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Medical Geography

Medical geography, also known as health geography, is the application of geographical methods and techniques to the study of health. Research in medical geography has as wide a reach as research in the health sciences to address issues of disability, access to health care, parasitology, the spatial distribution of cancer cases, and the diffusion of diseases.

Although studies of human-environment interactions in relation to health are among the oldest recorded in medical research (e.g., Hippocrates), medical geography has gained particular prominence today as a way to better understand health beyond the confines of the human body, by examining health in local, regional, and global contexts. The way in which this is done ranges from postmodern Foucauldian critiques of the construction of mental health and the physical design of sanatoriums to the mapping of cancer rates across cities and states. While there are many approaches adopted within medical geography, three common theoretical views are described here: (1) human ecology, (2) the structuralist interpretation, and (3) critical approaches. Subsequently, common techniques, involving geographic information systems (GIS), spatial analysis, and remote sensing, are described as they relate to the field of medical geography.

Human Ecology

The human ecology approach to medical geography proposes an understanding of health that is integrative, concerning population, behavioral, and habitat characteristics of the state of individual health. Population factors affecting health include genes, gender, and age. Stages and differences in the life course of individuals are significant determinants of health status. However, of importance to the human ecology approach is the subjugated role of genetics, where behavior and habitat rank equivalently with demographic and genetic measures in understanding health. Behavioral factors integral to understanding health include belief systems, social networks and organization, and access to technology, broadly defined. Habitat components include characteristics of the natural habitat, the built environment, and the social environment. Also important to the human ecology approach is the recognition that the factors that affect health operate at a variety of scales, microbiotic to global, and are mediated in a number of ways by social and natural environments.

The human ecology approach interweaves geography with numerous disciplines: ecology, population biology, genetics, demography, epidemiology, the social sciences, public administration and policy, urban and regional planning, and architecture and environmental design, as well as medicine and the health sciences. Rarely is it possible for research scientists to span the ecological approach with necessary attention to all its components; however, an appreciation for the larger interactions among individuals, across scales, and spanning time offers a quintessentially geographical grounding to the research.

The Structuralist Interpretation

Types and organizations of power structures have enormous implications for understanding inequities in health, vulnerabilities to disease, and lack of access to heath care. A structuralist approach to health examines the ways in which power arrangements play out on individual health. Medical geographers have adapted this approach by helping to articulate and visualize the ways in which disempowerment is shown through inequities in health across space (across countries and within countries). For example, to critique economic indicators such as national income, health metrics, such as infant mortality rates and life expectancy, are increasingly used to understand development differently.

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