Medical Geography

Medical geography is a small sub-discipline of academic geography. Its presence within histories of geography depends in part upon whether geography is considered as a discipline or whether there is a broader understanding of geographies as forms of practical and popular knowledge. If we take the second approach, medical geography would seem to be quite important in the development of geographical imaginations. There are connections of cause and responsibility between these popular and academic geographies.

Background Mortality estimates can measure and monitor the impacts of conflict on a population, guide humanitarian efforts, and help to better understand the public health impacts of conflict. Vital statistics registration and surveillance systems are rarely functional in conflict settings, posing a challenge of estimating mortality using retrospective population-based surveys. Results We present a two-stage cluster sampling method for application in population-based mortality surveys. The sampling method utilizes gridded population data and a geographic information system (GIS) to select clusters in the first sampling stage and Google Earth TM imagery and sampling grids to select households in the second sampling stage. The sampling method is implemented in a household mortality study in Iraq in 2011. Factors affecting feasibility and methodological quality are described. Conclusion Sampling is a challenge in retrospective population-based mortality studies and alternatives that im...

The public health approach to alcohol control focusses on efforts to reduce overall consumption and therefore the prevalence of “harmful” drinking and its negative health and social consequences.  Within this logic, evidence is corralled in favour of three particular strategies: tax increases; restricting access; and bans on alcohol advertising. In turn, it is argued that these strategies represent the most cost-effective and efficient ways to reduce consumption and its harms. However, the majority of the evidence base from which these recommendations stem derives from studies from countries of the Global North, and in particular, North America, Western Europe and Australasia.  Yet, as the WHO has been quick to note in its Global Strategy to Reduce the Harmful Use of Alcohol, countries of the Global South actually bear the greatest burden of alcohol-related harms. Geographical and anthropological approaches to health and wellbeing remind us that health and consumption practices are inherently contextual, rendering the logic and possibility of global ”best buys” for alcohol control a fallacy. Moreover, they may also engender a homogenisation of national alcohol control strategies. Yet, local contexts must always be inculcated within public health policy endeavours if they are to be plausible and sustainable. In many countries of the Global South, the janus-faced importance of alcohol as a source of income, but also of gross harms, needs to be reconciled. And, such questions will only ever preclude the possibility of the universalist policy solutions that has become so deeply enshrined in the public health literature.

Health is a basic element of every citizen in a country. The well being of the people is an important foundation of the prospective nation. The health of the people is determined by many factors, however, the role of healthcare resources are very significant. Primary care is recognized as the most important form of healthcare for maintaining population health because it is relatively inexpensive, can be more easily delivered than specialty and inpatient care, and if properly distributed it is most effective in preventing disease progression on a large scale. Recent advances in the field of health geography have greatly improved our understanding of the role played by geographic distribution of health services in population health maintenance. However, most of this knowledge has accrued for hospital and specialty services and services in rural areas. The paper has studied the hobliwise distribution of healthcare resources in Hunsur taluk. The data has revealed the uneven distribution of healthcare centres, which has indicated that Hanagodu hobli has high concentration of healthcare centres, while as Gawdagere has low. Secondly, the hobliwise ratio between population and health workforce has been carried out which has shown, the concentration of high health workforce were found in Hunsur hobli and less in Bilikere hobli which indicates higher and lower healthcare facilities respectively.

