Health Geography

Dengue’s increasing trends raise concerns over global health and pose a challenge to the Brazilian health system, highlighting the necessity of a strong surveillance system to reduce morbidity, mortality, and the economic burden of this disease. Although the Brazilian surveillance system reports more dengue cases than any other country, recent studies suggest that non-reported cases are the majority. The aim of the study is to explore the strengths and weaknesses of the Brazilian surveillance system, particularly looking at the functioning of data collection and reporting. This was done through qualitative semi-structured interviews with 17 experts in dengue surveillance, supported by quantitative data from the official notification system. To select the interviewees, purposive and theoretical sampling were used. Data were analyzed through thematic analysis. The research highlighted that a lack of human and technological resources in healthcare units and surveillance departments slo...

Calls for a political ecology of health have recently emerged in geography. This article builds on these to suggest a practice of a political ecology of health by incorporating the insights of medical anthropology, STS, and history of medicine. Framed around three perspectives – partial and situated knowledges, Marxist- feminist approaches, more-than-human geographies of health – this article argues that incorporating the insights of political ecology and cognate disciplines into the problems we investigate and the methods we use will make for a stronger practice of a political ecology of health.

Social science researchers interested in human health have generally neglected the production of health care spaces and the experience of medical workers, particularly physicians. Health care researchers have contributed to our knowledge of the discursive and material construction of disease and ill health, the
embodied experience of ill-health, and the socio-spatial relations of care networks. Yet, similar developments have been relatively absent in spatialities of medical services. This is particularly true if one looks beyond a few key sites in New Zealand, Canada, and England. This project reviews the geographies of medical services literature and then identifies three key areas which would benefit from greater engagement: macro- and micro-scale interactions, primary care spaces, and a greater range of places. I then use
a case study of the privatization of a primary care space in Milwaukee, Wisconsin to illustrate the usefulness of geographic approaches for medical service research.

Since 2003, more than twenty hospitals in New York City have closed because of debt and a state-driven downsizing program. During this same time period, the labor market for nurses has tightened substantially, shifting from an overall nurse shortage since the 1980s to a job shortage since the mid-2000s. Drawing on an analysis of media and government publications on hospital closures since 2003 and interviews with nurses working in the metropolitan area, I argue that hospital closures and the new job shortage are intertwined. By pushing an austerity agenda in the wake of the 2008 economic crisis, New York City and state government agencies as well as private health care institutions are actively restructuring—or “rightsizing”—the health care sector. Ultimately, this is a downsizing of care provisions by another name. Capitalism's continued devaluation of social reproduction manifests in New York City as a restructuring of the spaces and work of health care. Hospital closures are central to this restructuring that involves the mutually constituted transformations in the built environment, health care provisioning, and the nursing profession. In conclusion, this process risks making good health and good jobs less accessible.

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.

In the National Health Service (NHS) system General Practices (GP) are providers of Primary Health Services (PHSs). PHS are managed by Primary Care Trusts (PCTs) and are generally conceived as the first point of access to public health. Good provision of PHSs can avoid patient reliance upon secondary health services like Accident and Emergency (A&E) or hospitalisation – both of which tend to be much more expensive for NHS balances. The backbone of NHS policy is set out in

Public health and health care are important aspects to consider when looking at all developing
countries in the world. Zimbabwe is one of the world`s developing countries that is striving to achieve a
good health care environment for all.
Recent studies have shown that not all parts of the developing countries have good qualities in terms of
access and availability of health services, hence this study will concentrate on the Primary Health Care
(PHC) facility distribution in Gweru a city in Zimbabwe. PHC facilities are usually those that provide
community care and home care programmes for disabled people and people with chronic or terminal
illness (Kaur and Hall, 2001).
Since the access to health care services is multi-dimensional, Peters (2008) describes the four
dimensions to be: geographic accessibility, availability, fnancial accessibility and acceptability.
Accessibility coverage determines how physically accessible resources are for the population
(Tamahashi, 1978) whereas availability coverage demonstrates how available and in what amount for
delivery services (Munoz & Kallestal, 2012). Munoz and Kallestal (2012) go on to state that, “the
availability of such resources limits the maximum capacity of the service and this determines the
amount of service that can be provided to the target population.”

