HISTORICAL BACKGROUND AND INTRODUCTION OF MEDICAL GEOGRAPHY
Introduction
Medical geography,
sometimes called health geography, is an area of medical research that
incorporates geographic techniques into the study of health around the world
and the spread of diseases. In addition, medical geography studies the impact
of climate and location on an individual's health as well as the distribution
of health services. Medical geography is an important field because it aims to
provide an understanding of health problems and improve the health of people
worldwide based on the various geographic factors influencing them.
Medical
Geography (Health Geography) is the branch of Human Geography that deals with
the geographic aspects of health (status) and healthcare (systems). It seeks,
along with related disciplines such as Medical Anthropology, Medical Sociology
and Health Economics, to improve our understanding of the various factors which
affect the health of populations and hence individuals. In other words, these
interrelated disciplines can enhance the concepts or "models" we have
about health and disease, and hence enhance the final outcomes of healthcare.
History
of Medical Geography
Medical
geography has a long history. Since the time of the Greek doctor, Hippocrates
(5th-4th centuries BCE), people have studied the effect of location on one’s
health. For example, early medicine studied the differences in diseases
experienced by people living at high versus low elevation. It was easily
understood that those at living low elevations near waterways would be more
prone to malaria than those at higher elevations or in drier, less humid areas.
Though the reasons for these variations were not fully understood at the time,
the study of this spatial distribution of disease is the beginnings of medical
geography.
This
field of geography did not gain prominence until the mid-1800s though when
cholera gripped London. As more and more people became ill, they believed they
were becoming infected by vapors escaping the ground. John Snow, a doctor in
London, believed that if he could isolate the source of the toxins infecting
the population then and cholera could be contained.
As
part of his study, Snow plotted the distribution of deaths throughout London on
a map. After examining these locations, he found a cluster of unusually high
deaths near a water pump on Broad Street. He then concluded that the water
coming from this pump was the reason people were becoming sick and he had
authorities to remove the handle to the pump and making it unusable. Once
people then stopped drinking the water, the number of cholera deaths
dramatically decreased.
Snow’s
use of mapping to find the source of disease is the earliest and most famous
example of medical geography. Since he conducted his research however,
geographic techniques have found their place in a number of other medical
applications.
Another
example of geography aiding medicine occurred in the early 20th Century in
Colorado. There, dentists noticed that children living in certain areas had
fewer cavities. After plotting these locations on a map and comparing them with
chemicals found in the groundwater, they concluded that the children with fewer
cavities were clustered around areas that had high levels of fluoride. From
there, the use of fluoride gained prominence in dentistry.
Medical Geography Today
Today,
medical geography has a number of applications as well. Since the spatial
distribution of disease is still a large matter of importance though, mapping
plays a huge role in the field. Maps are created to show historic outbreaks of
things like the 1918 influenza for example or current issues like the index of
pain trends across the United States. In the pain map example, factors like
climate and environment can be considered to determine why high amounts of pain
cluster where they do at any given time.
Other
studies have also been conducted to show where the highest outbreaks of certain
types of disease occur. The Center for Disease Control and Prevention (CDC) in
the United States for instance uses what they call the Atlas of United States
Mortality to look at a wide range of health factors across the United States,
Data ranges from the spatial distribution of people at different ages to places
with the best and worst air quality. Subjects such as these are important
because they have implications on the population growth of an area and the
instances of health problems such as asthma and lung cancer. Local governments
can then consider these factors when planning their cities and or determining
the best use of city funds.
The
CDC also features a website for traveler’s health. Here, people can get
information about the distribution of disease in countries worldwide and learn
about the different vaccines needed to travel to such places. This application
of medical geography is important to reduce or even stopping the spread of the
world’s diseases through travel.
In
addition to the United States’ CDC, the World Health Organization (WHO) also
features similar health data for the world with its Global Health Atlas. Here,
the public, medical professionals, researchers, and other interested persons
can gather data about the distribution of the world’s diseases in an attempt to
find patterns of transmission and possibly cures to some of the more deadly
illnesses such as HIV/AIDS and various cancers.
Importance of medical
geography
It aims to improve the understanding of
the various factors which affect the health of populations and hence individual.