Although not strictly a highlands province, Morobe encompasses large highlands areas, the most important being Aseki, Menyamya and Wau-Bulolo. A series of rapid malaria surveys conducted in both the wet and dry seasons found malaria to be clearly endemic in areas below 1400 m in Menyamya and Wau-Bulolo, with overall prevalence rates in the wet season (25.5%, range: 9.1%-39.2%) greatly exceeding those in the dry season (8.3%, range: 2.4%-22.8%; p <0.001). In the wet season surveys Plasmodium falciparum was the clearly predominant species, accounting for 63% of all infections. P. vivax increased in frequency in the dry season (from 27% to 46%, p <0.001), while P. falciparum and P. malariae decreased. In line with past surveys a low prevalence of malaria was found in the Aseki area. Malaria was found to be the main source of febrile illness in the wet season with at least 60% of measured or reported fever associated with parasitaemia. Other causes of febrile illness dominated in the dry. In villages with parasite prevalence rates <20% mean haemoglobin levels and prevalence of severe anaemia were strongly correlated with overall parasite prevalence. In addition concurrent malarial infections were associated with a strong reduction of individual haemoglobin levels (-1.2 g/dl) and there was increased risk of moderate-to-severe anaemia with concurrent malaria. Malarial infections are thus the most significant cause of febrile illness and anaemia in the highlands fringe populations in Morobe. As a consequence all villages below 1500-1600 m in Morobe Province should be included in malaria control activities.

Studies of well-being have been dominated by perspectives that stem from Western, health-science notions of individual's health and psychological development. In recent times, however, there has been a developing sensitivity to the cultural and place-specific contexts affecting the health and well-being of contrasting populations in different environments. Drawing on these advances, this article explores the potential in conceptualizing a place-based notion of well-being that recognizes the cultural and environmental specificity of well-being for specific populations in a given setting. We argue that a geographical approach to well-being enables the linking of culture and environment for future indigenous research into both ecosystems and human health. Taking the case of an indigenous population, we identify the contexts that affect Maori well-being and we argue that key sociocultural and environmental dimensions need to be integrated for a culturally appropriate approach to Maori well-being.

This paper combines insights from political philosophy, bioethics, and political geography to examine the practice of medicine by the Khmer Rouge during the Cambodian genocide. Through a discussion of both destructive and constructive health-related policies and practices enacted by the Khmer Rouge between 1975 and 1979, this paper documents how the practice of medicine provides a broader understanding of state sovereignty and the right to live or to let die. In so doing this paper contributes to our understanding in two areas: fi rst, to the specifi c geographies of the Cambodian genocide and, second, the politics surrounding the calculated management of life and death.

The task of studying the impact of social class on physical and mental health involves, among other things, the use of a conceptual toolbox that defines what social class is, establishes how to measure it, and sets criteria that help distinguish it from closely related concepts. One field that has recently witnessed a wealth of theoretical and conceptual research on social class is psychology, but geographers' and sociologists' attitude of diffidence toward this " positivistic " discipline has prevented them from taking advantage of this body of scholarship. This paper aims to highlight some of the most important developments in the psychological study of social class and social mobility that speak to the long-standing concerns of health geographers and sociologists with how social position, perceptions, social comparisons, and class-based identities impact health and well-being.
DOI: https://doi.org/10.1016/j.socscimed.2017.11.037

In  this twenty-first  century,  electricity  has  become  the  pivot  of  global  activities.  Electricity  has become  the  engine  for  social  development  and  economic  growth  (Pachauri  et  al.,  2011).  The world  lives  and  operates  on  electricity  -  electricity  is  so  vital  to  our  everyday  lives.  However, access  to  adequate  and  reliable  electricity  is  a  big  issue  in  most  developing  countries  (BrewHammond,  2010,  Kanagawa  and  Nakata,  2008,  Reddy  et  al.,  2000)  and  Ghana  is  of  no exception.  This  provides  the  starting  point  to  this  seven-chapter  qualitative  research  on ‘living  under  the  electricity  load  shedding  in  Ghana;  a  case  study  of  businesses  in  Accra Newtown and residences  in  North Legon suburbs of Accra, Ghana’. The  data  for  this  research  were  collected  in  the  summer  of  2014  in  Ghana.  The  informants were  categorised  under  three  groups;  institutions  involved  in  the  electricity  load  shedding, offset  printing  presses in  Accra  Newtown  and  households in  North  Legon  suburbs  of  Accra. In all,  four  institutions  (MoP,  VRA,  GRIDCo  and  ECG),  ten  business  owners  and  ten  households were  interviewed  with  the  help  of  semi-structured  interview  guides.  One  focus  group discussion  was  also  conducted.  All  the  interviews  and  discussion  were  conducted  in  both English  and  Twi  language,  recorded  and  later  transcribed  into  English  and  analysed thematically  by the  researcher. Theoretically,  I  positioned  myself  within  the  Capability  Approach  by  Amartya  Sen  coupled with  the  Right  Based  Approaches  to  Development  by  Britha  Mikkelsen;  and  Structuration Theory by Anthony Giddens to develop a conceptual framework for the research. From  the  data,  it  was  found  out  that,  the  electricity  load  shedding  is  as  a  result  of  two  major challenges.  The  first  major  challenge  boils  down  to  the  policies  and  decisions  of  the government.  The  other  challenge  had  to  do  with  the  non-performance  of  responsibilities  by the duty bearers. The  research  therefore  argues  that  though  the  duty  bearers  could  contribute  to  the  wellbeing of  the  right  holders  in  the  electricity  sector  in  Ghana,  with  the  findings,  the  load  shedding  in Ghana  has  led  to  an  adverse  impact  on  the  wellbeing  of  the  right  holders  (businesses  and households)  in the research area.