Öz: Sağlık sorunları insan hayatı buyunca önemini yitirmemiştir. Günümüzde şehirlerde artan nüfus yoğunluğu sağlık
alanında bazı sorunlara yol açmaktadır. Doktor başına düşen hasta sayısının artması, verilen sağlık hizmetinin kalitesinin
düşmesine yol açmaktadır. Doktor başına düşen hasta sorunun giderilmesi için 2004 yılında kurulmaya başlayan aile
sağlık merkezleri 2010 yılında sağlık ocaklarının yerini almış ve aile hekimliği uygulaması başlatılmıştır. Sağlık alanında
görülen diğer bir sorun ise sağlık kuruluşlarının erişilebilirliğidir. Aile sağlık merkezleri ne kadar yaygın olsa da
Mekânsal Planlar Yapı Yönetmeliği'nde belirtilen 500 metrelik mesafede erişim problemleri yaşanabilmektedir. Bu ve
bunun gibi problemleri ortadan kaldırmak için ise gelişen teknoloji ile birlikte ortaya çıkan akıllı kent bilişim sistemleri
kullanılmaktadır. Coğrafi bilgi sistemleri yardımıyla uygulanan mekânsal analizler sorunun belirlenmesinde ve
çözümünde etkili olmaktadır. Çalışmada ele aldığımız Turgutlu şehrinde bulunan aile sağlığı merkezlerine uygulanan
erişilebilirlik analizi de mekânsal analizlere örnektir. Analiz kısmında ArcMap 10.5 paket programı ile aile sağlığı
merkezlerine Network (ağ) analizi uygulanarak erişilebilir alanlar belirlenmiştir. Analiz soncunda yasal mevzuatta
belirtilen mesafe dikkate alındığında şehrin %65'lik kısmının erişilebilir alan içerisinde kaldığı belirlenmiştir. Erişilebilir
mesafe iki katına çıkarıldığında ise oran %98'e çıkmıştır. Bu oranlar aile sağlık merkezi sayısının azlığını ortaya
koymaktadır.
Anahtar Kelimeler: Sağlık Coğrafyası, Coğrafi Bilgi Sistemleri, Erişilebilirlik, Ağ analizi, Turgutlu kenti
Abstract: Health problems have not lost their importance in human life. Today, increasing population density in cities
leads to some problems in the field of health. The increase in the number of patients per doctor leads to a decrease in the
quality of health services provided. Family health centers, which started to be established in 2004 in order to resolve the
problem of the patient to the doctor, replaced the health centers in 2010 and the implementation of family medicine was
initiated. Another problem seen in the field of health is the accessibility of health institutions. Although the prevalence of
family health centers is widespread, access problems can be experienced at a distance of 500 meters as stated in the
Building Regulations of the Spatial Plans. In order to eliminate these and other problems, smart city information systems
which are developed with developing technology are used. The spatial analyzes applied with the help of geographic
information systems are effective in determining and solving the problem. Accessibility analysis applied to family health
centers in Turgutlu, which we discussed in the study, is an example of spatial analysis. In the analysis section, ArcMap
10.5 package program was used to determine accessible areas by applying network analysis to family health centers.
Considering the distance specified in the legal regulations, it was determined that 65% of the city remained within the
accessible area. When the reachable distance was doubled, the ratio increased to 98%. At this rate, the number of family
health centers is low.
Keywords: Health Geography, Geographical Information System, Accessibility, Network Analyze, Turgutlu city

Energy projects may profoundly impact Indigenous peoples. We consider effects of Canada’s proposed Trans Mountain oil pipeline expansion on the health and food sovereignty of the Tsleil-Waututh Nation (TWN) through contamination and impeded access to uncontaminated traditional foods. Federal monitoring and TWN documentation show elevated shellfish biotoxin levels in TWN’s traditional territory near the terminus where crude oil is piped. Although TWN restoration work has re-opened some shellfish-harvesting sites, pipeline expansion stands to increase health risk directly through rising bioaccumulating chemical toxins as well as through increased hazardous biotoxins. Climate change from increased fossil fuel use, expected via pipeline expansion, also threatens to increase algae blooms through higher temperature and nutrient loading. As the environmental impact assessment process failed to effectively consider these local health concerns in addition to larger impacts of climate change,...

