Geography Reference
In-Depth Information
Figure 31.3
Location map of
the Bronx, New York City.
health problems in the Bronx, namely the
epidemic of AIDS and its causative agent, the
human immunodeficiency virus (HIV).
Remedial responses to the spread of HIV/
AIDS in the cities of North America, and
elsewhere, are largely dependent on the integrity
of local social networks. These networks underpin
the operation of outreach services and provide the
conduits for an efficient propagation of HIV-
related information and education. When these
networks have been shredded through the
processes of population relocation, as in the case
of the Bronx (Box 31.2) and areas of other US
cities, the success of HIV/AIDS control
programmes is crucially dependent on a wider set
of urban policies that promote geographical
stability and the reknitting of personal, family and
community networks.
and allied literature is replete with examples of the
manner in which health, disease and mortality
vary spatially with levels of absolute and relative
poverty, deprivation and other socio-economic
indicators. Precisely what these variations mean,
however, remains open to considerable debate.
More often than not, it seems that
complexes
of
factors are likely to underlie many socio-spatial
variations (for examples, see WHO 1992; McNally
et al.
1998). Clarification of these factors, and the
formulation of appropriate policy responses to
erase the related health variations, are set to occupy
medical geographers, health scientists and others
well into the third millennium. But the new
millennium will undoubtedly bring fresh health
challenges, and a number of intrinsically
geographical factors can be expected to impinge
on health variations. These factors are likely to
include: continued and rapid demographic
growth; population migration and urban growth;
increased geographical interaction and the
telescoping of time-space; land-use change and
agricultural colonisation; and climate change and
global warming. Geographers, by their training,
are uniquely placed to study the health outcomes
of these phenomena.
In this chapter, two case studies have illustrated
very different aspects of socio-spatial variations in
health. The case study in Box 31.1, set in England,
confirms many of the expected socio-economic
CONCLUSION
In his report for the year 1995, the Director-
General of the World Health Organization
observed that 'The world's most ruthless killer and
the greatest cause of suffering on earth is listed in
the latest edition of WHO's International
Classification of Diseases under the code Z59.5. It
stands for extreme poverty' (WHO 1995: p. 1).
Consistent with this observation, the geographical
