Population, Health and Place – Lecture notes
Lecture 1 – Introduction
Topics related to population health
- Cholera outbreak in Yemen (2017)
o Civil war people cut off from clean water and sanitation
- Zika Virus in Brazil (2014)
o Spread to other countries over the world
- Covid 19 more than 7 million deaths
- World Obesity Epidemic
o Increase in obesity over the world
o More overnourished than undernourished people in the world
o 5 million deaths in 2019
Maternal health and child development
- A lot of births in developing regions in young girls
o Complications during pregnancy and childbirth are leading
cause of death for 15-19 year-old girls globally
o Unsafe abortions
o Higher risks in adolescent (10-19) mothers than in women 20-
24
And these children higher risks of school
underperformance etc.
Dementia and Alzheimer’s disease
- Alzheimer 60-70% of dementia cases
o Risk of Alzheimer can be reduced (lack of exercise, smoking,
depression, poor education)
Links between geography and health
- Cholera example: importance of sanitation, housing, health care
facilities, medical staff
- Zika example: housing situation, income, climate change,
migration/mobility
- Covid 19: age, socioeconomic status, health behavior, public
prevention
- Adolescent pregnancies: education, cultural beliefs, poverty
- Alzheimer: care provision, aging, health behaviors
Intermediate summary:
- Place, health and population are highly interlinked
- Place can determine health risks (infectious disease, external
shocks)
- Population structures/dynamics determine health risks and place
characteristics
- Health can determine population dynamics and development
Micro and macro level relationships the link between health and
geography
- Micro level = relates to individuals = individual level
, o Specific diseases or disabilities by persons (caused by
individual characteristics or behaviors)
- Macro level = relates to populations (cities, regions, countries) =
population level
o Aggregated information of (individual) health
Affected by physical or social environment
- Risk factors and determinants can be clustered on the macro and/or
micro level
o Change in these determinants can lead to individual and
population level outcomes
Coleman’s Bathtub
- Illustrates the relationship between the macro and micro level
, o Link 1+2 = micro level processes (how individual outcomes
are affected)
o Link 3+4 = macro level processes (how macro level outcomes
are affected)
- Geographical concepts environment (physical and social)
o Natural environment = components such as soil, air,
vegetation and water
o Social environment = aspects of human behavior and
organization within which we live
o Built environment = human-constructed parts such as
buildings and roads
- Dual link between geography, health and place mutual
infleuences that determine macro and micro level conditions and
outcomes
o Two-way influence
Place influences health
But health also influences the place (selective migration)
Geographical concepts
Space/location = primarily spatial definition of area
Place = meaning/value
Different approaches
- Spatial approaches
o Analyzing the regional availability of medical resources on
preventable mortality
- Ecological approaches
o The impact of the development of irrigation on the spread of
schistosomiasis
- Social approaches
o Language as a barrier to healthcare access for immigrants
- Interdisciplinarity
o Health geography is inherently interdisciplinary
E.g. biology, medicine, epidemiology, ecology, sociology
etc.
Geographical epidemiology relationship ill/health and
environment
Health care geography provision, access, utilization of
healthcare services
The ‘new’ geography of health dynamic relationship between health and
place (Kearns 1993)
- Key characteristics: adoption of social-cultural theories, more critical
perspective, place matters, subjective experiences, qualitative
approaches, embodiment
- More holistic approach to understand health and population
dynamics including politics, identity, social attachment,
discrimination
, o Increasing importance of multidisciplinary and individual
factors
Geographical epidemiology = the relationship between disease and the
social and physical environment
- Focus on disease spatial variations, spread and diffusion, relations
disease-spread-environment, mapping, modelling
- from geographical epidemiology to the new geography of health:
Politics of health influence of politics on health and health care
- Organization and financing of health care systems
o E.g. socialized vs private medicine
o Regulation of individual behavior
Lecture 1 – Introduction
Topics related to population health
- Cholera outbreak in Yemen (2017)
o Civil war people cut off from clean water and sanitation
- Zika Virus in Brazil (2014)
o Spread to other countries over the world
- Covid 19 more than 7 million deaths
- World Obesity Epidemic
o Increase in obesity over the world
o More overnourished than undernourished people in the world
o 5 million deaths in 2019
Maternal health and child development
- A lot of births in developing regions in young girls
o Complications during pregnancy and childbirth are leading
cause of death for 15-19 year-old girls globally
o Unsafe abortions
o Higher risks in adolescent (10-19) mothers than in women 20-
24
And these children higher risks of school
underperformance etc.
Dementia and Alzheimer’s disease
- Alzheimer 60-70% of dementia cases
o Risk of Alzheimer can be reduced (lack of exercise, smoking,
depression, poor education)
Links between geography and health
- Cholera example: importance of sanitation, housing, health care
facilities, medical staff
- Zika example: housing situation, income, climate change,
migration/mobility
- Covid 19: age, socioeconomic status, health behavior, public
prevention
- Adolescent pregnancies: education, cultural beliefs, poverty
- Alzheimer: care provision, aging, health behaviors
Intermediate summary:
- Place, health and population are highly interlinked
- Place can determine health risks (infectious disease, external
shocks)
- Population structures/dynamics determine health risks and place
characteristics
- Health can determine population dynamics and development
Micro and macro level relationships the link between health and
geography
- Micro level = relates to individuals = individual level
, o Specific diseases or disabilities by persons (caused by
individual characteristics or behaviors)
- Macro level = relates to populations (cities, regions, countries) =
population level
o Aggregated information of (individual) health
Affected by physical or social environment
- Risk factors and determinants can be clustered on the macro and/or
micro level
o Change in these determinants can lead to individual and
population level outcomes
Coleman’s Bathtub
- Illustrates the relationship between the macro and micro level
, o Link 1+2 = micro level processes (how individual outcomes
are affected)
o Link 3+4 = macro level processes (how macro level outcomes
are affected)
- Geographical concepts environment (physical and social)
o Natural environment = components such as soil, air,
vegetation and water
o Social environment = aspects of human behavior and
organization within which we live
o Built environment = human-constructed parts such as
buildings and roads
- Dual link between geography, health and place mutual
infleuences that determine macro and micro level conditions and
outcomes
o Two-way influence
Place influences health
But health also influences the place (selective migration)
Geographical concepts
Space/location = primarily spatial definition of area
Place = meaning/value
Different approaches
- Spatial approaches
o Analyzing the regional availability of medical resources on
preventable mortality
- Ecological approaches
o The impact of the development of irrigation on the spread of
schistosomiasis
- Social approaches
o Language as a barrier to healthcare access for immigrants
- Interdisciplinarity
o Health geography is inherently interdisciplinary
E.g. biology, medicine, epidemiology, ecology, sociology
etc.
Geographical epidemiology relationship ill/health and
environment
Health care geography provision, access, utilization of
healthcare services
The ‘new’ geography of health dynamic relationship between health and
place (Kearns 1993)
- Key characteristics: adoption of social-cultural theories, more critical
perspective, place matters, subjective experiences, qualitative
approaches, embodiment
- More holistic approach to understand health and population
dynamics including politics, identity, social attachment,
discrimination
, o Increasing importance of multidisciplinary and individual
factors
Geographical epidemiology = the relationship between disease and the
social and physical environment
- Focus on disease spatial variations, spread and diffusion, relations
disease-spread-environment, mapping, modelling
- from geographical epidemiology to the new geography of health:
Politics of health influence of politics on health and health care
- Organization and financing of health care systems
o E.g. socialized vs private medicine
o Regulation of individual behavior
