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PubMed2003

From miasma to asthma: the changing fortunes of medical geography in America.

Historians of modern medicine often divide their subject into two parts, separated by the bacteriological revolution of the late nineteenth century, when medicine supposedly became 'scientific' for the first time. The history of medical geography--to say nothing of other subjects--calls this common view into question. At least in the United States, students of medical geography, arguably the pre-eminent medical science in an age dominated by miasmatic theories of disease, readily adapted to the discovery of germs. And although bacteriology quickly eclipsed medical geography in the world of medicine, place remained an important consideration in treating asthma (and allergies generally) throughout the post-bacteriological period.

Asthma↗
PubMed2000

Y-chromosomal diversity in Europe is clinal and influenced primarily by geography, rather than by language.

Clinal patterns of autosomal genetic diversity within Europe have been interpreted in previous studies in terms of a Neolithic demic diffusion model for the spread of agriculture; in contrast, studies using mtDNA have traced many founding lineages to the Paleolithic and have not shown strongly clinal variation. We have used 11 human Y-chromosomal biallelic polymorphisms, defining 10 haplogroups, to analyze a sample of 3,616 Y chromosomes belonging to 47 European and circum-European populations. Patterns of geographic differentiation are highly nonrandom, and, when they are assessed using spatial autocorrelation analysis, they show significant clines for five of six haplogroups analyzed. Clines for two haplogroups, representing 45% of the chromosomes, are continentwide and consistent with the demic diffusion hypothesis. Clines for three other haplogroups each have different foci and are more regionally restricted and are likely to reflect distinct population movements, including one from north of the Black Sea. Principal-components analysis suggests that populations are related primarily on the basis of geography, rather than on the basis of linguistic affinity. This is confirmed in Mantel tests, which show a strong and highly significant partial correlation between genetics and geography but a low, nonsignificant partial correlation between genetics and language. Genetic-barrier analysis also indicates the primacy of geography in the shaping of patterns of variation. These patterns retain a strong signal of expansion from the Near East but also suggest that the demographic history of Europe has been complex and influenced by other major population movements, as well as by linguistic and geographic heterogeneities and the effects of drift.

Africa, Northern↗
PubMed1986

Computer systems to support census geography.

The development of computer systems that support the geography of the census in Canada is described. The authors "present proposals for the 1991 Census that increase the level of automation, whether the geography changes or not. In addition, opportunities for change and improvement, should the geography change, are outlined. To minimize the risks involved, it is important to give these different proposals serious consideration early in the planning of a census."

Americas↗
PubMed1984

Soviet journal "Medical Geography" and its role in the development of this branch of science.

A brief review of the "Medical Geography" (USSR), the only subject abstracting journal in the world, and the main branches of the Soviet medical geography: theory and methodology, application of mathematical methods (mathematical modelling) and computers, medico-geographical cartography, nosogeography, epidemiological geography, effects of the geographical environment on the health and organization of public health, medical study in the countries are presented.

Epidemiology↗
PubMed1986

The uses of spatial analysis in medical geography: a review.

This paper is a review of how geographers and others have used spatial analysis to study disease and health care delivery patterns. Point, line, area and surface patterns, as well as map comparisons and relative spaces are discussed. Problems encountered in applying spatial analytic techniques in medical geography are pointed out. The paper is intended to stimulate discussion about where medical geography can and should go in this area of study. Point pattern techniques include standard distance, standard deviational ellipses, gradient analysis and space and space-time clustering. Line methods include random walks, vectors and graph theory or network analysis. Under areas, location quotients, standardized mortality ratios, Poisson probabilities, space and space-time clustering, autocorrelation measures and hierarchical clustering are discussed. Surface techniques mentioned are isolines and trend surfaces. For map comparisons, Lorenz curves, coefficients of areal correspondence and correlation coefficients have been used. Case-control matching, acquaintance networks, multidimensional scaling and cluster analysis are examples of methods that are based on relative or non-metric spaces. The review gives rise to the discussion of several general points: problems encountered in spatial analysis, theory building and verification, the appropriate role of technique and computer use. Some suggestions are made for further use of spatial analytic techniques in medical geography: Monte Carlo simulation of point patterns, network analysis to study referral systems and health care for pastoralists, geographic information systems to assess environmental risk, difference mapping for disease and risk factor map comparisons and multidimensional scaling to measure social distance.