The entry begins with a definition of geography and with a description of what the discipline shares with the other social sciences and what makes it distinctive among them. Terminological clarifications are provided with regard to the relationship between human geography and physical geography, and between human geography and urban geography. After a brief history and overview of human geography’s engagement with social theory, the entry offers a discussion of the politicization of contemporary human geography and of how this phenomenon is reflected in theory building and concept development.
DOI: https://doi.org/10.1002/9781118430873.est0464

In the last decades alone, about 1.4 billion people were directly or indirectly affected by floods and about 100,000 lost their lives. Asokore Mampong Municipal is one of the severely affected flood areas in the Ashanti Region. This has resulted in the loss of lives and properties in diverse ways. This is due to the undulating nature of topography, the negligence of the authorities and further unplanned growth of the municipality which is disturbing the natural flow of water, especially Aboabo River and Sisai stream. This study maps flood areas in the municipality using the Boolean Approach in GIS and to identify the towns and population likely to be affected by flood. The final results contribute to a comprehensive understanding of the extent of floods in the study area where, out of the overall land size of 23.91 Sq. km, approximately 5 Sq. km was covered by floods. Also, 4 out of 10 people in the municipal are likely to be affected by floods. It is recommended that future research should focus on other anthropogenic factors such as waste dumping in flood ways as it also appears to be another important factor that contributes to annual floods in the municipality.

Wprowadzenie. Istnieje potrzeba analizy przestrzennej szczepień p/COVID-19 w Polsce w celu przygotowania szczegółowych rozwiązań, umożliwiających podejmowanie działań minimalizujących zagrożenie dla zdrowia publicznego w czasie możliwej już czwartej fali zachorowań mogących wystąpić na jesieni 2021.
Cel pracy. Zaprezentowana analiza ma na celu ukazanie nierówności szacowanego stopnia wyszczepialności i jego predyktorów. Różnice były analizowane na poziomie powiatów NUTS-4. Różnice w poziomie wyszczepialności uwypuklają problemy nierówności w dostępie do ochrony zdrowia.
Materiał i metoda. W opracowaniu zastosowano przestrzenne techniki eksploracyjne i statystyczne w ramach zastosowania modelu czynników warunkujących poziom wyszczepialności z dokładnością do powiatu. Główną zmienną wyjaśnianą jest procentowy poziom wyszczepienia pełnym schematem w danym powiecie, a zmiennymi wyjaśniającymi predyktory społeczne, polityczne, demograficzne, ekonomiczne i epidemiologiczne.
Wyniki. Uzyskane wyniki sugerują, że to bariery systemowe (organizacyjne) wydają się być wiodącym czynnikiem decydującym o wyszczepialności. Akceptacja szczepień przez mieszkańców, na której skupia się uwaga mediów i organizatorów szczepień jest ważna, ale jedynie drugorzędna (w kontekście wyznaczania różnic przestrzennych). Okazuje się również, że model z wykorzystaniem zaledwie kilku kluczowych zmiennych społeczno-epidemiologicznych wyjaśnia aż >75% zmienności zmienności w liczbie szczepień między powiatami (zwłaszcza preferencje polityczne-konkretnie wybór partii obecnie rządzącej-wyjaśnia aż 30%). Wyslekcjonowaliśmy powiaty zagrożone wykluczeniem, czyli przede wszystkim wiejskie i małomiasteczkowe powiaty wschodniej ściany wschodniej (Podhala, Beskidu Wschodniego, pogranicza województw świętokrzyskiego i podkarpackiego, pogranicza województw mazowieckiego i podlaskiego, pogranicze województw mazowieckiego i lubelskiego) oraz powiaty potencjalnie zagrożone rozproszone wyspowo i klastrowo po całej Polsce.
Wnioski. W związku z tym, że regiony peryferyjne z wysokim poparciem dla partii rządzącej słabiej sobie radzą z kampanią szczepień, należy wzmocnić wybrane gminy i powiaty personalnie, informacyjnie i medycznie.

