This book has examined how where you live can kill you by looking at health divides at various scales – internationally, nationally, regionally and locally. It has focused on case studies of the US health disadvantage, the ‘Scottish health effect’, the North–South health divide in England and local health inequalities within the towns and cities of wealthy democracies. It has examined the historical emergence of these divisions, drawing parallels with the 19th century. It has outlined what they are like today, and how place matters in terms of a variety of different health outcomes. It has also explored the determinants of geographical inequalities in health, arguing that while place matters for health, politics matters for place. It has asserted that the fundamental determinants of health are political and arise from the unequal distribution of economic and political power. The role of politics in both increasing and reducing health divides has been examined with a particular focus on the role of neoliberalism. The book has also explored the failure of previous policies to properly tackle these issues in the context of growing social and spatial inequalities during the neoliberal era. It has also reflected on what the evidence suggests should be done to reduce the relationship between health and place. Drawing on the public health research evidence, this concluding chapter focuses on what can be learned about the political geography of life and death from past experience, what dangers the present holds for health divides and what the future might look like.

The case studies examined in this book show that health divides have waxed and waned over time as the importance of place for health has varied. This has important lessons for how health divides can be reduced and what they might be like in the future. In the 19th century, industrialism and the emergence of liberal, laissez-faire capitalism resulted in environmental, living and working conditions in which infectious disease thrived and in which population health was reduced (such as the falling life expectancies of the early- to mid-19th century), and substantial health divides between rural and urban areas, North and South, and rich and poor were produced.