Cross-Sectional Studies↗
PubMed2001

Making space for the 'intellectual' in geographies of disability.

There is a growing body of work on geographies of deinstitutionalisation and its consequences, but the weight of this scholarship has focussed on people with mental health problems and physically disabled people. With only few exceptions, the 'post asylum geographies' of intellectually disabled people remain neglected by geographers. We advocate a redressing of this imbalance. First, we assess reasons for the relative absence of 'intellectual' considerations in geographies of disability. We then consider ways in which the full spectrum of those with mental differences might be included in geographical research. We conclude that Wolpert's call 25 years ago to 'open closed spaces' is just as applicable to our efforts to conceptually link health, place, and disability, as it is to the material welfare of vulnerable groups in society.

Deinstitutionalization↗
PubMed1998

The geography of mental health in Dunedin, New Zealand.

The process of deinstitutionalization of people with chronic mental disabilities in Western countries has often produced a spatial concentration of ex-psychiatric patients, and of mental health services, in inner city urban neighbourhoods. In this paper, the geography of mental health services and patients in Dunedin is examined, and it is shown that a concentration does exist in one neighbourhood. The history and characteristics of this neighbourhood are described. The key factors in contemporary New Zealand that have generated this spatial pattern are then considered, and Dunedin's centralized mental health geography is contrasted with the North American "zone of dependence" phenomenon. The paper concludes by considering to what extent Dunedin's emergent geography of mental health provides a supportive environment for people with mental illnesses, and exploring the policy implications for health care planners and service providers.

Community Mental Health Centers↗
PubMed2006

Geography and macroeconomics: new data and new findings.

The linkage between economic activity and geography is obvious: Populations cluster mainly on coasts and rarely on ice sheets. Past studies of the relationships between economic activity and geography have been hampered by limited spatial data on economic activity. The present study introduces data on global economic activity, the G-Econ database, which measures economic activity for all large countries, measured at a 1 degree latitude by 1 degree longitude scale. The methodologies for the study are described. Three applications of the data are investigated. First, the puzzling "climate-output reversal" is detected, whereby the relationship between temperature and output is negative when measured on a per capita basis and strongly positive on a per area basis. Second, the database allows better resolution of the impact of geographic attributes on African poverty, finding geography is an important source of income differences relative to high-income regions. Finally, we use the G-Econ data to provide estimates of the economic impact of greenhouse warming, with larger estimates of warming damages than past studies.

Journal Article↗
PubMed2005

The geography of mental health: an established field?

PURPOSE OF REVIEW: The purpose of this review is to offer an outline introduction to a field of inquiry known as the geography of mental health (or mental health geographies). Since this is the first time the field has been reviewed in this journal, attention will be paid to the history of the field, not just recent findings. RECENT FINDINGS: Research has chiefly, but not exclusively, tackled (i) the spatial epidemiology of mental ill-health and (ii) the changing locational associations of mental health care. SUMMARY: This review has concentrated chiefly on contributions to this field of inquiry made by researchers with a background in the academic discipline of geography. While there are 'geographical' contributions made by workers from other disciplinary backgrounds, there is arguably something distinctive, particularly in the most recent scholarship, arising from a theorized sensitivity to the entangled relations of mental health, society, space and environment.

Journal Article↗
PubMed1976

[The geography of leukemias and hematosarcomas].

The geography of leukemias and haematosarcomas is comprised of two parts 1) The study of geographic lymphomas, Burkitt tumor, and alpha heavy chain disease. 2) The general geography of leukemias and haematosarcomas a) leukemias: variations of frequency according to the country, variations of the frequency of different forms of leukemia, temporal variations b) haematosarcomas, increased frequency in hot countries, unequal distribution of Hodgkin's disease in children and adults. Geography of animal and human leukemias. First description of "ethnologic hematology".

