Health Geographies

Question 1

Medical Geographies - Mapping

Answer 1

John Snow in 1854 mapped the cases of Cholera outbreak in London making it apparent that the cases clustered around a pump in Broad (now Broadwick Street).

Question 2

Disease Ecology approach

Answer 2

• Examining the social and environmental causes of ill health
• Linked to epidemiology – the study of the distribution and determinants of disease frequency in humans
• Focus on the spatial variations of disease frequency to provide clues about the causes of disease

Question 3

Multilevel modelling

Answer 3

Type of statistical analysis that allows us to seperate out the strength of influences at different spatial levels on an outcome, such as health. It assumes that we live in a ‘hierarchy’ of areas e.g. a street sits within a neighbourhood, which sits within a city, that sits within a county and so on. This model assumes that the characteristics of each of these may have an influence on health

Question 4

Medical geo: Visualisation

Answer 4

“Visualisation in social science aims to produce graphic descriptions that accurately portray the information they purport to contain” (Dorling, 1992: 613)

Question 5

Inequalities in income relating to health

Answer 5

‘Inequalities in income both create inequalities in wealth and reduce the overall level of health and the quality of life of population as a whole’ (Dorling, 1992)
‘As income and wealth inequalities rise, so too do health inequalities. By May 2010 it had become apparent that men and women had a combined average life expectancy of 74.3 years in Glasgow compared to 88.7 in the Royal Borough of Kensington and Chelsea (2007-09 data). Therefore the gap between an affluent enclave of London and economically run-down Glasgow exceeded 14 years, a 19% difference

Question 6

dominant tendency to view ill health people

Answer 6

‘The dominant tendency has been for people to be viewed as patients, disease to be disembodied from human subjects, and for geographies of disease and health care to be reduced to dots on maps’ (Kearns and Gesler, 1998

Question 7

Change from medical to health geographies

Answer 7

World Health Organization (1957)
‘Health as a state of complete physical, mental and social well-being, and not merely the absence of disease and infirmity.
“A focus on the interactive set of relationships between a population and its social, cultural and physical environment. This contrasts with the linear and unidirectional relationships implied by the biomedical model, with its emphasis on the monocausal origins of disease” (Smith, 2000:330 – Dictionary of Human Geography)

Question 8

Health Geographies

Answer 8

• Emphasis on the subject as a person (not a patient), attention to power relations and critique of biomedical authority e.g. Foucault
• Focus on how place shapes individuals health experiences e.g. therapeutic landscapes
• Foregrounding subjective and embodied experiences and situating these within wider social/cultural aspects
• Broader definition of healthcare
• Theoretically nuanced (feminist, post-structuralist)

Question 9

Health Geographies - Gender

Answer 9

‘what women do, and where they live – as mothers, wives, daughters and paid workers, for example – has a profound effect on health status and health behaviour’ (Dyck, 2006

Question 10

Agoraphobia disease effect on gendered identities

Answer 10

Joyce Davidson (2000) looks into the impact of disease on gendered identities – feminized identities and shopping, inability – deprives women of the ability to reconstruct their identities in crucial ways

Question 11

Contemporary health messages

Answer 11

When we study contemporary health messages, for example, and notice that they urge body-practices that have traditionally been associated with femininity, most notably the conscientious monitoring of the body and behaviour that might cause bodily excess, we are also studying hegemonic gender norms’
(Moore 2010)

Question 12

Health Geographies - Gender and responsibilisation

Answer 12

concepts of reproductive and sexual embodiment as they were represented in the apps were strongly gendered, supporting norms and assumptions about male and female sexual and reproductive bodies.
Male sexuality was rendered as ideally high-performing and competitive, unrelated to reproduction

Question 13

Disease ecology

Answer 13

• Disease ecology provides an illustration of the potential for geography to unite the physical and social words.
• It is based on the concept, which May originally formulated that, for disease to occur, it is necessary for some agent and host to come into mutual contact at the same time and in the same place – it therefore becomes essential to understand the social, cultural and political factors which influence disease

Question 14

Political ecology of disease

Answer 14

• I argue in favour of a new approach to medical geography which complements existing approaches, and does not exclude other approaches. This new approach is the political ecology of disease
• Basic to the disease ecologic approach is understanding how humanity, including culture, society and behavior; the physical world, including topography, vegetation and climate, interact together in an evolving and interactive system, to produce foci of disease.
  Mayer (1996).

Question 15

Rawlings, 2008 New Labour conception

Answer 15

conception of a good citizen is an individual who looks after their own body not merely for their own sake but for the good of the nation as a whole.

Question 16

Rawlings, 2008 Blame Culture

Answer 16

blame culture that is beginning to form around the ‘legitimised’ fat discrimination in the UK is part of a more widespread aim of rationing health care provision on the NHS.
- This will impact most on those who are least able to access the networks of economic, social and cultural capital in order to maintain their health.

Question 17

Rawlings, 2008 Citizenship and Health education

Answer 17

• The UK government has felt it necessary to introduce Citizenship Education and health education in schools to enable individuals to make the ‘right’ choice.
• This study has revealed that children still often choose not to follow this advice and often resist or subvert health education messages.

Question 18

Media portrayal of the body

Answer 18

Valentine (1999) has pointed out ‘discourses in the media, medicine, consumer culture and fashion industry map our bodily needs, pleasures, possibilities and limitations to produce geographically and historically specific norms about how the space of your body should be produced.

Question 19

Pregnant bodies

Answer 19

Longhurst’s work on pregnant bodies (2000) provides examples of how bodies can become othered, partly through the power of medical discourse and medicalized lay knowledges influencing social understandings about how and where pregnant bodies should be located.

Question 20

Parr, 2002 - geographies of health

Answer 20

Geographies of health could clearly go further ‘beyond the medical’ than they have at present, to consider more widely the contemporary spaces of healthy lifestyles, health consumption practices, fitness regimes and alternative health solutions.
Second, there is currently an understated argument which proposes that geographers of health do not need to ‘do away with’ the medical, but can continue to engage with it, albeit in a more critical capacity than has been the case previously.

Question 21

Medical theory as a ‘political tool’

Answer 21

Craddock’s (1999) work on smallpox, syphilis and the Chinese population in 19th Century San Francisco demonstrates how medical knowledge helped to construct and produce Chinese bodies and their places as more diseased than the rest of the city, illuminating how medical theory can work as ‘a political tool’