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Medical Geography

Health geography is the application of geographical information, perspectives, and methods to the study of health, disease, and health care.

Medical Geography : Overview

Initially referred to as medical geography Health geography was based on the biomedical model of health and grounded in the logical positivism philosophy. The social or socio-ecological model, adopts a more holistic approach to disease and illness.

It emphasises treatment of the whole person and not just components of the system. Under this model, new illnesses (for eg. mental ill health) are recognised, and other types of medicine (for eg. complementary or alternative medicine) are combined with traditional medicine.

This alternative methodological approach meant medical geography was broadened to incorporate philosophies such as structuration, structuralism, social interactionism, feminism, et cetera. Thus the field of health geography was born.

History of health geography

A classic piece of research in health (or medical) geography was done in 1854 as cholera gripped London. Death tolls rang around the clock from church towers and the people feared that they were being infected by vapors coming from the ground. Dr. John Snow thought that, if he could locate the source of the disease, it could be contained. He drew maps showing the homes of people who had died of cholera and the locations of water pumps. He found that one pump, the public pump on Broad Street, was central to most of the victims. He figured that infected water from the pump was the culprit. He instructed the authorities to remove the handle to the pump, making it unusable. After that the number of new cholera cases decreased.

Medical Geography : Areas of study

Health geography can provide a spatial understanding of a population's health, the distribution of disease in an area, and the environment's effect on health and disease. deals also with accessibility to health care and spatial distribution of health care providers. The study is considered a subdiscipline of human geography, however, it requires an understanding of other fields such as epidemiology, climatology.

Geography of Health Care Provision

Although health care is a public good, it is not 'pure'. In other words, it is not equally available to all individuals. The geography of health care provision has much to do with this. Demand for public services is continuously distributed across space, broadly in accordance with the distribution of population, but these services are only provided at discrete locations. Inevitably therefore, there will be inequalities of access in terms of the practicality of using services, transport costs, travel times and so on. Geographical or 'locational' factors (e.g. physical proximity, travel time) are not the only aspects which influence access to health care. Other types (or dimensions) of accessibility to health care except for geographical (or spatial) are social, financial and functional. Social accessibility to health care depends on race (like separate hospitals for white and black people), age, sex and other social characteristics of individuals, important here is also relationship between patient and the doctor. Financial depends upon the price of a particular health care and functional reflects the amount and structure of provided services. This can vary among different countries or regions of the world. Access to health care is influenced also by factors such as opening times and waiting lists that play an important part in determining whether individuals or population sub-groups can access health care – this type of accessibility is termed 'effective accessibility'.

The location of health care facilities depends largely on the nature of the health care system in operation, and will be heavily influenced by historical factors due to the heavy investment costs in facilities such as hospitals and surgeries. Simple distance will be mediated by organisational factors such as the existence of a referral system by which patients are directed towards particular parts of the hospital sector by their GP. Access to primary care is therefore a very significant component of access to the whole system. In a 'planned' health care system, we would expect the distribution of facilities to fairly closely match the distribution of demand. By contrast, a market-oriented system might mirror the locational patterns that we find in other business sectors, such as retail location. We may attempt to measure either potential accessibility or revealed accessibility, but we should note that there is a well-established pattern of utilisation increasing with access, i.e. people who have easier access to health care use it more often.