This paper critically reviews the current status of the concept of distance in human geography in order to argue that recent experimentally-driven work in construal-level theory offers ample opportunities for recasting distance as a key geographical trope. After analysing the four entangled dimensions of distance revealed by construal-level theory (spatial distance; temporal distance; social distance; and hypothetical distance), the paper articulates this research program from experimental psychology with geographical work on non-representational theory, geographical imaginations/imaginative geographies, learning as a geographical process, TimeSpace theorizing, and ontogenetic understandings of space. It is argued that the subjective understanding of distance afforded by construal-level theory can rescue distance from its entrenched association with positivistic geography and spatial analysis. https://doi.org/10.1016/j.geoforum.2016.07.018

Place, Memory and Healing: An Archaeology of Anatolian Rock Monuments investigates the complex and deep histories of places, how they served as sites of memory and belonging for local communities over the centuries, and how they were appropriated and monumentalized in the hands of the political elites. Focusing on Anatolian rock monuments carved into the living rock at watery landscapes during the Late Bronze and Early Iron Ages, this book develops an archaeology of place as a theory of cultural landscapes and as an engaged methodology of fieldwork in order to excavate the genealogies of places.

Advocating that archaeology can contribute substantively to the study of places in many fields of research and engagement within the humanities and the social sciences, this book seeks to move beyond the oft-conceived notion of places as fixed and unchanging, and argues that places are always unfinished, emergent, and hybrid. Rock cut monuments of Anatolian antiquity are discussed in the historical and micro-regional context of their making at the time of the Hittite Empire and its aftermath, while the book also investigates how such rock-cut places, springs, and caves are associated with new forms of storytelling, holy figures, miracles, and healing in their post-antique life. Anybody wishing to understand places of cultural significance both archaeologically as well as through current theoretical lenses such as heritage studies, ethnography of landscapes, social memory, embodied and sensory experience of the world, post-colonialism, political ecology, cultural geography, sustainability, and globalization will find the case studies and research within this book a doorway to exploring places in new and rewarding ways.

Leptospirosis is the most common bacterial zoonosis in the world, with at least half a million severe human infections annually. It is an emerging infectious disease in many contexts, with increasing frequency and severity of outbreaks; changing geographic distribution, populations affected, and serovar patterns; and evolving climatic, sociodemographic, and environmental drivers of transmission such as flooding. The ecology of leptospirosis emergence is therefore highly complex, and varies significantly in different epidemiological settings. The ability to plan, implement and sustain effective control measures is restricted by the paucity of epidemiological data, lack of effective tools to accurately identify and predict high-risk areas for infection and outbreaks, and limited evidence-based strategies for public health interventions. This thesis examines the research hypothesis that environmental variables could be used to predict geographic areas where humans are at high risk of leptospirosis infection. The research aims to provide an evidence base for environmental risk factors for human leptospirosis infection, which could be used to direct public and environmental health interventions to reduce the disease burden resulting from the emergence of leptospirosis. A field study was designed to investigate the environmental drivers of human leptospirosis transmission in American Samoa, a tropical island ecosystem where leptospirosis was known to be a common infection. The research consisted of determining the seroprevalence of leptospirosis, investigation of individual-level risk factors using a questionnaire, analysis of household-level environmental risk factors using geo-referenced environmental data and geographic information systems, exploration of potential leptospiral serovar emergence, development of multivariable regression models to quantify the importance of risk factors and predict seroprevalence, validation of predictive models, and mapping infection risk based on environmental risk factors.

