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PubMed2006

Writing place: a comparison of nursing research and health geography.

The concept of 'place', and general references to 'geographies of ...' are making gradual incursions into nursing literature. Although the idea of place in nursing is not new, this recent spatial turn seems to be influenced by the increasing profile of the discipline of health geography, and the broadening of its scope to incorporate smaller and more intimate spatial scales. A wider emphasis within the social sciences on place from a social and cultural perspective, and a wider turn to 'place' across disciplines are probably equally important factors. This trend is raising some interesting questions for nurses, but at the same time contributes some confusion with regard to imputed meanings of 'place'. While it is clear that most nurse clinicians and researchers certainly understand that place of care matters to their practices and patients, many diverse uses of 'place' are found within nursing literature, and contemporary understandings of the term 'place' within nursing are not immediately clear. It is in this context that this article plans to advance the discussion of place. More specifically, the aims of this paper are threefold: to critique 'place' as it appears in nursing literature, to explore the use of 'place' within health geography, whence notions of place and 'geographies of' have originated and, finally, to compare and contrast the use of 'place' in both disciplines. This critique intends to address a deficit in the literature, in this era of growing spatialization in nursing research. The specific questions of interest here are: 'what is "place" in nursing?' and 'how do concepts of place in nursing compare to concepts of place in health geography?'

Body Image↗
PubMed1987

Human geography in the French Institute: new discipline or missed opportunity?

The geography section of the Class of Moral and Political Sciences of the French National Institute, which was in existence from December 1795 to January 1803, responded inadequately to the theoretical challenges of Montesquieu, the hygienists, Volney, and Degérando to study thoroughly native peoples to determine the effects of physical geographic conditions on the body and mind. Most geographers had no interest in human geography, and even statistical geography received only superficial discussion. Despite the emergence of the scientific journal, only a few authors partly transcended the stereotypes of the noble-ignoble savage. The only expedition partly planned by the Institute in this period had an ambitious exploration program that precluded a linguistically sophisticated study of native peoples. Bonaparte's dissolution of the Class hindered further opportunities for studying human geography during the Empire.

Anthropology, Cultural↗
PubMed1992

Therapeutic landscapes: medical issues in light of the new cultural geography.

Employing an expanded meaning of the concept of landscape taken from the 'new' cultural geography, this paper explores why certain places or situations are perceived to be therapeutic. Themes from both traditional and recent work in cultural geography are illustrated with examples from the literature of the social science of health care. The themes include man-environment relationships; humanist concepts such as sense of place and symbolic landscapes; structuralist concepts such as hegemony and territoriality; and blends of humanist concerns, structuralist concerns, and time geography. The intention of this broad overview is to bring some particularly useful concepts developed in cultural geography to the attention of social scientists interested in matters of health and to stimulate research along new lines.

Culture↗
PubMedDate not supplied

Geographies of risk in studies linking chronic air pollution exposure to health outcomes.

This article addresses the question of how to incorporate spatial processes into the assessment of chronic health effects from air pollution exposure. An analytic framework is developed around three related concepts: (1) the geography of susceptibility; (2) the geography of exposure; and (3) points of intersection between these two, termed the geography of risk. The article discusses how each concept encompasses many lower level issues such as meteorological dispersion of pollutants, time-space activity patterns, and population distributions of susceptible individuals in time and space. A key premise is that researchers should target studies with high degrees of overlap between geographies of exposure and susceptibility. Instances where the overlap remains incomplete, or systematically biased, usually produce attenuated or unreliable risk estimates, and some of this discordance may find expression in spatially autocorrelated residuals.

Air Pollutants↗
PubMedDate not supplied

[Geography and health: themes and perspectives in Latin America].