People
have also been aware of the process of disease diffusion across geographic
regions for centuries even during times when etiology of infectious diseases
was a mystery, example the Black Death (plague, 1346-51 AD pandemic, which was
carried along trade routes from China to Europe. Frequently, attempts to
understand why certain diseases seem to only occur in certain places and not
others has led to new insights into the nature of the disease itself (example
environmental and socio-economic causes or factors).
The
Black Death was one of the most devastating pandemics in human history,
resulting in the deaths of an estimated 75 to 200 million people in Eurasia and
peaking in Europe in the years 1346–1353.The bacterium Yersinia pestis,
resulting in several forms of plague, is believed to have been the cause. The
plague created a series of religious, social, and economic upheavals, which had
profound effects on the course of European history.
The
Black Death is thought to have originated in the dry plains of Central Asia,
where it then travelled along the Silk Road, reaching Crimea by 1343.From
there, it was most likely carried by Oriental rat fleas living on the black
rats that were regular passengers on merchant ships. Spreading throughout the
Mediterranean and Europe.
Medical geography help Geographer
to merges mapping and research to plot the spread of disease. An outbreak may
show up only in certain cities, or cluster around a source of contaminated
water. By tracking reports of illness, you uncover patterns that help identify
the cause of the virus.
Medical
geography help Geographer to protects international travelers. You provide
advice to travel organizations on common illnesses in a specific country, and
what vaccines a traveler should receive before vacationing there. You aim to
find and stomp out disease in all parts of the world. Example Ebola in West
Africa.
People
have also been aware of the process of disease diffusion across geographic
regions for centuries even during times when causes of infectious diseases was
a mystery, example the Black Death of 1346-51 AD, which was carried along trade
routes from China to Europe. Frequently, attempts to understand why certain
diseases seem to only occur in certain places and not others has led to new
insights into the nature of the disease itself example environmental and socio-economic
causes/factors. In the early part of the 20th century, for example, two
dentists in Colorado discovered that children living in areas with high levels
of naturally-occurring fluoride in groundwater had reduced dental caries.
Helps
the geographers to know the source of diseases, example Dr. John Snow, a London
physician and anesthesiologist, Using maps showing the locations of water pumps
and the homes of people who died of cholera, Snow was able to show that one
pump, the public pump on Broad Street, was causing most of the disease. People
could also see on this map that cholera deaths were not confined to the area
around the cemetery and were therefore convinced that the infection was not due
to vapors coming from it.
Analysis also includes
doing comparisons with other relevant patterns or clusters (in the same place
at different times and in other places) and again trying to methodically
explain any spotted differences or trends.
Obstacles
in Medical Geography
Although medical
geography is a prominent field of study today, geographers have some obstacles
to overcome when gathering data. The first problem is associated with recording
a disease’s location. Since people sometimes do not always go to a doctor when
ill, it can be difficult to get entirely accurate data about a disease’s location.
The second problem is associated with the accurate diagnosis of disease. While
the third deals with the timely reporting of a disease’s presence. Often,
doctor-patient confidentiality laws can complicate the reporting of a disease.
Since, data such as
this need to be as complete as possible to monitor the spread of illness
effectively, the International Classification of Disease (ICD) was created to
make sure that all countries use the same medical terms to classify a disease
and the WHO helps monitor the global surveillance of diseases to help data get
to geographers and other researchers as quickly as possible.
Through the efforts of
the ICD, the WHO, other organizations, and local governments, geographers are
in fact able to monitor the spread of disease fairly accurately and their work,
like that of Dr. John Snow’s cholera maps, are essential to reduce the spread
of and understanding contagious disease. As such, medical geography has become
a significant area of expertise within the discipline.
REFERENCES
Meade, M.S.& Earickson, R. J. (2000). Medical
Geography. New york, Guilford. (Chapter 1). Reading Health Research Crtical
Department of clinical Epidemiology and Biostatistics.
Pyle, G. F (1979).Applied Medical Geography. Washington,
DC: V.H.Winston
Hunter, J. (1974).Social Science and
Medicine.Oxford:Pergamon,1973.
PREPARED BY MICHAEL CHAINA(MCHAINA NEWS&TV)
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