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Flashcards in Approaches to health geography Deck (23):

What are the 5 approaches to health geography?

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


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


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


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.


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


What is epidemiology?

the study of disease incidence among specified populations


What is an ecological study?

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


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


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)


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


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

- experience of place is more important than fixed areal units


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


What are the downsides of the social interactionist approach?

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


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


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


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’.


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


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)


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’.


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


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


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


Whats the best approach?

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