Animals↗
PubMed1992

[Gene pool and gene geography of the USSR population].

Gene pool and gene geography are discussed from the point of view of their conceptual history beginning from the original concept of A.S. Serebrovskiĭ (1928). Difference between the present-day gene geography and gene geography of gene pool is accentuated: the former only represents a portion of the latter. Historical and territorial integrity of the USSR population gene pool, in conjunction with its huge diversity, is the main problem being analysed by various means of computerized genetic cartography. Coupled with the gene frequency mapping, following methods were also used: mapping of average heterozygosity, of interpopulation differentiation, of principal component scores and mapping of geographical trend for each mapped genetic parameter. The work is based on 100 allelic genes and haplotypes from 30 independent loci studied on the average in 225 local populations. Statistical analysis of gene geographical maps is based on 3975 nodes of regular cartographic net for the USSR territory. The wind rose of systematic changes in the USSR gene pool has three main geographic orientations: W-E, SW-NE and S-N. At the same time, there are only two main systematic forces of gene pool evolution: the force of social history with predominant W-E orientation and the force of natural history with predominant S-N orientation of their actions. The heterozygosity level of gene pool declines strictly in accordance with the resultant in the SW-NE direction.

Alleles↗
PubMed1990

China's urban geography.

"In this paper I seek to review recent work on Chinese urban geography and to appraise the development of China's urban geography as a field of study both inside and outside China. The temporal scope will span scholarship finished and published mainly during the 1980s." The focus is on works published in English. The author examines the primary topics of interest, methodologies and theories, and available sources of data.

Asia↗
PubMed1998

Towards a theory of modern human origins: geography, demography, and diversity in recent human evolution.

The origins of modern humans have been the central debate in palaeoanthropology during the last decade. We examine the problem in the context of the history of anthropology, the accumulating evidence for a recent African origin, and evolutionary mechanisms. Using a historical perspective, we show that the current controversy is a continuation of older conflicts and as such relates to questions of both origins and diversity. However, a better fossil sample, improved dates, and genetic data have introduced new perspectives, and we argue that evolutionary geography, which uses spatial distributions of populations as the basis for integrating contingent, adaptive, and demographic aspects of microevolutionary change, provides an appropriate theoretical framework. Evolutionary geography is used to explore two events: the evolution of the Neanderthal lineage and the relationship between an ancestral bottleneck with the evolution of anatomically modern humans and their diversity. We argue that the Neanderthal and modern lineages share a common ancestor in an African population between 350,000 and 250,000 years ago rather than in the earlier Middle Pleistocene; this ancestral population, which developed mode 3 technology (Levallois/Middle Stone Age), dispersed across Africa and western Eurasia in a warmer period prior to independent evolution towards Neanderthals and modern humans in stage 6. Both lineages would thus share a common large-brained ancestry, a technology, and a history of dispersal. They differ in the conditions under which they subsequently evolved and their ultimate evolutionary fate. Both lineages illustrate the repeated interactions of the glacial cycles, the role of cold-arid periods in producing fragmentation of populations, bottlenecks, and isolation, and the role of warmer periods in producing trans-African dispersals.

Animals↗
PubMed1991

Explanation in medical geography: evidence and epistemology.

This paper discusses some basic questions about evidence, proof, argument, and explanation in medical geography. The main objective is an evaluation of the underlying epistemological robustness of the field and the cogency of its claims to possess knowledge. It is argued that the constraints imposed by inductive and deductive reasoning prevent the formulation of causal explanations of a kind likely to satisfy those potential external consumers of medical geography's output who unreflectively apply a criterion of certainty. It is suggested that all forms of empirically relevant explanation will fall short of this standard, which must, therefore be relaxed to a criterion of adequacy as developed by the American Pragmatists, especially William James.

Geography↗
PubMed2004

Conceptualising geographies of health knowledge: the emergence of new education spaces for public health.

