Geographies of Health, Disease and Well-being

Recent Advances in Theory and Method

Mei-Po Kwan

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781134902880
• Edition: 1
• Topic: Physical Sciences
• Subtopic: Geography
• Index: Geography

This book is a collection of papers reflecting the latest advances in geographic research on health, disease, and well-being. It spans a wide range of topics, theoretical perspectives, and methodologies - including anti-racism, post-colonialism, spatial statistics, spatiotemporal modeling, political ecology, and social network analysis. Health issues in various regions of the world are addressed by interdisciplinary authors, who include scholars from epidemiology, medicine, public health, demography, and community studies. The book covers the major themes in this field such as health inequalities; environmental health; spatial analysis and modeling of disease; health care provision, access, and utilization; health and wellbeing; and global/transnational health and health issues in the global south. There is also a specially commissioned book review in addition to the chapters included in these six sections. Together, these chapters show cogently how geographic perspectives and methods can contribute in significant ways to advancing our understanding of the complex interactions between social and physical environments and health behaviors and outcomes.

This book was published as a special issue of Annals of the Association of American Geographers.

Geographies of Health, Disease, and Well-being

Mei-Po Kwan

Department of Geography and Geographic Information Science, University of Illinois at Urbana-Champaign

In the past two decades or so, geographers and researchers in cognate disciplines have significantly advanced our understanding of the geographies of health, disease, and well-being in different areas of the world (e.g., Gatrell and Elliott 2009; Brown, McLafferty and Moon 2010; Meade and Emch 2010; Pearce and Witten 2010). Various theoretical perspectives and geographic methods have been applied to study health issues (e.g., Kearns 1993; Dorn and Laws 1994; Elliott et al. 2000; Andrews and Evans 2008; Cromley and McLafferty 2011). Importantly, health scholars have re-asserted the roles of environment, place, context, and neighborhood as significant influences on health behaviors and outcomes (e.g., Jones and Moon 1993; Diez Roux 1998, 2001; Curtis and Jones 1998; Macintyre, Ellaway, and Cummins 2002; Kawachi and Berkman 2003; McLafferty 2008; Nemeth et al. 2012). It is now widely recognized that geographic variations in health, disease, and well-being cannot be explained exclusively in terms of the characteristics of individuals, as specific characteristics of place or neighborhoods (e.g., collective efficacy) also exert significant influence on health.

The fourth annual special issue of the Annals of the Association of American Geographers focuses on the geographies of health, disease, and well-being. The call for abstracts was issued in early 2010, and review of full papers and revised submissions lasted from December 2010 to March 2012. Papers were sought to address social, cultural, political, environmental, theoretical, and methodological issues related to health, disease, and well-being, including topics such as access to health care, spatial disparities in health outcomes, the effect of geographic context on health outcomes, mobility and health, environmental health, development and health, space-time modeling and geographic information systems (GIS)-based analysis of health outcomes. The purpose of the annual special issues is to publish articles that reflect the range of research contributions of geographers and scholars in cognate disciplines to contemporary issues of significant social relevance. They seek to highlight the work of geographers around an important global theme and publish articles covering a wide spectrum of the discipline in a format accessible to a wide range of readers.

The articles in the special issue (and this book) reflect some of the latest theoretical and methodological advances in geographic research on health, disease, and well-being.¹ They span a wide range of topics, theoretical approaches, and methodologies (e.g., anti-racism, post-colonialism, spatial statistics, political ecology, nature-society perspectives, biopolitics, spatial cluster analysis, social network analysis, governmentality, and spatial-temporal modeling). Many of them are highly interdisciplinary, involving researchers from disciplines like epidemiology, medicine, public health, demography, and community studies. Health issues in about fourteen countries are addressed (Bangladesh, Belize, Canada, Cuba, Ghana, India, Kenya, Mexico, Netherlands, New Zealand, South Africa, Taiwan, U.K., U.S.)

