, well-being, and health-related practices, and addresses a range of different substantive issues. These include spatial epidemiological questions of how and why human health varies from one area to another at the “ecological” (aggregated population) level. Geography also examines how individual health outcomes and health- related practices relate to one’s varying experience of (and exposure to) physical and social environments. Geographical research uses methods ranging from statistical studies using quantitative indicators of health and health determinants to qualitative techniques, including unstructured interviews or ethnographic observations. Also, “mixed methods” include participative mapping techniques, allowing individual research participants to determine the selection and interpretations of geocoded observations on the ground. Geographical Information Systems (GIS) are one of many methods used in health geography. The various themes in geography of health reviewed below show the field has evolved over time. Future developments in the field seem likely to include work to extend the concern with environmental change, globalization, and the significance of social processes and social theory for our understanding of the relationships between health and the environment.

General Overviews

Overviews of health geography show how the field has evolved over time. The following are rather broad in scope, and there are others in subsequent sections that review work on particular aspects of health and health variation. There was initially a dominant focus on “medical geography,” emphasizing research on geographical factors associated with specific diseases, as presented in Meade and Earickson 2000. Other overviews show how the field has evolved to be viewed as “health geography,” considering health and illness as socially as well as medically constructed phenomena: this is well explained, for example in Jones and Moon 1987. The overviews below also emphasize the different theoretical and methodological perspectives used in health geography discussed in Gatrell and Elliott 2009. Compendia such as Brown, et al. 2009 also represent the breadth of the field and its relevance for public health research embracing fields including disease, health, and well-being, as well as accessibility and use of services and the ways that users interact with services in different settings (all of which are considered in more detail below in this section). In addition to research on geographical factors as determinants of health, health geographers also investigate the ways that our state of health affects our experience of physical and social environments.

• Brown T., S. McLafferty, and G. Moon. 2009. A companion to health and medical geography. Chichester, UK: Wiley-Blackwell.

  DOI: 10.1002/9781444314762

  A collection of essays by leading researchers in the field, this provides an overview of major debates in geographies of health. It also includes sections on geographical perspectives on disease, health and well-being, public health, and health care, and caring.

• Gatrell A., and S. Elliott. 2009. Geographies of health. Chichester, UK: Wiley-Blackwell.

  This updates an earlier edition published by Anthony Gatrell and provides a useful introduction to the field, clearly showing how different theoretical and methodological approaches can be brought to bear on questions of health geography.

• Gesler, W., and W. Kearns. 2002. Culture place and health. Critical Geographies. London: Routledge.

  A comprehensive overview, from a health geography perspective, of the ways that theoretical and empirical knowledge of cultural and social processes help us to understand the relationships between place and health.

• Jones, K., and G. Moon. 1987. Health disease and society. London: Routledge.

  This groundbreaking book contributed to the shift in health geography from a geographical perspective on medically defined disease to a more broadly interpreted idea of health and illness as socially constructed processes. Argues for the ways that places help to constitute health and includes chapters on mental as well as physical health.

• Kearns, R., and G. Moon. 2002. From medical to health geography: Novelty, place and theory after a decade of change. Progress in Human Geography 26.5: 605–625.

  DOI: 10.1191/0309132502ph389oa

  Discusses the development of the focus on geography of health with new emphasis on themes of place and engagement with social and critical theory to complement models aligned with positivist science.

• Meade, M., and R. Earickson. 2000. Medical geography. New York: Guildford.

  This is the second edition of an important review of the field from a medical geography perspective by leading American specialists. Has a particularly strong emphasis on disease ecology and the links between geography and medicine.