Relations between geography and health have been recognized since ancient times. Investigation of such relations has been characterized by isolated and scant efforts. This article aims to explore potential links between geography's theoretical and methodological frame of reference and knowledge and interpretation of the population's health. It approaches the antecedents of medical or health-related geography and the use of the theoretical and methodological framework of geographic space, as well as identifying alternatives for its implementation. Finally, it raises several points relating to current development in the relations between geography and health in Latin America, as well as alternatives for such development.

Disease↗
PubMed2007

The need for the "new health geography" in epidemiologic studies of environment and health.

Growth during the past decade in what can be broadly referred to as social and environmental epidemiologic research has been an important contributor to an emerging understanding of environment and health relationships. While the incorporation of geographic information systems as well as concepts such as "neighborhoods" might be viewed as evidence of social epidemiology moving closer to health geography, I argue that the two fields are not well aligned. Health geography has much more to contribute to studies of environment and health, and attention by social epidemiologists to those potential contributions could help rectify this misalignment. This paper suggests a number of geographic perspectives on health and environment that could create useful connections between geography and public health, via social epidemiology. To illustrate this potential, I use an ongoing study of a Texas community exposed to a large petrochemical complex-an inquiry constructed in the mode of social epidemiology - as a case in point. I apply several perspectives and concepts from geography to the case study. Cultural ecology, discourse materialized, political ecology, and territoriality are used to assess the Texas City situation and suggest important types of understandings that can enhance the social epidemiology approach to environment and health. I conclude with a discussion of the prospects for a social epidemiology infused with this type of geographic thought and analysis.

Chemical Industry↗
PubMedDate not supplied

The 'three waves' of research in mental health geography: a review and critical commentary.

OBJECTIVE: To consider research conducted in the sub-field of mental health geography, concentrating on work published in English. METHODS: The paper offers an comprehensive, in-depth and critical reading of the relevant literature on mental health geography since the inception of this subfield of inquiry in the early-1970s. RESULTS: The paper identifies three 'waves' of research within work on mental health geography. It describes these 'waves' in detail, interprets certain strengths and weaknesses of the first two 'waves', which are well-established, and provides suggestions about important questions to be addressed in a future third 'wave'. CONCLUSION: Much excellent research has so far been undertaken within mental health geography, but there is scope to increase the relevance of this research through widening the focus of research and by being prepared to connect research more directly to mental health policy and politics.

Ill-Housed Persons↗
PubMed2003

Implications of SARS: medical geography and surveillance in disease detection.

OBJECTIVE: To expose pharmacy educators and practitioners to concepts of medical geography and medical surveillance. Severe acute respiratory syndrome (SARS) is used as a case example because it is an emerging infection and a prime example of the type of disease that pharmacists may encounter in daily practice (e.g., easily transmitted, resembles the common cold). DATA SOURCES: We retrieved data from publications related to medical geography, medical surveillance, and SARS. Data on current SARS cases in Hong Kong were obtained from the Hong Kong Department of Health Web site. STUDY SELECTION AND DATA EXTRACTION: Variables regarding new cases and deaths due to SARS were evaluated. DATA SYNTHESIS: Background information on medical geography and medical surveillance was reviewed. Descriptive statistics were calculated for incidence, prevalence, and the number of deaths due to SARS in Hong Kong from March 14 to May 31, 2003. CONCLUSIONS: Emerging infections are a serious concern for both the public and healthcare practitioners. The recent global diffusion of SARS highlights the ease in which diseases can diffuse from place to place. Understanding concepts related to medical geography and medical surveillance can help pharmacists be better prepared to anticipate disease diffusion and to evaluate signs of emerging infections. In turn, this can help pharmacists be better prepared to provide information and care to their patients. The long-term benefit of understanding how diseases spread and the specific activities related to disease detection is an opportunity for expanding the scope of pharmacy practice.

