Geographies of health

Human geography is the study of human activity in relation to the places and environments that people inhabit, and health geography seeks to describe and explain how health (and wellbeing, and illness and disease, and the determinants of such) varies from place to place (Gatrell & Elliott 2015; Brown et al. 2018). Places can encompass diverse settings, including the home, workplace, neighbourhood, region and country. As a result, the subject matter spans a considerable range, such as the experiences of those living at home with chronic illness, how access to resources affects the wellbeing of those living in different neighbourhoods, and regional inequalities in morbidity and mortality. Most importantly, as I hope to show in this book, relations between (and within) different nation states; the flows of people, materials and infections, along with the historical, political and economic linkages between them, are – or should be – a focus of health geographers’ attention. Geography, as a distinct discipline, should be added to Koplan et al.'s disciplinary mix.

Approaches to the study of health geography are diverse, as revealed in Gatrell and Elliott (2015: ch. 2), the breadth of essays in the collection edited by Crooks, Andrews and Pearce (2018) and the critical introduction to the subject by Brown et al. (2018). Until the 1990s geographical enquiry that focused on illness and disease was labelled “medical geography” (Mayer 2010 has an excellent overview). Although some of that research looked at the distribution of morbidity (illness) and mortality in advanced economies, other research dealt with tropical diseases such as malaria. That tradition was called “disease ecology” (Learmonth 1988) – discussed more fully below – and it explored the ways in which the incidence of disease was associated with environmental conditions. Paralleling this was a rich tradition of mapping and analysing the distribution of mortality and morbidity (as well as the spread or diffusion of disease) that led to sophisticated visualizations and spatial analysis, often linked to the use of geographical information systems.