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

Cette thèse défend l’intérêt d’appliquer une démarche d’analyse exploratoire de données spatiales pour examiner un phénomène complexe irréductible, dans un contexte limité en données : le paludisme-infection à Dakar. Chaque partie du système pathogène du paludisme est nécessaire mais
non suffisante au fonctionnement du système. Il n’y a paludisme-infection que lorsque les trois composantes sont en contact : le parasite, le vecteur et l’hôte humain. La recherche des lieux où ces contacts peuvent s’opérer facilement est donc primordiale dans la lutte contre le paludisme et l’amélioration des programmes visant à la diminution voire l’élimination de la maladie. L’analyse exploratoire, encore très peu appliquée dans les pays dits du Sud, se définit ainsi comme une démarche de recherche mais aussi comme un moyen d’apporter des réponses aux besoins sanitaires. Elle pousse à l’observation, sous différents angles, des déterminants sociaux et spatiaux qui sont impliqués dans la réalisation du phénomène, tout comme à l’examen des interactions existantes entre eux. Nous avons récolté des informations quantitatives variées, en lien direct et indirect avec l’étude du paludisme. Interprétation d’images satellites, données censitaires, résultats d’enquêtes sociales et
sanitaires ont été intégrées dans un système d’information géographique pour décrire la ville et ses habitants. Le croisement de ces sources a permis d’étudier les faces spatiales du risque épidémique palustre. Le recours à des analyses statistiques et géostatistiques, bivariées et multivariées, a permis de souligner que le risque d’infection des populations dépendait fortement d’une distance, que l’on a qualifié de sociale. Celle-ci décrit la faculté des habitants à s'extraire du risque d'infection en s'éloignant, physiquement ou matériellement, des espaces pathogènes, lieux de prolifération de vecteurs potentiellement infectés. On a pu ainsi montrer le lien fort existant entre l'exposition (qui favorise un réservoir parasitaire plus important dans les quartiers défavorisés), et la vulnérabilité sociale des individus (qui augmente considérablement le risque d’infection au paludisme).

This thesis examines the shifting relationship between the state and its subjects with regard to responsibility for and entitlement to care. Using Malaysia as a case study the research engages with international medical travel (IMT) as an outcome of the neoliberal retrenchment of the welfare state. I offer a critical reading of postcolonial development strategies that negotiate the benefits and challenges of extending care to non-national subjects.

Cette recherche vise à analyser les logiques, les dynamiques et les impacts locaux de la mondialisation contemporaine dans la province d’Almería (Andalousie, Espagne). La région s’est globalisée suite au développement récent de l’agriculture intensive sous serre et de la refonte du secteur tertiaire (services, tourisme). L’adoption du modèle économique néolibéral a entraîné une bifurcation historique du système spatial régional. Almería est aujourd’hui considérée comme une province « paradigmatique » du contexte espagnol du début du siècle (Sanchez Picon et Aznar Sanchez, 2002). Deux entrées sont privilégiées : les migrants internationaux comme « acteurs sociaux en situation » de la mondialisation (Assayag, 2007) et la santé comme « indicateur » révélateur d’inégalités. En s’ouvrant au monde et dans une échelle de temps réduite, la province située aux portes du sud de l’Europe est devenue un carrefour migratoire mondial qui accueille des types de migrations hétérogènes (migrations socio-professionnelles (il)légales, migrations de retraites, etc.). L’analyse se base sur une étude comparative des conditions de vie des quatre principaux collectifs de populations étrangères installées dans la province (Maroc, Roumanie, Royaume-Uni, Afrique de l’ouest). On examine les liens entre l’espace de résidence dans la province, le lieu d’origine et la phase de transit. Le cœur méthodologique de cette investigation repose sur une enquête qualitative normée et spatialisée auprès de 464 individus. La recherche participante via la collaboration avec la Croix-Rouge d’Almería a permis de rendre visible des populations « non officielles ». La typification des lieux de résidence à l’échelle fine des migrants interrogés ainsi que les champs migratoires et sanitaires, montrent des processus de différenciation, voire d’hyperdifférenciation spatiale locale, liés à l’origine de l’individu. Les frontières politico-administratives se mobilisent, se déplacent et se réorganisent : les disparités socio-économiques locales sont un miroir des inégalités mondiales. La province d’Almería offre un espace d’étude heuristique pour reconsidérer les logiques  multiscalaires des processus de différenciation du monde contemporain. Les enjeux socio-spatiaux et sanitaires permettent d’esquisser un modèle de « région glocale ».

