In This Article Geography of Disease

  • Introduction
  • General Overviews
  • Journals
  • Historical Trends
  • Cancer and the Environment
  • Health Disparities and Neighborhoods
  • Health Disparities, Environmental Exposures, and Toxic Substances
  • Vector-Borne Diseases
  • Zoonoses and Wildlife
  • Spatial Dimensions of Molecular Epidemiology
  • Diseases Related to Water
  • Diseases, Weather, and Climate Change
  • Mapping and Surveillance
  • Spatial Models of Risk

Geography Geography of Disease
Marilyn O. Ruiz
  • LAST MODIFIED: 28 February 2017
  • DOI: 10.1093/obo/9780199874002-0153


Research on the geography of disease seeks to determine how health is influenced by geographical factors. Geographical investigations of the spatial variation of diseases provide important insights into what contributes to disease outcomes and options for disease prevention. When diseases occur in some places but not in others, or when disease rates vary from place to place, the characteristics that differentiate those places provide clues to etiology. When the number of cases of a disease changes across time periods, spatiotemporal analysis can reveal the direction and speed that the disease has spread, and declining disease rates may indicate the effect of preventative actions or development of immunity. Preventative actions include vaccinations, early detection and treatment, quarantine, reduction in exposure or (in the case of animals) culling. Each of these can also vary by location—thus having an impact on the local patterns of health or illness. Diseases vary dramatically, so investigations of the causal factors that lead to them are likewise varied. Biologists and ecologists, for example, often work on the transmission of vector-borne illnesses. Social scientists have been more active in neighborhood health issues and social justice. Civil and environmental engineers often investigate water-borne illnesses and conditions related to toxic exposures. Spatial epidemiologists provide a methodological core for model-based work, but significant trends in methods and theoretical frameworks come from multiple disciplines. Besides those already listed, these include geography, public health and medical sciences, environmental science, anthropology, and biostatistics. Besides accounting for the diseases themselves, investigations into the geographical drivers of diseases must account for the characteristics and dynamics of pathogens; vectors and host populations; the presence of xenobiotic chemicals; and the movement of vectors, hosts, or toxic agents. These are related to the weather and geohydrology of a region, the built and natural environment, and population differences in age and cultural and social habits. Spatial patterns are often linked to temporal factors. Seasonal differences in rainfall and temperature, patterns of movement due to sporting or religious events, and agriculture can affect disease patterns and transmission. Sometimes disease occurs only after long exposure, even skipping generations, and prior immunity, nutritional health, and genetic differences can have significant impacts on the spatial patterns of diseases. Given this variety, cross-disciplinary research is critical for research on complex disease problems. The organization and content of this article reflects an attempt to represent methodological and theoretical threads across a variety of disease systems that are all related to the geography of diseases.

General Overviews

The study of the geography of diseases involves a varied set of theoretical frameworks, multiple sources of data, and many different methods and technological approaches. On top of this, disease transmission is complex and varies significantly depending on the specific nature of the disease system of interest. The research most central to study of the geography of disease includes the work of medical geographers, disease ecologists, and spatial epidemiologists. But many other disciplines contribute to geographically oriented analyses related to particular diseases. Analyses that combine sophisticated and appropriate methods with a deep biological understanding of the disease in question are often carried out by interdisciplinary groups. For geographers with an interest in health, Meade and Emch 2010 is a standard tome that spans disease systems. Infectious diseases have been less central to geographical research in the past fifty years or so, but that has changed more recently, and infectious diseases will be reflected more thoroughly in the next edition of Meade and Emch 2010, due for publication in 2017. A practical and application-oriented text, Cromley and McLafferty 2012 offers information on methods related to measuring disease clusters and provides a wealth of case studies geared mostly toward human illnesses of public health concern. Pfeiffer, et al. 2008 is one of the few that has examples on the geography of animal diseases and is especially helpful for veterinary scientists. An online book, Burton, et al. 2011 provides a social psychology view of places and their contribution to health. The contributing authors emphasize the theoretical aspects of place and how various options for operationalizing these concepts affect the analyses. Macintyre, et al. 2002 is a more succinct view of the role of places in health and disease from the social science perspective of public health. The contributors note especially the need to go beyond purely ecological studies of spatial associations, the need for an expansion of spatial statistical techniques, the growing practice of the inclusion of geographical location fields with health data, and the need to coalesce the theoretical views of place with those of a technical bent.

  • Burton, Erlinda L. M., Stephen A. Matthews, Mai-Chui Leung, eds. Communities, Neighborhoods, and Health Expanding the Boundaries of Place. Social Disparities in Health and Health Care 1. New York: Springer, 2011.

    E-mail Citation »

    The thirteen chapters in this book were conceived originally in 2009, when a group met in Seattle, Washington, to discuss the topic of health and place. The book includes a good treatment of the theoretical frameworks related to the health of neighborhoods, and it is useful especially in providing a perspective on social justice and health inequalities.

  • Cromley, Ellen K., and Sara L. McLafferty. GIS and Public Health. 2d ed. New York: Guilford, 2012.

    E-mail Citation »

    This text provides comprehensive information about many of the same topics as are found in this article. It is a good survey of the geographical dimensions of public health topics, ranging from health-care access to disease mapping to models of infectious and vector-borne illness.

  • Macintyre, Sally, Anne Ellaway, and Steven Cummins. “Place Effects on Health: How Can We Conceptualise, Operationalise and Measure Them?” Social Science & Medicine 55.1 (2002): 125–139.

    DOI: 10.1016/S0277-9536(01)00214-3E-mail Citation »

    This foundational and widely cited paper is especially important for readers who are interested in the social science perspectives on the geography of disease. It includes a breakdown of five factors that characterize a healthy neighborhood and provides a good rationale for the selection of variables to represent neighborhood characteristics.

  • Meade, Melinda S., and Michael Emch. Medical Geography. 3d ed. New York: Guilford, 2010.

    E-mail Citation »

    From the medical geography tradition started by Jacques May. A text for both undergraduate and graduate students covering the geographical aspects of both disease ecology and health-care services.

  • Pfeiffer, Dirk, Timothy P. Robinson, Mark Stevenson, et al. Spatial Analysis in Epidemiology. Oxford: Oxford University Press, 2008.

    DOI: 10.1093/acprof:oso/9780198509882.001.0001E-mail Citation »

    This succinct text describes GIS data structures, digital mapping, spatial clustering metrics, methods to identify environmental factors related to disease, and the concept of risk. The dataset used for examples is on bovine TB in Great Britain, making this book especially useful for veterinary audiences.

back to top

Users without a subscription are not able to see the full content on this page. Please subscribe or login.

How to Subscribe

Oxford Bibliographies Online is available by subscription and perpetual access to institutions. For more information or to contact an Oxford Sales Representative click here.