The thirty-four main chapters in this book are organized in six sections according to their main themes and the nature of their contribution: (1) health inequalities (five articles); (2) environmental health (seven articles); (3) spatial analysis and modeling of disease (seven articles); (4) health care provision, access, and utilization (seven articles); (5) health and well-being (four articles); and (6) global/transnational health and health issues in the Global South (four articles). There is also a specially commissioned book review by Melinda Meade in addition to the thirty-four main chapters. This organization, however, should be understood largely as a heuristically derived scheme, as many of the chapters address issues that cross-cut the themes of several sections and thus cannot be unproblematically assigned to any one section (e.g., McLafferty et al. (Chapter 2) and Weeks et al. (Chapter 6) examine issues of health disparities in transnational contexts; Messina et al. (Chapter 17) investigate environmental health through dynamic spatial models).

Investigations of health inequalities and their social and policy implications have been an important research theme in public health for decades. The five chapters on health inequalities highlight how geographic processes and factors affect the health and well-being of various social groups. Using a GIS-based ethnic density measure (kernel density estimation) and spatial data on mothers’ residential locations, McLafferty et al. (Chapter 2) examine infant health inequalities in New York City. The study found that in 2000, Bangladeshi immigrant women living in isolated settings and those in the highest ethnic density areas are vulnerable to poor infant health outcomes. Based on interviews with members of First Nations communities in the northern interior region of British Columbia in Canada, de Leeuw et al. (Chapter 3) found that colonial geographies and anti-Indigenous racism are important determinants of the health and well-being of the Indigenous people who live on Indian reserves in the region.

Using census data of New Zealand geocoded to local and urban area levels and multilevel modeling, Moon, Pearce, and Barnett (Chapter 4) observe that individual ethnic status and area-level deprivation are important factors shaping people’s smoking behavior. Grady and Darden (Chapter 5) examine the relationship between local racial residential segregation and infant health in Detroit, Michigan. The study found persistent effects of racial residential segregation and socioeconomic neighborhood inequality on the health of black women and their low birth weight infants when compared to white women. Using satellite imagery and census and survey data, Weeks et al. (Chapter 6) investigate the spatial and health characteristics of cities in Accra, Ghana and observe that local levels of health and well-being are closely related to the abundance of vegetation in a neighborhood.

Research on environmental health seeks to assess the influence of physical and social environments on health outcomes or behaviors. Seven chapters address this theme. Lam (Chapter 7) addresses the need to reduce errors and uncertainties in environmental health risk assessment. She identifies four major sources of uncertainties (data, methods of analysis, interpretations of the findings, and reactions to the findings) and discusses five groups of geospatial methods that can help reduce these uncertainties. Focusing particularly on studies that examine the effects of area-based attributes on individual behaviors or outcomes, Kwan (Chapter 9) articulates a fundamental methodological problem that can confound research results in significant ways: the uncertain geographic context problem (UGCoP). The chapter clarifies the nature and sources of the problem, highlights some of the inferential errors it may cause, and discusses some means for mitigating the problem. Together these two chapters discuss many important methodological issues pertinent to the study of environmental health.

Guthman (Chapter 8) and Mansfield (Chapter 10) assert the importance of the human body as a lens through which new insights about environmental health can be gained. Through a critical political ecology perspective, Guthman argues that investigations of the relationship between urban form and obesity tend to “black-box the biological body as the site where excess calories are putatively metabolized into fat and made unhealthy.” The chapter highlights some anomalies not well explained by current geographic approaches and discusses evidence from emerging biomedical research that questions these approaches to examining the relationship between obesity and health. Informed by the Focauldian perspective of biopolitics, Mansfield interrogates current approaches in public health research on contaminated seafood. She argues that the “dominant approach is one in which risk is used to secure the population by calculating the net benefits and hazards of women’s seafood consumption,” with the intention to influence women’s seafood choices.