El contenido de esta obra es una contribución del autor al repositorio digital de la Universidad Andina Simón Bolívar, Sede Ecuador, por tanto el autor tiene exclusiva responsabilidad sobre el mismo y no necesariamente refleja los puntos de vista de la UASB. Este trabajo se almacena bajo una licencia de distribución no exclusiva otorgada por el autor al repositorio, y con licencia Creative Commons-Reconocimiento de créditos-No comercial-Sin obras derivadas 3.0 Ecuador La epidemiología crítica: una nueva forma de mirar la salud en el espacio urbano

The world's population consists roughly of 50% women and girls. Slum and gender interrelate in many ways; women have lower rates of access to and control over water resources and weaker influence on planning and management of local development processes than men . Many of the health problems in urban slums stem from the lack of access to safe water or demand for it. Lack of domestic water is posing series of threats to the health of slum dwellers, women and girls in particular, as they spend most of their time in and around the unhygienic environment. They are responsible for collecting water for cooking, cleaning, health and hygiene and have to walk long distances to access water often spending four to five hours per day carrying heavy containers and suffering acute physical problems (Khosla 2004). Such water stressed and unhygienic urban environment of Jorhat Town is due to water scarcity. Therefore, an attempt has been made in the present paper to analyze the women health implications due to water stress, especially in slums of Jorhat town, Assam. Water stress levels have been determined with the help of water supply stress index (WaSSI) method and its impact on women health has been discussed in the paper. The study is based on both primary and secondary data.

Esta investigación expone los elementos conceptuales de la determinación en la salud en el ámbito de la geografía y la epidemiología. Se abordan los Determinantes Sociales en la Salud como una propuesta para abatir las causas de mortalidad prematura por desigualdades sociales que pueden ser solventadas a través de estrategias de derivan de la justicia social mediante la redistribución y mejora de las condiciones de la población. Dicho estudio aplica la propuesta metodológica en el municipio de Lolotla en el estado de Hidalgo, México.

The aim of this work was to investigate the seasonal and spatial variations in malaria prevalence in Imo State, Nigeria. Secondary data was used for the study; data on reported malaria cases were collected from the ministry of health on both male and female cases in the study area while climatic data on rainfall, temperature and humidity was collected from NIMET sub-station in the area. The climatic year in the study area was divided into four seasons; the early wet, late wet, early dry and late dry seasons to help ascertain the influence of climate on the prevalence of malaria. The malaria data was used to determine and analyze the distribution pattern of malaria in the study area and during the different seasons of the year. It was also used to identify the hotspot of malaria in the state. The malaria data was entered into a GIS database for modelling and analyses in order to show the spatial distribution. The results of the study indicated that over the study period (2011-2015), Imo State had an incidence rate of 9.2%. The results of the analysis indicated that there were more malaria cases in the late wet season than other seasons of the year. It also indicates that clusters of low, moderate and high malaria incidences were interspersed but Owerri region (Owerri north, west and municipal) was seen to be hotspots. The results from Imo state, showed that the rain forest had more malaria cases (213,288 or 59.9%) than the oil palm belt (142,465 or 40.1%) over the study period. The study calls for scaling up of the control strategies by Governments, Non Governmental Organizations, International Bodies and Individuals especially in the Owerri region. There is an urgent need to upgrade and strengthen malaria measures both at health facility and population levels to measure up with international standard and a constant drive towards maintaining quality and achieving the sustainable development goals

