1,721,086 research outputs found
Health geography in New Zealand and Australia: global integration or Antipodean exceptionalism?
No full textThis paper examines the hallmarks of an emergent and distinctive Australian and New Zealand (NZ) heath geography over the last 30 years. Building on an assessment of the early development of the sub-discipline in the two countries, a review of published work reveals the co-presence of local themes alongside connections to more global perspectives associated notably with health behaviour. Further common themes are the influence of year-round exposure to outdoor spaces and the proximity of “blue spaces” to urban centres. However, there are divergences in the evolution of the sub-discipline. A comparison of attendance at the biennial International Medical Geography Symposia (held since 1985) with publications in the journal Health & Place reveal differentially globalised characters. A steady flow of international visitors and appointments to New Zealand universities as well as more apparent connections to the wider discipline of geography contrast with more applied geo-spatial and public health connections in Australian health geography
Spatial scale and the geography of tobacco smoking in New Zealand: a multilevel perspective
Full text linkSmoking in New Zealand is more common in deprived areas and in areas with a
significant Maori population. Despite its status as a major health problem there has
been little work investigating this apparent geography of smoking. Data from the
1996 Census is used to construct a multilevel ‘proportions-as-responses’ model of
smoking prevalence. This enables an exploration of the geography of smoking at
different spatial scales. Levels within the model distinguish contextual variation
between local authorities, census area units and meshblocks. Particular account is
taken of the influence of deprivation and ethnicity on smoking. Results confirm the
importance of ethnicity and deprivation and indicate that cross-level interaction
between meshblock and census area units measures is significant. They also challenge
crude stereotypes about the apparent geography of smoking and suggest that, while
levels of smoking may be high in parts of North Island, they are less high than might
be expected given the socio-demographic composition of the areas concerned.
Conversely, smoking is more prevalent than expected in parts of South Island. The
paper notes the health policy implications of these emergent geographies.<br/
The spatial structure of chronic morbidity: evidence from UK census returns
No full textBackground: Disease prevalence models have been widely used to estimate health, lifestyle and disability characteristics for small geographical units when other data are not available. Yet, knowledge is often lacking about how to make informed decisions around the specification of such models, especially regarding spatial assumptions placed on their covariance structure. This paper is concerned with understanding processes of spatial dependency in unexplained variation in chronic morbidity.Methods: 2011 UK census data on limiting long-term illness (LLTI) is used to look at the spatial structure in chronic morbidity across England and Wales. The variance and spatial clustering of the odds of LLTI across local authority districts (LADs) and middle layer super output areas are measured across 40 demographic cross-classifications. A series of adjacency matrices based on distance, contiguity and migration flows are tested to examine the spatial structure in LLTI. Odds are then modelled using a logistic mixed model to examine the association with district-level covariates and their predictive power.Results: The odds of chronic illness are more dispersed than local age characteristics, mortality, hospitalisation rates and chance alone would suggest. Of all adjacency matrices, the three-nearest neighbour method is identified as the best fitting. Migration flows can also be used to construct spatial weights matrices which uncover non-negligible autocorrelation. Once the most important characteristics observable at the LAD-level are taken into account, substantial spatial autocorrelation remains which can be modelled explicitly to improve disease prevalence predictions.Conclusions: Systematic investigation of spatial structures and dependency is important to develop model-based estimation tools in chronic disease mapping. Spatial structures reflecting migration interactions are easy to develop and capture autocorrelation in LLTI. Patterns of spatial dependency in the geographical distribution of LLTI are not comparable across ethnic groups. Ethnic stratification of local health information is needed and there is potential to further address complexity in prevalence models by improving access to disaggregated data
Health geography
No full textHealth geography is a close relative of medical geography. It shares a focus on geographical variations in health and healthcare. Its specific concern is with a social model of health and particularly with a definition of health that emphasizes positive health and wellness over death and disease. It has also been particularly concerned with health-related behaviors such as diet, drinking, smoking, and exercise and with the provision of healthcare outside medical settings. Health geography emerged from medical geography over the past 30 years and the process of emergence is continuing. It has stressed place awareness, a critical position, and an engagement with sociocultural theory, but has not always succeeded in these aims. It is particularly associated with work on therapeutic landscapes and the application of multilevel modeling techniques to the identification of area effects on healt
Space, place, and the evidence base: part II - rereading nursing environment through geographical research
