Health, Bambraa 2019 x2

What is the main limitation of current research into geographical health inequalities?

It uses a narrow concept of place that undervalues political processes shaping health inequalities.

What are the two main traditional explanations for health inequalities?

Compositional and contextual explanations.

What is a compositional explanation of health?

Health differences are explained by the characteristics of individuals living in an area (e.g. income, behaviour, demographics).

What is a contextual explanation of health?

Health is shaped by the characteristics of the place itself, including environment, services, and neighbourhood quality.

What is a limitation of the contextual approach?

It mainly focuses on local neighbourhood effects and ignores wider political and economic structures.

Why is current health inequality research criticised as “micro-focused”?

It focuses on local areas and neglects macro-level political and economic influences.

What is the relational perspective in health geography?

Health results from interactions between people, place, and wider structural processes; composition and context are interconnected.

How does the relational perspective view place?

As dynamic, unbounded, and shaped by interactions rather than fixed and bounded.

How does the compositional-contextual (C-C) model view place?

As static, bounded, and separable from wider systems.

What is a key criticism of local health interventions?

They may be constrained by national fiscal policies and central government priorities.

What is the political economy of health?

The idea that health inequalities are shaped by political, economic, and power structures at multiple scales.

How do macro-structures influence health inequalities?

Through systems such as welfare state design, labour markets, economic policy, and political decisions.

What is meant by “health inequality is a political choice”?

Inequalities reflect decisions about distribution of power, wealth, and resources in society.

What does political economy argue about determinants of health?

That they are shaped by broader structural forces beyond individual control.

What does the concept of selective migration and displacement refer to?

Political and economic processes influence who moves, who is excluded, and who is displaced, affecting health outcomes.

What is the definition of politics used in this context?

The process by which scarce resources are produced, distributed, and used in society.

Why is a political economy approach needed?

Because compositional and contextual factors are themselves shaped by macro-level political and economic structures.

What is the US mortality disadvantage explained by compositional factors?

High smoking rates, high calorie intake, and high relative poverty levels.

What is a contextual explanation for poor US health outcomes?

Low social cohesion and unequal access to healthy environments.

Why is a political economy explanation needed for US mortality?

It explains underlying causes such as weak regulation, inequality, and lack of universal healthcare.

How does healthcare access contribute to US health inequality?

About 33 million people lack insurance, reducing life expectancy by around 4 years.

How does labour organisation affect US health outcomes?

Low trade union membership reduces representation of working-class interests in policy.

What is the key finding about regional health inequalities in England?

The North has about 2 years lower life expectancy than the South.

What is the health gap between East and West Germany?

Very small—only a few months for women and just over 1 year for men.

How did reunification affect health in Germany?

Economic and social improvements in the East reduced mortality differences significantly.

What political economy factor explains German health change?

State-led economic reunification policies shaped employment, income, and living conditions.

What is Glasgow’s “excess mortality” example used to show?

That health inequalities persist even when poverty levels are similar across regions.

What is a key compositional factor in Glasgow’s health inequalities?

High rates of alcohol and drug-related deaths.

What environmental/contextual factors affect health in Glasgow?

Poor housing, dereliction, overcrowding, low sunshine, and environmental degradation.

What is the political economy explanation for Glasgow’s health inequalities?

Historical housing policy, deindustrialisation, urban planning decisions, and democratic deficits.

What does “lifecourse of place” mean?

The idea that historical decisions about a place have long-term effects on health outcomes.

What is the overall conclusion about health geography and inequality?

Health is shaped by interacting local, national, and global political-economic processes, requiring both horizontal and vertical analysis.

What is a criticism of the “inequality industry”?

That some research focuses on studying inequality rather than driving real political or policy change.