Key words: Spatial Distribution, Climate, Malaria, Prevalence, Nigeria

El 11 de marzo de 2020, la Organización Mundial de la Salud (OMS) declaró pandemia global el brote de la enfermedad COVID-19, producida por el nuevo coronavirus SARS CoV-2. En este artículo se efectúa una revisión de las contribuciones científicas publicadas hasta la fecha que relacionan las condiciones atmosféricas con la distribución del SARS CoV-2. La mayor parte de ellas concluyen que existe cierta influencia del tiempo atmosférico y/o el clima en la distribución y el progreso de la COVID-19. En concreto, un ambiente fresco y seco, en el contexto de un clima mesotérmico, parece el más idóneo para la expansión del SARS CoV-2. Sin embargo, un número significativo de estudios revisados adolece de diseños de investigación inadecuados, lo que hace muy difícil aislar de forma fehaciente el efecto genuino de las condiciones atmosféricas en la propagación de la enfermedad de otros efectos, incluidos los posibles artefactos derivados de la prevalencia observada, la dependencia espacial y temporal de los datos y la propia geografía humana: conectividad geográfica, movilidad, sistema sanitario, etc. Se concluye que sólo existen indicios, no evidencia, de que las condiciones atmosféricas pueden llegar a explicar una fracción muy limitada de la dinámica espaciotemporal del SARS CoV-2.

Medical geographers specialize in creating visual representations of the spatial‐temporal layout for medical services within a nation and they also identify rates of mortality in different regions of a country due to diseases, e.g., malaria, cholera, and the Ebola virus disease (EVD). Medical geographers recognize that there is not a uniform distribution of health facilities or resources or services throughout the nation of Guinea [14]. This directly contributes to the uneven rates of mortality throughout this country. Medical anthropologists work in collaboration with medical geographers in order to counteract the gaps in medical coverage. Through pragmatic initiatives, medical anthropologists strive to respect cultural practices, while also educating individuals on how to use alternative forms of medicine in order to both improve their wellbeing and increase their life expectancy [03].

This paper examines the struggle against malaria undertaken by the fascist regime in the Pontine Marshes, south of Rome, and relates it to discourses of domination of nature on the one hand, and modernization and civilization through technological networks such as health and medical networks on the other. The marshes’‘first nature’ is described first of all, focusing on malaria and the difficulty of making an impact on marsh biology before the fascist enterprise and before the large-scale employment of modern technology for the subjugation, channelling and development of the marshes. Secondly, the paper focuses on the organization of medical anti-malaria networks in the marshes during the years immediately preceding and during the fascist period (1922–43). Thirdly, the ‘second nature’ produced in the marshes following the land reclamation and anti-malaria projects is examined, and an assessment is provided of the fascist anti-malaria project in the marshes.

Scholars in the field of population health need to be on the constant lookout for the danger that their tacit ideological commitments translate into systematic biases in how they interpret their empirical results. This contribution illustrates this problematic by critically interrogating a set of concepts such as tradition, trust, social capital, community, or gender, that are routinely used in population health research even though they carry a barely acknowledged political and ideological load. Alongside this wider deconstruction of loaded concepts, I engage critically but constructively with Lindström et al.'s paper "Social capital, the miniaturization of community, traditionalism and mortality: A population-based prospective cohort study in southern Sweden" to evaluate the extent to which it fits with other empirical findings in the extant literature. Taking as a point of departure the intriguing finding that social capital predicts cardiovascular and all-cause mortality only for men, but not for women, I argue that future research on the nexus of social capital, health, and mortality needs to frame gender not only as a demographic and statistical variable, but also as an ontological conundrum and as an epistemological sensibility.
DOI (Open Access): https://doi.org/10.1016/j.ssmph.2021.100971