Bu kitapta Türkiye'deki intiharın mekansal dokusu incelenmiştir. İntihar ve coğrafya ilişkisi tartışılmış, Dünya'da intihar ile intihara genel bir bakış yapılmıştır. İntihar sonucu ölümler yıllara, yaş gruplarına, nedenlerine, mevsimselliğine, mekansal dokusuna göre incelenmiştir. Yıllara göre intiharın mekansal değişimi konusu da gözden geçirilmiştir. İntihar edenlerin cinsiyet oranları, intiharın büyüme hızı, kullanılan intihar yöntemleri, intihar edenlerin medeni durumları, intihar edenlerin iş/meslek düzeyleri ve intiharın mekansal dağılımı ile bazı değişkenler arasındaki ilişkilere kitapta yer verilmiştir. Kitapta intiharın mekansal yapısını açıklamak için 26 haritaya yer verilmiştir.

Increasingly, governments are experimenting with ways to provide public goods by involving the private sector in the planning, financing, building and operating of a range of services, facilities, infrastructure, etc. In the geographical literature on neoliberalism this entanglement of the state and markets has been loosely conceptualized as a process of marketization. This concept describes the insertion of markets or market forces into the state and public sector. In this paper we unpack this concept by highlighting the need to think about a range of marketization processes at play across a range of geographies.

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.

Kitapta sağlık coğrafyası, sağlık ceomatiği, sağlık coğrafyası ile ilgili araştırmalar ile konuya genel bir bakış yapılmaktadır. Ölüm oranı haritalarının hazırlanmasına ilişkin bilgiler verildikten sonra 14 ölüm nedeninin mekansal dokusu verilerek incelenmiştir. Kitapta 54 haritaya yer verilmiştir.

Whereas anthropologists have long been concerned with how people regard non-human animals, the politics of multi-species entanglements appear to be increasing in prominence within anthropology. Meanwhile, an interdisciplinary field dedicated to the study of relationships and interactions between humans and non-human animals has become established; this field is known in some circles as ‘anthrozoology’ and in other circles as ‘human-animal studies’. Yet few influential treatments of multi-species realities have been published by medical anthropologists, as evinced by a lack of in-depth discussion regarding  health, illness, or disease in Annual Review of Anthropology articles on environmental anthropology (Ingold 2012, Cassidy 2012) or anthrozoology (Mullin 1999, Shanklin 1985). Drawing on the concept of ‘environmental health justice’ (Masuda, Poland, and Baxter 2010), this chapter invites deeper dialogue between animal geographers, health geographers, environmental anthropologists and medical anthropologists.

‘Ageing in place’ is a well-established concept within gerontological and geographical literatures as well as continuing to be mobilised as a potentially effective policy mechanism for addressing the needs and choices of ageing populations. To date, ageing in place research has highlighted many factors that enable older adults to age well in the (home) place focusing on the physical dimensions of housing or the home as a site of care. Gerontological researchers also recognise that ageing in place, or community living, implies a two-way relationship between the physical contexts and the social and emotional places of ageing. However we argue for a subtle, yet crucial, inversion of the roles of people and place in the experiences of ageing. In particular we suggest that what makes ageing in place successful is the potential of place to support meaningful relationships. We suggest that too often the word ‘place’ constrains focus to those spaces that are geographically proximate to the ageing body or are physically bounded such as the house or neighbourhood. Instead, drawing on a review of current literature, we explore the idea that what is of greater consequence to many people who are ageing in place is the multiple, networked social and non-social relations they develop across different spatial scales and over time. This revised approach to ageing in place allows us to understand better older adults’ layered connectivity to place and well as the ability to differentiate the meaning of ageing in place by the scale and types of relationships.

