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Flashcards in Approaches to health geography Deck (23):
1

What are the 5 approaches to health geography?

- Positivist
- Social interactionist
- Structuralist
- Post- structuralist
- Structurationalist

2

What are the characteristics of the positivist approach?

- scientific approach- often uses natural science methods
- relies on accurate measurement
- searches for statistical irregularities
- tests and explains hypothesis using quantitative/ statistical methods
- Views the body from a biomedical perspective- like a machine

3

In a positivist approach is space or place more important?

- Space is important- (i.e. location and spatial arrangement)
- Place less so
- Positivist approaches can be used to map disease data and describe / explain spatial distribution

4

What was the aim of the NYC childhood asthma study?

To describe and explain spatial variation in the rates of hospitalisation of children due to asthma.

5

What was the methodology of the NYC childhood asthma study?

- Used a map of rates for 2016 neighbourhoods in NYC- and looked for clusters
- Explained by using statistical methods to relate the incidence of childhood asthma to housing conditions and household income

6

What is epidemiology?

the study of disease incidence among specified populations

7

What is an ecological study?

- A study in which individual data are grouped or aggregated to a set of areal units

8

What is ecological fallacy?

- making unwarranted influences about individuals on the basis of aggregate or ecological data
- Risk in positivist studies if area data is used

9

What are the downsides of the positivist approach?

- sees people as rational, abstract objects - people don't follow models
- ignores social or political processes
- [feminist critique] masculine view of the world- orderly, rational, quantifiable, predictable,
abstract, and theoretical
(Kitchin, 2014)

10

What are the characteristics of social interactionist approach?

- an emphasis on individual meaning- subjective experience of illness/ health
- focus on human beliefs, values, meanings and intentions- researcher describes, interprets and understands these
- people are seen as having agency
- "lay beliefs" matter as much as those of a health professional
- qualitative methods- interviews, focus groups etc

11

Is space or place more important in the social interactionist approach?

- experience of place is more important than fixed areal units

12

Describe the smoking Glasgow study?

- Aimed to understand how smoking varied between places in Glasgow
- Used focus groups to understand the reasons why people smoke
- Themes from data included economic insecurity, isolation and stress, community (sharing cigarettes)
- gives a voice to lay people

13

What are the downsides of the social interactionist approach?

- results are subjective and hard to verify
- usually smaller study numbers

14

What is the structuralist approach to health geography?

- focus on economic structures and power relations which underpin all areas of human activity, including health
- draws impetus from Marxism but there are other perspectives including patriarchy
- for some, the legacy of colonialism serves to explain on-going health problems
- healthcare is preventative not curative because it's a commodity
- poverty caused by capitalism- causes ill health

15

What are some examples of structuralist caused poor health? (x3)

- In Haiti HIV maps reflect maps of American neocolonialism and structural adjustment programs- poorer people get HIV more - turn to sex work more
- disabled women more likely to be unemployed and have low income -> diabetes and depression
- Women doing dangerous work in sweatshops and have little say in unions

16

Describe the First nations study?

- The aim was describe and explain health outcomes of First Nations peoples.
- Findings: Socio-economic inequalities ‘can determine the health of populations’...’there are many varied and interlaced determinants, most of which are entrenched in unequal power relations and a history of colonization’.

17

What is the structurationist approach?

- understands the duality of structure and agency- they shape each other
- e.g. parents may find it hard to vaccinate their kids between 9-5, changing opening hours would increase vaccinations and improve health
- humans make their own health but not in conditions of their choosing

18

What is the post structuralist approach to health geog?

- emphasis on otherness and difference
- origins in foucault and the enlightenment tradition- search for truth and order
- discusses how knowledge and experience are constructed in the context of power relations
- self governance through laws (e.g. seat belt/ smoking) and pressure from society (e.g. to be slim)

19

What is governmentality?

Foucault – the ‘governing’ of public health using various assemblages of human and non-human actors (survey, vaccination, clinics, hospitals, health professionals), all coming together to form a ‘network’.

20

Discuss the HIV/AIDS positivist study?

- Malawi has very high rates of HIV/ AIDS understanding spatial variation is very important for targeting support
- Study shows spatial variation of HIV drivers
- Method- very quantitative- used data about HIV in pregnant women from 19 HIV clinics, plotted it spatially and found probabilities
- compared HIV to other socioeconomic factors
- data displayed in graphs, charts and maps
- highlights hotspots, coldspots and clusters
- HIV worse in the south, and urban areas
- HIV worse away from public transport and where education is poor

21

Discuss the mental health social interactionist study?

(Lewis, 2014)
- interview 48 gay men in USA/ Canada for 45-75 mins
- Focus on the experience of being gay, migration and mental health problems
- Found that migration gives more freedom but also new stresses of newer communities
- provide evidence for the minority stress model
- intersectionality increases risk of mhp
- issues: focused on only 1 type of migration, big range in migration years, misses root causes due to focus on migration

22

Discuss the HIV/AIDS structuralist study?

(Farmer, 2003)
- "texture of dire affliction is better felt in gritty details of biography"
- suffering is not well conveyed in stats of graphs
- allows addition of historical aspects
- Can weight different forces of suffereing
- helps to understand structural violence and the structural causes of HIV/AIDS

23

Whats the best approach?

- It depends on the question
- Positivist for how
- Structuralist/ social interactionalist for why