In recent years both new knowledges and new experts have been introduced into public health as part of the development of multidisciplinary practice. This paper presents an analysis of these recent changes, which is informed by theoretical ideas around governmentality and geographies of knowledge. Although critical geographies of public health are starting to emerge the education of professionals, specifically the production and consumption of knowledges within education spaces, remains relatively unexplored. This research extends existing work by critically examining the academic instruction of professionals through the Masters in Public Health programmes. Specifically the paper argues that new spaces of education are emerging to meet the requirements of multidisciplinary practice, however there is no blueprint. Instead a geographically based diversity of practice can be observed which is characterised by enclosures of expertise wherein competing forms of public health knowledge and expert are held as ideal.

Education, Graduate↗
PubMed2006

Different public health geographies of the 2001 foot and mouth disease epidemic: 'citizen' versus 'professional' epidemiology.

Recently, there have been calls for health geographers to add critical and theoretical debate to 'post-medical' geographies, whilst at the same time informing 'new' public health strategies (Soc. Sci. Med. 50(9)1273; Area 33(4) (2002) 361). In this paper we reflect on how, alongside 'professional epidemiologies', 'citizen epidemiologies' can have credibility in informing public health policy and practice. We do this by drawing on mixed method and participatory research that used a citizens' panel to articulate the health and social outcomes of the 2001 foot and mouth disease disaster. We consider the difficulties of creating dialogue between on the one hand, time-limited, discrete, theoretical, visible and by implication legitimate, 'professional' knowledge and on the other, ongoing, holistic, experiential and often hidden 'citizen' knowledge of the foot and mouth disease epidemic. Despite significant evidence that in disaster and crisis situations, people need to be actively involved in key 'recovery' decisions (see for example At Risk Natural Hazards, People's Vulnerability, and Disasters, Routledge, London; A New Species of Trouble, Norton, New York), lay accounts, which may in themselves provide valuable evidence about the impact of the disaster, are often ignored. If health geographers are to critically inform 'new' public health policy then we need to consider research approaches that give voice to citizens' understanding of health outcomes as well as those of professionals. If 'new' public health is concerned with the material character of health inequalities, with fostering 'healthy' living and working environments, the promotion of community participation and individual empowerment (Area 33(4) (2002) 361), then we argue that situated, negotiated, everyday geographies of lay epidemiologies can and should inform public health policy.

Animal Husbandry↗
PubMed2005

Complexity theory and geographies of health: a critical assessment.

The interest of social scientists in complexity theory has developed rapidly in recent years. Here, I consider briefly the primary characteristics of complexity theory, with particular emphasis given to relations and networks, non-linearity, emergence, and hybrids. I assess the 'added value' compared with other, existing perspectives that emphasise relationality and connectedness. I also consider the philosophical underpinnings of complexity theory and its reliance on metaphor. As a vehicle for moving away from reductionist accounts, complexity theory potentially has much to say to those interested in research on health inequalities, spatial diffusion, emerging and resurgent infections, and risk. These and other applications in health geography that have invoked complexity theory are examined in the paper. Finally, I consider some of the missing elements in complexity theory and argue that while it is refreshing to see a fruitful line of theoretical debate in health geography, we need good empirical work to illuminate it.

Geography↗
PubMed2002

Changing local geographies of private residential care for older people 1983-1999: lessons for social policy in England and Wales.

The population structures of many developed countries are changing and shifts towards much older age distributions are common. One way of meeting the resulting increasing demand for long-term care is through small business private sector provision allocated through market systems. However, the private residential care sector in England and Wales demonstrates some of the potential problems of leaving long-term care to the market. During the 1980s, the private residential sector for older persons enjoyed substantial state financed support. Since the 1990 National Health Service and Care in the Community Act introduced markets in social care in 1993, homes have had to compete amongst each other for a much smaller number of clients funded by limited local authority budgets. This impacted on their business and caring operations. Based on a three-stage quasi-longitudinal survey of over 100 residential care homes in one county, this paper considers changes in the overall size and structure of a local sector, discusses the specific management strategies that have been adopted by proprietors and the development of a purchasing and providing market culture. The paper also highlights the importance of interdisciplinary perspectives on the topic by illustrating how changes in social policy can influence local and national geographies of long-term care provision and how, in turn, an understanding of these geographies can inform the sensitive implementation of future social policy initiatives.

Aged↗