health geog // history, what is health

In 400 BC, Hippocrates writes ________, which proposes theories about how ______ shapes health. Considered to be the _____ of health geography

On Airs, Waters, and Places, place, roots

what theory dominated pre-19th century thinking about how disease is caused…when was this theory abandoned?

miasma theory, which posited that disease was caused by a poisonous vapor or mist filled with particles from decomposed matter (miasmata) and was identifiable by foul smell. theory abandoned in mid 1800s in favor of the germ theory

Germ theory

first major paradigm shift in health history, posited that microbes caused disease. pioneers included Louis Pasteur (fermentation guy), Robert Koch (identified bacteria that caused a few diseases) and John Snow

John Snow + London cholera outbreak

“father of modern epidemiology,” suspected that the cholera outbreak in London in 1854 was due to contaminated water. he mapped pump locations in London and compared this with clusters of mortality to prove this theory

20th century challenges with disease

development of widely available antibiotics and insecticides after WWII…less focus on infectious diseases as there is a rise in complex chronic diseases like heart disease and diabetes…complex etiologies need new theories because germ theory no longer fits  

Medical geography emerges in the ______ with the help of the “father of epidemiology” in the United States ______

1950s, Jacques May. He wondered why patients in Vietnam responded differently to disease/treatment then European patients and produced the first maps of global disease distributions in the “Atlas of Diseases”

In the 1970s-80s there are two main schools of health geography: ______ and _______

disease ecology and health services

disease ecology

looks at the production of disease as being a combo of pathogens, host, and environment

health services

used to be no planning of where to put health services so in the 70s-80s they were like oh shit we should probably plan a little

in the ______, medical geography transitions into _______

1990s, health geography

3 broad themes of modern health geography

social theory, social determinants, and systems landscapes

what should i take away from health histoy?

health geography has ancient roots linked to place and has evolved through time as causes of disease changed (from primarily infectious to complex). today, health geography focuses on how place and space shapes health

define health geography

Subdiscipline of human geography, which deals with the interaction between people and the environment. Conceptualizes the role of place, location and geography in health, well-being and disease…BUT it’s difficult to define because of political, cultural, and personal factors

disease

a condition that disrupts normal bodily function or structure, often characterized by specific symptoms or signs

illness

subjective experience of feeling unwell or unhealthy

impairment

restricted general physical or mental function that do not necessarily limit daily activities

disability

a physical, mental, or sensory impairment that significantly limits one or more major life activities

WHO defines health…

A state of complete physical, mental and social well‐being and not merely
the absence of disease or infirmity

why is it so hard to define health

it’s an abstract concept, the absence of health is much easier to define and measure, it can be both personal and political, and it costs money to have

health as a social construct

Barbara Ellen Smith’s Black Lung: The Social Production of Disease (1977) — be able to summarize/explain

what is a MODEL OF HEALTH

concenptual framework to understand health. they include biomedical, disease ecology, behavioral, biopsychosocial, and socio-ecological 

biomedical model of health

health is the presence or absence of biological/physiological factors and processes

biomedical model approaches

evidence based approaches, scientific methods, diagnostic testing

biomedical model criticisms

Under-appreciation of psychological, social, environmental
influences

disease ecology model of health

health is a state influenced by interaction between humans and their environments (habitats)

disease ecology model approach

systems thinking, ecological relationships, environmental dynamics, evolutionary processes

disease ecology model criticisms

no guidance on relative importance or casual mechanisms

behavioral model of health

health his the result of individual lifestyle choices and behaviors

behavioral model approaches

achieve positive changes via changing beliefs and attitudes and changing behaviors

behavioral model criticsms

over-reliance on individual choices and rational decision making

biopsychosocial model of health

health is a culmination of biological, psychological, social, and cultural interactions

biopsychosocial model approaches

holistic understanding of human experience in a clinical encounter

biopsychosocial model criticisms

incomplete explanation of how factors interact and it’s expensive (bc doctor has to spend more time with patient, get more info)

socio-ecological model of health

health is the product of multiple levels that interact to produce behaviors and health…individual to interpersonal to organizational to community to public policy

socio-ecological model approach

informs opportunities for broader interventions

socio-ecological model criticisms

limited guidance on interaction across levels and prioritization

interdisciplinary paradigms of health

public health, health promotion, population health

public health

focuses on protecting and improving health through organized efforts and policies. linked to epidemiology. includes things like surveillance, sanitation, immunization, and health systems.

epidemiology

science that provides the evidence base to inform public
health practice

health promotion

focuses on enabling people/groups to increase their control and improve their own health and wellbeing. views health as a resource.

Ottawa Charter for Health Promotion 1986

landmark international agreement that defined health promotion 

population health

focuses on upstream factors that influence the health of entire populations. looks at population-wide strategies as opposed to targeting high risk people and tries to address root causes as opposed to treating disease