La présente recherche visera à comprendre au moyen d’une approche féministe matérialiste, les répercussions de la douleur et de la fatigue chronique, provoquées par la spondylarthrite ankylosante et la fibromyalgie sur la spatialité des femmes vivant avec ces pathologies. Pour ce faire, elle montrera que la maladie est un processus d’adaptation interrelationnel, se traduisant spatialement par la recomposition des géographies quotidiennes. Elle cherchera ainsi à mettre en évidence la nouvelle normalité sociospatiale qui s’institue en réaction à une corporéité endolorie. Cette recherche postule, par conséquent, que la restructuration des spatialités quotidiennes s’articule autour d’une fréquentation de nouveaux espaces, d’une resignification de la symbolique attribuée à certains lieux et d’une diminution de certains déplacements et de certaines activités. L’hypothèse soutenue sera évaluée sous l’angle de la production discursive récoltée durant une étude de terrain exploratoire. Celle-ci a été menée au sein de communautés virtuelles dédiées à ces affections et réalisée à l’aide d’outils de méthodologie qualitative tels que l’ethnographie en ligne et l’entretien biographique.

Introduction: Immunization, as a process of fighting against the COVID-19, has gained important research appeal, but very limited endeavor has been paid for vaccine behavioral studies in underdeveloped and developing countries. This study explores the vaccine demand, hesitancy, and nationalism as well as vaccine acceptance and domestic vaccine preference among young adults in Bangladesh. Methodology: This quantitative study followed the snowball sampling technique and collected responses from 1,018 individuals from various social media platforms. The analysis covered both descriptive and inferential statistics including chi-square, F-statistic, and logistic regression. Results: The findings of the fully-adjusted regression model suggest that the individuals who had more vaccine demand were 3.29 times (95% confidence interval = 2.39-4.54; p < 0.001) higher to accept vaccine compared to those who had no vaccine demand. Conversely, vaccine hesitancy was negatively associated with vaccine acceptance. Here, the odds ratio was found 0.70 (95% confidence interval = 0.62-0.80; p < 0.001), which means that those who had higher vaccine hesitancy were about 30% less likely to accept vaccines than those who had no hesitancy. In addition, the persons who had vaccine nationalism were 1.75 times (95% confidence interval = 1.62-1.88; p < 0.001) more prone to prefer domestic vaccine. Conclusions: This study suggests that policymakers may take initiatives for making people aware and knowledgeable about the severity and vulnerability to specific health threats. In this concern, perception and efficacy-increasing programs may take part in increasing protection motivation behaviors like vaccine acceptance and (domestic) vaccine preference.

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.

Air pollution is an important public health problem in Europe and there is evidence that it exacerbates health inequities. This calls for effective strategies and targeted interventions. In this study, we conducted a systematic review to evaluate the effectiveness of strategies relating to air pollution control on public health and health equity in Europe. Three databases, Web of Science, PubMed, and Trials Register of Promoting Health Interventions (TRoPHI), were searched for scientific publications investigating the effectiveness of strategies on outdoor air pollution control, public health and health equity in Europe from 1995 to 2015. A total of 15 scientific papers were included in the review after screening 1626 articles. Four groups of strategy types, namely, general regulations on air quality control, road traffic related emission control interventions, energy generation related emission control interventions and greenhouse gas emission control interventions for climate change mitigation were identified. All of the strategies reviewed reported some improvement in air quality and subsequently in public health. The reduction of the air pollutant concentrations and the reported subsequent health benefits were more significant within the geographic areas affected by traffic related interventions. Among the various traffic related interventions, low emission zones appeared to be more effective in reducing ambient nitrogen dioxide (NO 2) and particulate matter levels. Only few studies considered implications for health equity, three out of 15, and no consistent results were found indicating that these strategies could reduce health inequity associated with air pollution. Particulate matter (particularly fine particulate matter) and NO 2 were the dominant outdoor air pollutants examined in the studies in Europe in recent years. Health benefits were gained either as a direct, intended objective or as a co-benefit from all of the strategies examined, but no consistent impact on health equity from the strategies was found. The strategy types aiming to control air pollution in Europe and the health impact assessment methodology were also discussed in this review.