Canada↗
PubMed1997

["The Geography of Hunger": from regional logic to universality]

The Geography of Hunger, now the target of reflective reading 50 years after it was first published, shows the author' elegant combination of argumentative skill and scientific confidence. Josué de Castro's provocative focus is both a new way of thinking and acting towards the food and nutritional situation in Brazil and a pioneering approach to the issue of collective hunger as a geographically universal phenomenon. Based on regional specificities, the book admits that partial contributions may help establish a characteristic map of the problem's universal nature, thus helping build a different image of Brazil and the world and opening up the possibility of constructing a universal plan to combat hunger and new perspectives for those seeking to correct regional differences and overcome underdevelopment. In this book, which is also a manifesto, Josué de Castro reinterprets the role of classical geography, taking into account one of the most important explanatory dimensions, i.e., political analysis, to unveil the significance and consequences of uneven spatial development. The concepts and proposals raised by The Geography of Hunger are alive and provide essential tools for critically rethinking Brazilian reality, particularly that of the Northeast. On its fiftieth anniversary, The Geography of Hunger is more current than ever because of stimulating and disturbing message.

Journal Article↗
PubMed1995

(Re)theorising population geography.

"Population geography has become separated from other branches of human geography by not engaging strongly with recent debates in social theory. The reasons for this partly lie in the wealth of data that population geographers have available to them concerning their major interest--demographic events....A case is made here for population geographers to consider in particular three areas of social theoretic debate--social construction theories, realist ideas on extensive and intensive research, and the politics of position. Suggestions are made as to what a (re)theorised population geography might look like."

Demography↗
PubMed1985

Approaches to medical geography: an historical perspective.

This paper provides a brief account of the development of various approaches to medical geography through a tree diagram. It is possible to visually present six important aspects of medical geography through this diagram: various approaches to medical geography; the approximate time of their developments; the mother approaches from which they originated; their relationships with other approaches; scale; and extent of studies done in the past.

Epidemiology↗
PubMed1991

'Scurvy' Lind's medical geography.

The name James Lind is not one usually associated with medical geography. Yet Lind's book, An Essay on the Incidence of Diseases in Hot Climates, written in 1768, is of great importance in the development of medical geography. When Finke wrote his medical geography a quarter of a century later he quoted extensively from Lind.

Geography↗
PubMed1993

Space in its place: developing the link in medical geography.

This paper argues that a re-examination of the interrelationship between constructs of place and space is crucial to geography's involvement in the broader endeavour of health research. Place has re-emerged as nexus of ascribed meaning within contemporary social theory. Places, however, are related in space, by distance or proximity. The distinction needs to be made between this orthodox (geometric) view of space and two types of social space: the (experienced) space described by humanist geographers; and the more recent (socio-spatial) conceptualization which is both experienced and (re)produced by societal structures and advocated by social theorists in geography. We argue that advancing a recursive understanding of space and place is an appropriate direction in medical geography. This direction will include both an understanding of the ways in which space shapes the character of places and how the particularities of places resist or set in motion (orthodox) spatial processes. Illustrations are drawn from studies of mental illness and mental health care and primary health care in a remote area of New Zealand.

Cross-Cultural Comparison↗
PubMed1993

On the validity of language: speaking, knowing and understanding in medical geography.

This essay examines methodological problems concerning the conceptualization and operationalization of phenomena central to medical geography. Its main argument is that qualitative research can be strengthened if the differences between instrumental and apparent validity are better understood than the current research in medical geography suggests. Its premise is that our definitions of key terms and concepts must be reinforced throughout the design of research should our knowledge and understanding be enhanced. In doing so, the paper aims to move the methodological debate beyond the simple dichotomies of quantitative vs qualitative approaches and logical positivism vs phenomenology. Instead, the argument is couched in a postmodernist hermeneutic sense which questions the validity of one discourse of investigation over another. The paper begins by discussing methods used in conceptualizing and operationalizing variables in quantitative and qualitative research design. Examples derive from concepts central to a geography of health-care behavior and well-being. The latter half of the essay shows the uses and misuses of validity studies in selected health services research and the current debate on national health insurance.

Cross-Cultural Comparison↗
PubMed1996

Daniel Drake's medical geography.

