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Lecture 1 : Introduction Overview. DEFINITIONS Geography Health and Illness Sub-Branches Of Medical / Health Geography DATA SOURCES DISEASE CATEGORIES SPATIAL ANALYTICAL METHODOLOGY. Geography.
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Lecture 1 : IntroductionOverview • DEFINITIONS • Geography • Health and Illness • Sub-Branches Of Medical / Health Geography • DATA SOURCES • DISEASE CATEGORIES • SPATIAL ANALYTICAL METHODOLOGY
Geography • The main concerns of Geography may be summarised by the words ‘place’, ‘space’ and ‘environment’. • Environment: How people influence and are influenced by their environment, both physical and human (i.e. cultural, poltical, social, economic). • Space: How things vary over space, and how spatial variations in one thing influence spatial variations in other things. • Place: How the combination of factors found at a place make that place unique. People’s subjective attachment to places.
Health, Disease And Illness • Health: ‘not merely the absence of disease, but a state of complete physical, psychological and social well-being’ (WHO, 1947) • However, in practice ‘health’ tends to be regarded as the absence of disease. • Disease refers to an objective ‘malfunction’ (i.e. adverse physical condition), irrespective of whether the person feels unwell (e.g. hypertension – high blood pressure). • Illness: subjective feeling of feeling unwell (‘dis-ease’), even if there are no apparent symptoms.
Sub-Branches • A distinction is sometimes made between Medical Geography and Health Geography. Health geographers tend to focus on place as opposed to space or environment. They also tend to focus on subjective aspects (e.g. illness, as opposed to disease) and tend to favour qualitative (as opposed to quantitative) methodologies. • The main division in Medical / Health Geography is between the geography of health (i.e. the causes of diseases) and the geography of health care (i.e. the provision and uptake of medical services). • The first half of this module looks at the geography of health (Dennis Pringle) and the second half looks at the geography of health care (Ronan Foley).
Data Sources • Morbidity data. Information on people diagnosed as having a disease. • Mortality data. Information on people who died from a disease. • Survey data. Information collected using questionnaires. • Interview data. Information collected from talking to people. Usually less structured but more in depth than survey data.
Disease Categories • Infectious / transmissible / contagious / communicable. Diseases that can be transmitted from person to person (or between species). Usually involve a causal agent (e.g. bacteria or virus), but transmission may be genetic. • Degenerative / non-infectious / non-transmissible / non-communicable. Traditionally assumed to be associated with the ageing process (i.e. risks increase as body degenerates with age). • The first half of this module will focus on degenerative diseases (which now account for most deaths in developed countries). The third year module focuses on infectious diseases.
Spatial Analytical Methodology • Meaning of significance. Unlikely to have occurred by chance, therefore something must be causing it. • Indices. Crude death rates / crude morbidity rates can be very misleading. Need to calculate age specific or age standardised rates. • Indications of spatial significance: extreme variations between areas; spatial autocorrelation (clustering); temporal consistency. • Hypothesis testing. If the distributions of a disease is found to be significant, then the objective is to identify possible causes – i.e. factors having a similar spatial distribution.