No full text, the second and final article in the short health geography series, articulates how, moving beyond the models and assumptions associated with the metaparadigm of Nursing Environment, as a focused subdisciplinary approach, health geography might provide unique insights into nursing. A case study of a fictional yet somewhat typical children's hospital is presented and demonstrates some wide-ranging geographical issues and research questions (and hence potential geographical data) pertaining to nursing and the allied health professions. Indeed, this broad-brush approach is purposeful to make as many connections as possible to readers with varied theoretical, methodological, empirical, and practice expertise. In addition to the case study, to indicate further how geographical inquiry might locate quite comfortably in nursing research, the article also makes some initial and tentative connections between geography and an established nursing framework for the uptake of research evidence for practice.Although it is acknowledged that geographical inquiry should certainly never have the first call on researching the relationships between nurses and their environments, it is argued that its conceptual focus on space and place provides dedicated and detailed attention and a sound basis for a reformed, "spatialized" route to a more comprehensive understanding. Moreover, it is argued that it also demonstrates great versatility in terms of the scales and the subject matter with which it might engage. Some important issues certainly remain with respect to what might be the correct form of engagement between geographical and nursing research, but arguably, as a reformed disciplinary approach, health geography has the potential to provide a wealth of focused evidence for nursing practice
Closing Barts: community and resistance in contemporary UK hospital policy
No full textDebates concerning the nature and extent of hospital provision in London, England are longstanding. Reviews in the 1990s have focused on a perceived over-provision and recommended rationalisation. This paper explores the representations of place which emerged in the discourses surrounding the possible closure of St Bartholomew's Hospital (Barts), London. Through a discourse analysis of official and unofficial reports, Parliamentary debates, press releases, campaign material and coverage in the London Evening Standard and other newspapers, we assess resistance to closure and the construction of communities dedicated to the retention of Barts. Four different representations of Bart's are identified: as community resource, as a site of expertise, as a heritage symbol and as a site pertinent to the identities of Londoners. The effectiveness of these different strategies is considered and their positioning and use within the 'Campaign for Barts' is evaluated. We conclude that, notwithstanding the potential to present the (possibly temporary) retention of Barts as a recognition of its status as a locus of particular medical expertise, the potency of this health care facility as a symbol both of London and of medical tradition was the crucial factor in its reprieve
Twenty-five years of Health & Place: citation classics, internationalism and interdisciplinarity
Full text linkTo mark 25 years of Health & Place Health & Place, we identify and appraise some key contributions to the journal over this period. We use citation data to identify ‘classics’ from the journal's back catalogue. We also examine trends in the international reach and disciplinary homes of our authors. We show that there has been a near 7-fold increase in the number of published papers between the early and most recent years of the journal and that the journal's citation levels are amongst the top 2% of social science journals. Amongst the most cited papers, some clear themes are evident such as physical activity, diet/food, obesity and topics relating to greenspace. The profile of the journal's authors is becoming more internationally diverse, represents a broader range of disciplines, and increasingly demonstrating cross/interdisciplinary ways of working. Although Anglophone countries have led the way, there is an increasing number of contributions from elsewhere including emerging economies such as China. We conclude with some comments on likely future directions for the journal including enduring concerns such as greenspace, obesity, diet and unhealthy commodities (alcohol, tobacco, ultra-processed food) as well as more recent directions including planetary health, longitudinal and lifecourse analyses, and the opportunities (and challenges) of big data and machine learning. Whatever the thematic concerns of the papers over next 25 years, we will continue to welcome outstanding research that is concerned with the importance place makes to health
The spatial and temporal development of binge drinking in England 2001–2009: an observational study
No full textBinge drinking has been linked to escalating costs of hospitalisation and to premature mortality, and implicated in a range of acute and chronic health problems as well as crime, violence and other negative aspects of the wider well-being agenda. Variously defined, it can be characterised as brief periods of heavy drinking (across one day or evening) within a longer time-frame of lower consumption or even abstinence (across a week or several weeks). In England the current binge drinking epidemic has become particularly salient in the past decade and has been seen largely in terms of excessive consumption by younger people, particularly women in urban centres. It has also been linked to the liberalisation of licencing laws and the promotion of 24 h club cultures. This paper presents an observational study of the regional development of binge drinking between 2001 and 2009 as evidenced in the Health Survey for England. We innovate by using two different definitions of binge drinking within a multivariate multilevel modelling framework, with a focus on the random effects attributable to the year of study and region. We control for age, sex, ethnicity, marital status and individual socio-economic status, and confounding by neighbourhood deprivation and urbanisation. The paper identifies pronounced regional geographies that persist in the face of controls and vary little over time, and strong spatio-temporal gender differences which reflect the definition of binge drinking
Asylum and post-asylum geographies of psychiatric health care
No full textAsylum and post-asylum geographies are the geographies that emerged before and after the closure of large-scale residential asylums for people with various health problems. The term is generally taken to refer to the location and use of health care facilities for people with mental health problems but can also refer to provision for people with learning difficulties physical handicaps, or substance misuse problems. More rarely the term references isolation facilities for infectious disease treatment, notably tuberculosis sanatoria. The focus here is on mental health.<br/
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