Daniel Drake's two volume study, Principal Diseases of the Interior of North America (1850-1854), is examined in the context of the medical geographical and geographical medical literature of the period. His work covers an in-depth examination of the-geography of the interior of the continent as it relates to disease occurrence. Drake's contribution appears to have occurred independently of the then contemporary European literature. Certainly in its method of research no one up to that point had developed an approach of examining, in such detail, the relationships between geography and disease over so vast an area. Drake is another example of a physician who turned to a geographical approach to better understand disease. The question arises as to what stimulated Drake into taking this approach, and what were the opinions of his study by North American and European critics? Although in the historical development of medical geography it is a major contribution, to date no medical geographer appears to have written an in depth analysis of his work.

Epidemiology↗
PubMed2004

A Deweyan case for the study of uncertainty in health geography.

John Dewey long ago challenged the philosophical tradition by arguing that uncertainty is a central, but undertheorized, trait of existence. His challenge to philosophy is also a challenge to the social sciences, including those that focus on health. In this paper, I set out to accomplish two goals. One is to present Dewey's view on uncertainty and thereby develop an argument for an underappreciated theoretical construct. The second is to explore the congruence of uncertainty and health geography with a focus on uncertainty's meaning and validity for inquiry in a health geography context. I begin with an explication of Dewey's position on uncertainty and assess it within a larger philosophical milieu. I then discuss various implications of this view for health geography and argue that the Deweyan case for uncertainty fits the discipline well. In the final part of the paper, I share an analysis of assisted living for older persons that displays different forms of uncertainty playing important roles in the health and place experience. I conclude that Dewey's philosophical position on uncertainty is a potentially important avenue for further inquiry into health and place.

Aged↗
PubMed2001

Disease and dislocation: the impact of refugee movements on the geography of malaria in NWFP, Pakistan.

Studies of the health implications of refugee movements have generally focused on the effects of dislocation on the health of refugees and the impacts on health care provision at the destination. A somewhat more neglected aspect of the refugee-health research has been the impact of refugee flows on the geography of disease, i.e., how the spatial patterns of disease prevalence are modified through the influx and settlement of refugee populations. We examine this issue by examining the changing geography of malaria in Pakistan's North West Frontier Province (NWFP) between 1972 and 1997. Until the late 1970s, the highest incidence of malaria in the region was seen in the southern and eastern parts. During the 1980s, however, two and a half million Afghan refugees entered the NWFP and were housed in tented villages along the border and in some interior areas. As the decade progressed, there was a significant shift in the spatial pattern of malaria, with the regions of highest incidence shifting to the west and north, coinciding strongly with refugee concentrations. Our study draws attention to the manner in which refugee influx and settlement can alter the ecology of the disease system, leading to long-term changes in the geography of malaria.

Afghanistan↗
PubMed2002

Towards a more place-sensitive nursing research: an invitation to medical and health geography.

During recent years, nursing research has adopted and integrated perspectives and theoretical frameworks from a range of social science disciplines. I argue however, that a lack of attention has been paid in past research to the subdiscipline of medical geography. Although this may, in part, be attributed to a divergence between research priorities and foci, traditional 'scientific' geographical approaches may still be relevant to a wide range of nursing research. Furthermore, a recasting, redirecting and broadening of medical geography in the 1990s, towards what is termed health geography, has enhanced the discipline and provided a more cultural and expansive recognition of health, and a more comprehensive understanding of the dynamic relationship between people, health and place. Given the increasing range of places where health-care is provided and received, and some recent linkages made between nursing and place by nurse-theorists, these newer perspectives and concepts may be particularly useful for interpreting nurses' and patients' relationships both within and with a variety of healthcare settings and living spaces. Indeed, although a more place-sensitive nursing research is potentially a trans-disciplinary academic endeavor, a range of geographical approaches would be central to such a project.

Epidemiologic Methods↗