Background and Objectives: Research regarding the role that cherished possessions play in experiences of aging and daily life has tended to focus on how possessions assist individuals in "looking back" and remembering important experiences, relationships, and identities. Here, we consider how the possessions that older adults keep at home inform their present experiences of aging and also facilitate the ongoing maintenance of aging in place. Research Design and Methods: We employed an interpretive phenomenologically inspired research strategy that enabled an in-depth examination of older adult's experiences of cherished possessions. This approach emphasized participants' own situated meanings. In-depth interviews were followed by participatory photo-elicitation interviews and journaling. Results: The majority of study participants interacted with cherished possessions to connect with their past selves, but also to cope with times of challenge and change in the present, and in some cases, to cultivate a sense of being able to maintain aging in place. For some older adults, however, possessions disrupted sense of self, place attachment, and daily life. Cherished possessions, therefore, play a significant role in opportunities to maintain aging in place. Discussion and Implications: The material culture of home and its relationship to experiences of aging may provide or disrupt opportunities to maintain aging in place. Interventions based on possessions that are easy to access and employ to provide comfort and affirm peoples' preferred relationships to self, others, and the living environment could make a difference to the quality of life for older adults.

This paper addresses the question of how older adults’ experiences
of home maintenance issues shape their opportunities to maintain
ageing in place. We explore this question through a case study of
ageing in place on Waiheke Island, near Auckland, New Zealand. We
draw on in-depth interviews with 28 older adults aged 65 to 94, as
well as participatory photo elicitation interviews and research journals
conducted with 11 of these participants. We argue that older adults’
diverse personal circumstances and wider social contexts influence
how home maintenance concerns are understood and addressed. We
find that maintenance issues may cause stress and anxiety, thereby
rupturing affective ties to place, limiting access to preferred identities
and reducing well-being. Yet many feel connected to social networks
and gain a positive sense of self and autonomy through participation
in home maintenance tasks. Ultimately, how older adults experience
their home maintenance issues influences their opportunities to
maintain ageing in place.

Reumo: A presença de metais em águas superficiais pode promover uma série de agravos à saúde de uma população local que venha a consumir destas águas. Deve-se considerar o estudo das bacias hidrográficas e das complexas interações em seu interior que possam contribuir para o desenvolvimento de agravos a saúde na população local em função da presença de metais nas águas superficiais que a compõem e, neste sentido, procurou-se nesta pesquisa advogar em favor da utilização da bacia hidrográfica enquanto recorte espacial e analítico. Partiu-se do pressuposto que a mesma é a concreticidade de uma determinada combinação geográfica - um arranjo espacial e analítico caracterizado pela relação interdependente dos elementos ambientais e humanos em uma determinada área. Neste sentido, a pesquisa foi realizada junto à Bacia hidrográfica do Pirapó, situada na porção setentrional do estado do Paraná, localizando-se entre os paralelos 22º 32' e 26º 34' S e os meridianos 51º 17´5,33" e 52º 17´ 18,30" W. No curso dos rios Pirapó e Bandeirante do Norte (principal afluente) foram coletadas, um total de 36 amostras de água nos períodos de seca (agosto/2016) e cheia (janeiro/2017) para a detecção dos teores de metais em laboratório por meio de Espectrômetro de Emissão Atômica de Plasma Induzido por Microondas (MP-AES), sendo encontrados valores abaixo daqueles máximos permitidos (VMP) pelo CONAMA bem como pelo Ministério da Saúde. Para correlacionar estes teores aos óbitos obtidos no ano de 2016, entre os municípios que se situam na área da bacia hidrográfica, foram realizadas análises da distribuição espacial dos teores bem como das taxas de internação e mortalidade registradas naquele ano. Na área de estudo a maior parte da ocupação e uso do solo é representada por propriedades rurais e atividades ligadas ao plantio de soja, milho, algodão e cana-de-açúcar (corriqueiramente demandantes de agrotóxicos), bem como à pecuária de corte. Nas porções mais próximas do meio urbano, são preocupantes os aportes de efluentes industriais, lodo de esgoto, resíduos de tratamento de água, dentre outros identificados na área da bacia hidrográfica, principalmente no entorno dos pontos com teores elevados de metais na água coletada. Assim, foram constituídas as áreas de risco, representadas pelo teores anômalos de metais registrados nos pontos A1 (nascente), A2 (Apucarana), A4 (Mandaguari), A5 (Maringá/Astorga), A6 (Maringá/Iguaraçu), A9 (Paranacity), A11 (Colorado/Paranapoema), A13 (Jardim Olinda), A14 (Colorado/Lobato), A17 (Guaraci/Santa Fé), A16 (Jaguapitã) e A18 (Rolândia). Com base nas ocorrências na análise dos fatores geográficos envolvidos na distribuição destas áreas de risco, verificou-se que havia a necessidade de uma proposta de metodologia sistêmica, que enfatizasse as relações entre ambiente, sociedade e saúde, e portanto, foi elaborada uma proposta de percurso metodológico de análise com base na teoria das combinações geográficas de André Cholley, que defendesse atender o objetivo de se apoiar um subsídio teórico-metodológico que permita o estudo sistêmico da bacia hidrográfica do rio Pirapó no âmbito das relações saúde e ambiente.