Using three case studies as evidence, Scott, Robbins, and Comrie (Chapter 11) illustrate the coevolution dynamics of pathogen ecologies and human institutions. The study shows that mutual influence between humans and pathogens is significantly mediated by the motives and responses of individuals and institutions, and investigations of place-based contextual exposure provide only a partial explanation of disease transmission. Using data on birth defects in North Carolina, Root (Chapter 12) examines the geographic relationship between socioeconomic status (SES) and orofacial clefts (cleft lip and cleft palate) at different spatial scales. As an attempt to explore geographic and statistical methods for mitigating the modifiable areal unit problem (MAUP), the study illustrates how researchers can identify the best neighborhood size for examining such relationship using the Brown–Forsythe test. Groenewegen et al. (Chapter 13) report findings from a research program that examines the relationships between greenspace and health, focusing on three particular mechanisms: physical activity, stress reduction, and social cohesion. The results, as the authors elaborate, indicate that both the quantity and quality of greenspace in residential areas have positive impacts on people’s health (more because of stress reduction and social cohesion than physical activity).

The seven chapters on spatial analysis and modeling of disease showcase important advances in geographic methods for health research, and several of them focus on the spatiotemporal dynamics of disease transmission. Through a study of two bacterial diarrheal diseases in rural Bangladesh, Emch et al. (Chapter 14) explore how disease transmission may be mediated by kinship-based social networks and lead to variations in disease incidence beyond the effects of the local neighborhood context. The chapter concludes that simultaneous social network and spatial analysis can help us better understand disease transmission. Based on simulation of individuals’ vulnerability to influenza in an urban area in the Northeastern U.S., Bian et al. (Chapter 15) highlight the role of individuals in disease transmission and explore a model design for representing mobile, heterogeneous, and interacting individuals and their vulnerability to infectious diseases. With a focus on the effects of routine human movement on dengue transmission, Wen, Lin, and Fang (Chapter 16) examine the role of commuters in the transmission of the virus from their homes to workplaces in Tainan City, Taiwan. The chapter concludes that commuting was a significant risk factor contributing to the geographic diffusion of the epidemic and certain local neighborhood characteristics are independent facilitating factors.

Exploring spatiotemporal patterns of disease incidents can help researchers identify high-risk areas and specific disease risk factors. Through a Kenya case study, Messina et al. (Chapter 17) present a modeling framework for combining a temporally and spatially dynamic species distribution model with a dynamically downscaled regional climate model to predict tsetse populations over space and time. Using residential histories data, Wheeler, Ward, and Waller (Chapter 18) explore spatiotemporal clusters of non-Hodgkin lymphoma in four metropolitan regions in the U.S. The study found that genetic factors and exposure to polychlorinated biphenyls (PCBs) did not fully explain previously detected spatiotemporal clusters of the disease. Based on data from a sample of predominately injection drug users in Baltimore City, Tobin et al. (Chapter 19) investigate the spatial pattern of individuals who report sex exchange and who do not exchange. The results indicate spatial clustering of sex exchangers and in particular identify the high density of sex exchangers in one specific housing complex. The last chapter in this section by Beyer, Tiwari, and Rushton (Chapter 20) describes five important properties of disease maps that will lead to maps that are best for supporting public health uses. It presents an approach to implement these properties and demonstrates it with small-area data from a population-based cancer registry.

Seven chapters examine health care provision, access, and utilization from different theoretical and methodological perspectives. Drawing upon interview data from a study of long-term home care in Ontario, England and Dyck (Chapter 21) explore the lived experience of care work by migrant workers through the themes of routes, responsibilities, and respect that emphasize the embodied care work relation. The chapter shows that the experience of care workers can be understood in terms of the complex interplay among labor market inequalities, embodiment, and Ontario’s regulatory mechanisms of care provision. Based on a study of the siting of residential social service facility (“group home”) in central Massachusetts, Pierce et al. (Chapter 22) examine the role of informal development politics in generating landscapes of mental health provision that is highly uneven in socially and economically depressed areas. Results of the study highlight the need to include the social and political processes of siting in geographic analysis of mental health. Mennis, Stahler, and Baron (Chapter 23) examine how accessibility and neighborhood socioeconomic context influenced treatment continuity for a sample of drug-dependent patients at an inner city hospital in Philadelphia. The study found that a high crime rate in the patient’s home neighborhood or the hospital neighborhood and longer travel time to treatment suppress treatment continuity.

