What is Health Geography? Part I, 23 February 2015
Geography has a very great influence on health: people living in different areas will have different health outcomes. There are many ways to look at the relationship between geography and health, and these have changed over time. The old perspective was the of “medical geography,” which promotes a “biomedical viewpoint.” In the 1980s, naming and approach shifted to “health geography” which questions the ideas of authority inherent in healthcare. Ideas from the discipline of geography as well as other social sciences are now incorporated into the field of healthcare. Health is intimately linked to other factors in society; it is not a self-contained entity. This hybrid became “post-medical” geography.
Health geography problematizes some of the unquestioned beliefs of medical geography. This includes the assumption that doctors are “neutral,” and that factors such as gender and race are important to the provision of healthcare for various populations. Different populations are treated differently and view the system differently.
There are five strands of health geography, on a spectrum from traditional medical to most contemporary :
- Spatial patterning of disease and health: medical geography; illness is seen as a “fact”; quantitative
- Spatial patterning of service provision: government perspective; emphasis on quantitative approaches, and the utilization of healthcare; assumes that everyone acts from a “rational,” cost-driven thought process
- Humanistic approaches to ‘medical geography’: emphasis on lay rationality, qualitative approaches, and the idea that illness is socially constructed.
- Structuralist / materialist / critical approaches to ‘medical geography’: assumes inherent inequalities based on the social, political, and economic systems; incorporates Marxist critiques of capitalism; health and power cannot be separated
- Cultural approaches to ‘medical geography’: one should immerse themselves in a particular community to understand their point of view
These diverse approaches stem from fundamental differences in the understanding of humanity. These differences include the assumption of disease as “fact” rather than a function of geographical factors that affect access to healthcare; the role of place in health; the scale at which health is investigated; quantitative vs. qualitative analysis, and the centrality of social theory.
Some approaches combine multiple points of view. Often, both quantitative and qualitative analyses are combined, such as in mixed-mode analyses. The many-faceted field of health geography continues to overlap and change.