The aim of this rapid analysis was to investigate the spatial patterns of COVID-19 emergence across counties in Colorado. In the U.S. West, Colorado has the second highest number of cases and deaths, second only to California. Colorado is also reporting, like other states, that communities of color and low-income persons are disproportionately affected by COVID-19. Using GIS and correlation analysis, this study explored COVID-19 incidence and deaths from March 14 to April 8, 2020, with social determinants and chronic conditions. Preliminary results demonstrate that COVID-19 incidence intensified in mountain communities west of Denver and along the Urban Front Range, and evolved into new centers of risk in eastern Colorado. Overall, the greatest increase in COVID-19 incidence was in northern Colorado, i.e., Weld County, which reported the highest rates in the Urban Front Range. Social and health determinants associated with higher COVID-19-related deaths were population density and asthma, indicative of urban areas, and poverty and unemployment, suggestive of rural areas. Furthermore, a spatial overlap of high rates of chronic diseases with high rates of COVID-19 may suggest a broader syndemic health burden, where comorbidities intersect with inequality of social determinants of health.

Bangladesh, the eighth most populous country in the world with about 153 million people, has recently been applauded as an exceptional health performer. In the fi rst paper in this Series, we present evidence to show that Bangladesh has achieved substantial health advances, but the country's success cannot be captured simplistically because health in Bangladesh has the paradox of steep and sustained reductions in birth rate and mortality alongside continued burdens of morbidity. Exceptional performance might be attributed to a pluralistic health system that has many stakeholders pursuing womencentred, gender-equity-oriented, highly focused health programmes in family planning, immunisation, oral rehydration therapy, maternal and child health, tuberculosis, vitamin A supplementation, and other activities, through the work of widely deployed community health workers reaching all households. Government and non-governmental organisations have pioneered many innovations that have been scaled up nationally. However, these remarkable achievements in equity and coverage are counterbalanced by the persistence of child and maternal malnutrition and the low use of maternityrelated services. The Bangladesh paradox shows the net outcome of successful direct health action in both positive and negative social determinants of health-ie, positives such as women's empowerment, widespread education, and mitigation of the eff ect of natural disasters; and negatives such as low gross domestic product, pervasive poverty, and the persistence of income inequality. Bangladesh off ers lessons such as how gender equity can improve health outcomes, how health innovations can be scaled up, and how direct health interventions can partly overcome socioeconomic constraints.

This paper examined the spatial distribution of health care facilities in Babura local government area of jigawa state using GIS. Data were obtained from primary and secondary sources: a GPS was used to collect the coordinates of each health care facility. Data from the Ministry of Health (Jigawa State) about the location, name and types of health care facilities in the study area included one general hospital; one model primary health centre, fourteen primary health centers, one clinic, one dispensary and one health post. Population data was obtained from the National Population Commission (NPC, 2006). GIS analysis was used in analyzing the data. The analysis of nearest neighbour was done by using the extension of Arc GIS 10.1 in the spatial analyst tool and average nearest neighbour The result shows that there is less than 1% (0.01 level of significance) likelihood that the spatial pattern of the distribution of health care facilities in Babura Local Government Area is dispersed and this could be as a result of random chance. This might be as the result of the fewer number of health facilities. The research recommends that government should locate health care services close to the people as possible as distance was found to influence utilization.

Research on sexual orientation and gender identities, such as lesbian, gay, bisexual, transgender, and queer (LGBTQ), has been limited in health geography compared with other sub‐fields of the discipline. The reasons for this gap include both the logistical limitations of data on sexual orientation and the historical dominance of visible, measurable infectious, and chronic disease outcomes in medical geography research. While medical geographers were among the first to research HIV/AIDS diffusion among gay men, there is now something of a divide between qualitative geographers studying experience and embodiment and health science researchers examining the socio‐spatial determinants of LGBTQ health outcomes. In the following article, we review the LGBTQ health inequalities research, emerging geographies of mental health and substance use among those identified as LGBTQ, and potential avenues for health geographers to re‐engage with this field of study.

