A Deweyan case for the study of uncertainty in health geography

John Dewey long ago challenged the philosophical tradition by arguing that uncertainty is a central, but undertheorized, trait of existence. His challenge to philosophy is also a challenge to the social sciences, including those that focus on health. In this paper, I set out to accomplish two goals. One is to present Dewey's view on uncertainty and thereby develop an argument for an underappreciated theoretical construct. The second is to explore the congruence of uncertainty and health geography with a focus on uncertainty's meaning and validity for inquiry in a health geography context. I begin with an explication of Dewey's position on uncertainty and assess it within a larger philosophical milieu. I then discuss various implications of this view for health geography and argue that the Deweyan case for uncertainty fits the discipline well. In the final part of the paper, I share an analysis of assisted living for older persons that displays different forms of uncertainty playing important roles in the health and place experience. I conclude that Dewey's philosophical position on uncertainty is a potentially important avenue for further inquiry into health and place.     

The need for the "new health geography" in epidemiologic studies of environment and health

Growth during the past decade in what can be broadly referred to as social and environmental epidemiologic research has been an important contributor to an emerging understanding of environment and health relationships. While the incorporation of geographic information systems as well as concepts such as "neighborhoods" might be viewed as evidence of social epidemiology moving closer to health geography, I argue that the two fields are not well aligned. Health geography has much more to contribute to studies of environment and health, and attention by social epidemiologists to those potential contributions could help rectify this misalignment. This paper suggests a number of geographic perspectives on health and environment that could create useful connections between geography and public health, via social epidemiology. To illustrate this potential, I use an ongoing study of a Texas community exposed to a large petrochemical complex-an inquiry constructed in the mode of social epidemiology - as a case in point. I apply several perspectives and concepts from geography to the case study. Cultural ecology, discourse materialized, political ecology, and territoriality are used to assess the Texas City situation and suggest important types of understandings that can enhance the social epidemiology approach to environment and health. I conclude with a discussion of the prospects for a social epidemiology infused with this type of geographic thought and analysis.     

医学地理研究进展与展望

医学地理学是由多学科交叉而成的边缘学科,近期在人类生存大环境(地球环境)不断恶化,对人类健康带来一系列危害的情况下倍受关注。本文综述了医学地理研究的发展史,介绍了中国的医学地理研究动态和方向,提出疾病地理、健康地理将会成为中国近期研究的重点方向。     

Themes in British health geography at the end of the century: a review of published research 1998-2000

This paper provides a succinct overview of some recent trends in geography of health in Britain since 1998. We consider how the research we have reviewed illuminates the relationships between geographies of health and three fundamental processes which are widely recognized as being important for contemporary human geography as a whole: globalization, urbanization and polarization. We also consider the contribution of health geography to agendas in cultural geography agenda which we refer to here as 'geographies of imagination'. These perspectives all relate to dynamic and diverse processes operating in Britain and throughout the world. We explore how health geography is responding to change, and what the agenda for future research will be. By considering these themes, we also seek to show how the geography of health is contributing to a wider discourse, shared to some extent in human geography as a whole, and we discuss the themes which are likely to feature in the future health geography research agenda.     

广东省农村初保10年审评结果分析

文章运用多元方差分析等方法分析了广东省农村初保１０年审评结果及其年度变化趋势。结果发现，各个指标的分值完成率存在着不均衡性，初保得分与地理环境和经济水平有关。本文揭示，广东省广大农村地区的初级卫生保健经过１０年的努力，已取得显著的成绩，与此同时，由于初级卫生保健所固有的复杂性、动态性、艰巨性和长期性以及广东省内的地区差异，经济差异及进度的不同，广东省的广大农村地区卫生工作在可见的未来，仍需以初级卫生保健为卫生工作的龙头，在不断完善已取得的成绩基础上，将初级卫生保健不继引向深入。     

From distributions of deviance to definitions of difference: past and future mental health geographies

This paper reviews research in mental health geography that has examined landscapes of deinstitutionalisation, community care and everyday social life. It complements Philo's (1997, Across the water: reviewing geographical studies of asylums and other mental health facilities. Health and Place 3, 73-89) review of geographical studies concerned with asylums and other mental health facilities. Offering an interpretation of developments in this research sub-field, it charts a 'first wave' and a 'second wave' of inquiries, identifying shifts of substantive emphasis, theoretical approach and methodological practice. The gains and drawbacks of both 'waves' are discussed, with particular attention to absences both in what is researched and in the extent of political and policy engagement. The possible contours of a 'third wave' mental health geography, building on the strengths of earlier research but addressing new questions in new ways, are outlined in conclusion.     