Abstract: The presence of heavy metals in surface waters can promote a number of health problems for a local population that consumes these waters. Consideration should be given to the study of river basins and the complex interactions within them that may contribute to the development of health problems in the local population due to the presence of heavy metals in the surface waters that compose it and, in this sense, in this thesis advocate in favor of the use of the geographic basin as spatial and analytical clipping. It was assumed that the same is the concreticity of a particular geographical combination - a spatial and analytical arrangement characterized by the interdependent relation of the environmental and human elements in a given area. In this sense, the research was conducted near the Pirapó Basin, located in the northern portion of the state of Paraná, the Rio Pirapó basin is located between the parallels 22º 32 'and 26º 34' S and the meridians 51º 17'5,33 "and 52º 17' 18.30" W. In the course of the Pirapó and Bandeirante do Norte rivers (main tributary), a total of 36 water samples were collected in the dry period (August/2016) and filled period (January/2017) for detection with Microwave Plasma Atomic Emission Spectroscopy (MP-AES), with values below the maximum permitted values (VMP) being found by CONAMA and by the Ministry of Health. In order to correlate these levels of metals to the deaths obtained in 2016, among the municipalities located in the basin area, analyzes of the spatial distribution of the contents as well as the hospitalization and mortality rates recorded in that year were carried out. In the study area, most of the land use and occupation is represented by rural properties and activities related to the planting of soybean, corn, cotton and sugarcane (commonly demanded by pesticides), as well as to beef cattle. In the nearer portions of the urban environment, the contributions of industrial effluents, sewage sludge, water treatment residues, among others identified in the basin area, especially around the points with high levels of metals in the collected water, are of concern. Thus, the areas of risk were represented, represented by the anomalous levels of metals recorded in A1 (headspring), A2 (Apucarana), A4 (Mandaguari), A5 (Maringá / Astorga), A6 (Maringá / Iguaraçu), A9 ), A11 (Colorado / Paranapoema), A13 (Jardim Olinda), A14 (Colorado / Lobato), A17 (Guaraci / Santa Fe), A16 (Jaguapitã) and A18 (Rolândia). Based on the occurrences of the analysis of the geographic factors involved in the distribution of these risk areas, it was verified that there was a need for a systemic methodology that emphasized the relationship between environment, society and health. An methodological analysis based on the theory of geographical combinations of André Cholley, that defended to meet the objective of supporting a theoretical and methodological subsidy that allows the systemic study of the watershed of the Pirapó river in the scope of health and environment relations.

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.