The hospital's ambiguous relationship to everyday social space has long been a central theme of hospital ethnography. Often, hospitals are presented either as isolated "islands" defined by biomedical regulation of space (and time) or as continuations and reflections of everyday social space that are very much a part of the "mainland." This polarization of the debate overlooks hospitals' paradoxical capacity to be simultaneously bounded and permeable, both sites of social control and spaces where alternative and transgressive social orders emerge and are contested. We suggest that Foucault's concept of heterotopia usefully captures the complex relationships between order and disorder, stability and instability that define the hospital as a modernist institution of knowledge, governance, and improvement. We expand Foucault's focus on the disciplinary, heterotopic qualities of the hospital to explore the heterotopia as a space of multiple orderings. These orderings are not only biomedical. Rather, hospitals are notable for the intensity and heterogeneity of the ongoing spatial ordering processes, both biomedical and other, that produce them. We outline an approach to heterotopias that traces the contingent configuration of hospital space through relationships between the physical environment, technologies, and persons, while simultaneously considering the kinds of spatial imaginings, hopes for the future, and emotional responses that are rendered possible by those configurations. We provide three thematic frameworks through which the heterotopic and contingent qualities of hospital spaces might be explored: boundary work, generating scale, and layered space.

The paper shows how error statistical theory can be deployed to grasp the deeper epistemic logic of the peer-review process. The intent is to provide the readers with a novel lens through which to make sense of the practices of academic publishing.

Demonic geography is an approach to practicing human geography that operates from the premise that there are no such immaterial entities as 'souls', 'spirits', 'minds', integrated, stable 'selves', or conscious 'free will'. This paper elaborates the theoretical framework of demonic geography by spelling out how it is different from non-representational theory and by articulating it with recent developments in experimental psychology, neuroscience, and the philosophy of mind. Counterintuitively, the paper shows that the deflationary, materialistic ontology of human nature espoused by demonic geography need not lead to meaninglessness, unhappiness, or the collapse of moral behaviour. Instead, subscribing to demonic geography opens up new ways to find meaning, to pursue happiness, and to live the good life.

Dengue is an emerging disease, and the distribution of the mosquito vector is partially mediated by environmental conditions. In this article, a new conceptual model is suggested that emphasizes the importance of including environmental variability in mosquito modeling studies. In an applied sense, mosquito habitat maps are developed for Hawaii using a GIS overlay of mosquito survival thresholds of temperature, precipitation, and stream/wetland location. Populated areas represent locations with the potential for an outbreak. The maps are adjustable based on expert knowledge input, and efforts to prevent or control outbreaks can be concentrated in those zones delineated by this study.

This study examined the spatial effects of El Niño and vulnerability on cholera in Peru across the epidemic period of 1991 to 1998. Using Wavelet and GIS analyses, relationships between sea surface temperatures and department-level cholera rates were estimated. In addition, we constructed composite indices to assess spatial vulnerability during the 1997-98 extreme El Niño. The findings demonstrated strong temporal connections in 1997-98, most evident in northern Peru, and less clear connections from 1991-93. Spatially, we found patterns of difference, greater cholera risk in northern coastal Peru in 1997-98, compared to greater risk in central and southern coastal Peru in 1991-92. Overall, the spatial vulnerability analysis suggested preexisting social conditions and disaster impacts increased cholera exposure and infection in 1998. Our study supports the notion that the spatial nature of El Niño's impacts on cholera rates exacerbated cholera vulnerability following the emergence, rather than triggered the epidemic's onset in 1991.

Desde mediados del siglo XX las condiciones de salud presentaron un panorama divergente, en el que se experimentó el incremento de la esperanza de vida y en contraste, la persistente insatisfacción de las necesidades básicas con efectos en las tasas de morbilidad y mortalidad. Pobreza y salud componen una asociación de tipo bidireccional : la pobreza da paso a la mala salud y la mala salud perpetúa la pobreza. En este capítulo se observan las correlaciones de cinco enfermedades características de la pobreza distribuidas en México.