“Just because they aren't human doesn't mean they aren't alive”: The methodological potential of photovoice to examine human-nature relations as a source of resilience and health among urban Indigenous youth

Photovoice has been widely used as a participatory visual research methodology within the social sciences and health research. Given photovoice's critical and pedagogical potential, its advancement within Indigenous resilience and health research has been particularly prevalent. However, it has largely failed to problematize the concept of ‘voice’ to the extent of theorizing and engaging with the ‘voices’ of other kinds of life with consequences for theory and method. In this paper we re-examine the methodological potential and utility of photovoice methods to include other-than-human ‘voices’ during the empirical study of place-making, human-nature relations, and resilience and health. We analyze photo-narratives from a community-based, participatory research project involving Indigenous youth in Saskatoon, Saskatchewan in order to revisit 1) what we did to produce those images and 2) what we saw and heard in images. Our results suggest that when photovoice methods consider a relational and affective understanding of subjective reality during research practice, they have the capacity to capture and handle other-than-human ‘voices’. Accordingly, we discuss future directions when adapting photovoice methods for the study of environmental repossession and dispossession within contested contexts of and encounters with methodological complexity, uncertainty, and emergence.     

Affect, corporeality and the limits of belonging: breastfeeding in public in the contemporary UK

The UK has some of the lowest breastfeeding duration rates in the industrialised world. This paper considers women's experiences breastfeeding in public as a factor in breastfeeding duration. Research is based on an analysis of: 11 interviews and a 46-person survey of new mothers in Southampton, Hampshire; 180 postings about breastfeeding in public on UK parenting website mumsnet; and a patent application for a 'portable lactation module'. I analyse these data through an engagement with the work of cultural theorist Sara Ahmed to argue that the 'limits of sociability' in public space in the UK can be marked through affective practice. This paper makes three unique contributions to scholarship. First, it increases understanding regarding an issue of direct importance to health policy by filling a gap in knowledge about women's experiences breastfeeding outside the home in the UK. Second, it contributes to the field of health geography by showing how affective environments can constrain health-promoting behaviours. Third, it extends conceptual work in human geography more broadly through an analysis of the relationships between affect, embodiment and urban subjectivity.     

Postcolonial theory and Canada’s health care professions: bridging the gap

In recent years there have been several calls in professional and academic journals for healthcare personnel in Canada to raise the profile of postcolonial theory as a theoretical and explanatory framework for their practice with Indigenous people. In this paper I explore some of the challenges that are likely to confront those healthcare personnel in engaging with postcolonial theory in a training context. I consider these challenges in relation to three areas of conflict. First I consider conflicts around paradigms of knowledge, wherein postcolonial theory operates from a different base from most professional knowledge in health care. Second I consider conflicts of ideology, wherein postcolonial theory is largely at odds with Canada’s political and popular cultures. And finally I consider issues around the question of Canada’s legitimacy, which postcolonial theory puts in doubt. I suggest ways in which these conflicts might be addressed and managed in the training context, and also identify potential positive outcomes that would be enabling for healthcare personnel, and might also contribute to an improvement in Canada’s relationship with its indigenous peoples.

     

New communities, new relations: the impact of community organization on health outcomes

This paper addresses the debate concerning the 'added value' of complexity theory for health care research. In particular, it considers the way in which complexity theory can enable researchers to understand the relation between whole system processes and individual, and community, health outcomes. It presents a case study of a process of sustained regeneration which took place on a severely deprived estate in West Cornwall, UK. In so doing, it seeks to add to the stock of new empirical research, upon which debates about the value of complexity theory for health care research need to be founded. It also seeks to determine whether complexity theory can facilitate the transferability of successful regeneration processes from one place, or community, to another.