Wang (Chapter 24) provides a helpful review of recent methodological advances in the measurement, optimization, and impact of health care accessibility. The chapter suggests that the development of simplified and t...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Contents
• Citation Information
• 1 Geographies of Health, Disease, and Well-being
• 2 Ethnic Density and Maternal and Infant Health Inequalities: Bangladeshi Immigrant Women in New York City in the 1990s
• 3 With Reserves: Colonial Geographies and First Nations Health
• 4 Smoking, Ethnic Residential Segregation, and Ethnic Diversity: A Spatio-temporal Analysis
• 5 Spatial Methods to Study Local Racial Residential Segregation and Infant Health in Detroit, Michigan
• 6 Connecting the Dots Between Health, Poverty, and Place in Accra, Ghana
• 7 Geospatial Methods for Reducing Uncertainties in Environmental Health Risk Assessment: Challenges and Opportunities
• 8 Opening Up the Black Box of the Body in Geographical Obesity Research: Toward a Critical Political Ecology of Fat
• 9 The Uncertain Geographic Context Problem
• 10 Environmental Health as Biosecurity: “Seafood Choices,” Risk, and the Pregnant Woman as Threshold
• 11 The Mutual Conditioning of Humans and Pathogens: Implications for Integrative Geographical Scholarship
• 12 Moving Neighborhoods and Health Research Forward: Using Geographic Methods to Examine the Role of Spatial Scale in Neighborhood Effects on Health
• 13 Is a Green Residential Environment Better for Health? If So, Why?
• 14 Integration of Spatial and Social Network Analysis in Disease Transmission Studies
• 15 Modeling Individual Vulnerability to Communicable Diseases: A Framework and Design
• 16 Population Movement and Vector-Borne Disease Transmission: Differentiating Spatial–Temporal Diffusion Patterns of Commuting and Noncommuting Dengue Cases
• 17 Climate Change and Risk Projection: Dynamic Spatial Models of Tsetse and African Trypanosomiasis in Kenya
• 18 Spatial-Temporal Analysis of Cancer Risk in Epidemiologic Studies with Residential Histories
• 19 An Examination of Spatial Concentrations of Sex Exchange and Sex Exchange Norms Among Drug Users in Baltimore, Maryland
• 20 Five Essential Properties of Disease Maps
• 21 Migrant Workers in Home Care: Routes, Responsibilities, and Respect
• 22 Urban Politics and Mental Health: An Agenda for Health Geographic Research
• 23 Geographic Barriers to Community-Based Psychiatric Treatment for Drug-Dependent Patients
• 24 Measurement, Optimization, and Impact of Health Care Accessibility: A Methodological Review
• 25 Spatial Heterogeneity in Cancer Control Planning and Cancer Screening Behavior
• 26 Spatial Access and Local Demand for Major Cancer Care Facilities in the United States
• 27 Patterns of Patient Registration with Primary Health Care in the UK National Health Service
• 28 (Un)Healthy Men, Masculinities, and the Geographies of Health
• 29 Therapeutic Imaginaries in the Caribbean: Competing Approaches to HIV/AIDS Policy in Cuba and Belize
• 30 Producing Contaminated Citizens: Toward a Nature-Society Geography of Health and Well-Being
• 31 “We Pray at the Church in the Day and Visit the Sangomas at Night”: Health Discourses and Traditional Medicine in Rural South Africa
• 32 Critical Interventions in Global Health: Governmentality, Risk, and Assemblage
• 33 Spatial Epidemiology of HIV Among Injection Drug Users in Tijuana, Mexico
• 34 Structural Violence and Women's Vulnerability to HIV/AIDS in India: Understanding Through a “Grief Model” Framework
• 35 U.S. Migration, Translocality, and the Acceleration of the Nutrition Transition in Mexico
• 36 The Geography of Life and Death: Deeper, Broader, and Much More Complex
• Index