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Many academics and health professionals look to the World Health Organization’s (WHO) constitution for a definition of health. Here, health is recognized broadly as not merely the absence of disease or distress, but more positively as a state of physical, mental, and social well-being. It is also generally accepted that, although good health can be a collective goal and good for society on an individual level, different people have different needs for health, different ideas as to what exactly good health is and different thresholds for poor health (such as physical pain or mental distress).
The public have displayed a growing interest in health and body matters, particularly in weathier, Western societies. The media and the Internet have played a significant role in creating a consumerist health culture and sustaining demand through providing a wealth of information on diseases, products, treatments, and health maintenance. This has been mirrored by the increased interest shown in health by the private sector, which has begun to market a vast array of health-related products ranging from food supplements to fitness machines.
The fitness boom of recent years has involved higher percentages of people regularly partaking in activities to improve their health. Complementary and alternative medicine, often connected with nature and natural lifestyles, have become more mainstream. The “pull factors” include its holistic and personalized nature, the greater time spent in consultations, the spiritual dimension, and the wider identification with an alternative ideology or culture.
At the same time, a growing number of people are involved in health-harming activities such as drug use and high-fat and high-calorie diets. It has been necessary to target policy and public heath efforts against a wide range of unhealthy activities.
An array of complex measurement tools have been developed to define and measure health. Health economists have developed the QALY (Quality Adjusted Life Year) as a combined measurement of quality and quantity of life. Meanwhile, the SF-36 is a well known and widely used measure of health status. Hundreds of research studies investigate the many human activities that effect health. Concepts such as well-being and wellness, and subjects such as public health, sports, and fitness are increasingly scrutinized. Similarly, health systems and services now incorporate disease prevention and public health alongside their traditional clinical disciplines. A complex and interrelated array of health disciplines now coexist and focus on women, children, familes, nutrition, communities, and behavior.
Engaging with the Environment
All of these engage with the environment in their own unique ways. For example, academic geographers have begun to explore the dynamics between health and environment. In 1992, Wil Gesler noted the positive psychological responses that people obtain from places, and how they affect physical, mental, spiritual, social, cultural, and emotional components of healing.
An important debate over recent years has focused on the relationships between public health and the urban environment. Research has amply demonstrated the existence of geographical differences in mortality, morbidity, and health-related behaviors, but results vary on if health and healthrelated behavior in specific places is more greatly influenced by the characteristics of social composition – gender, marital status, employment status, income, and debt – or by the services and facilities available to them, such as the presence of primary care, particular retail outlets, and affordable and healthy foodstuffs. However, it is argued that, in contrast, the affluence and social and cultural norms of particular groups might affect their use of services and facilities within specific locales. This “collective” dimension to area-based explanations for health emphasizes the sharing of traditions, values, and interests-ethnic, religious, political, historical, cultural, and/or labor-based-within places. Such collective dimensions facilitate group actions and support that potentially impact health.
The substantial field of academic research known as environmental health considers the impact of local environmental conditions on population health and health-related behaviors, and primarily focuses on environmental impacts on physical health. These range from relatively minor aliments and complaints to persistent, long-term conditions of varying severity (such as asthma and eczema), to others that are often terminal (such as Leukemia and lung disease). Meanwhile, a lesser number of studies focus on environmental impacts on mental health.
A great deal of research on the scales of environments focuses on health impacts on communities within broad regions-for example, states or provinces in North America-while some is focused on health in smaller locales, typically towns and urban neighborhoods. Often taking an epidemiological approach, research studies have identified the negative impact of toxic hazards on health. Air pollution has been a substantive issue for investigation. In particular, researchers have studies the impacts of area sources of pollution (such as radon and ozone); linear sources that are often mobile (such as traffic pollution); point sources (such as industrial pollutants); and a range of factors adding to local air quality.
A smaller volume of research has considered the spatial impacts of waterborne disease (such as cholera, schistosomiasis, and gastroenteritis) and chemical contamination (such as aluminum and arsenic) on health. During the past decade, environmental health concerns and research has expanded to include an attention to the public’s health beliefs, localized environmental risk perception, community reaction and local health policy. In addition, researchers interested in public health have also extended their gaze and considered micro-scale individual polluting behaviors such as smoking. These studies engage with concepts such as social and moral responsibility and the roles of individuals and governments, and articulate the everyday conflicts that can occur within and over community spaces.
- Eyles, “Environmental Health Research: Setting an Agenda by Spinning Our Wheels or Climbing the Mountain?” Health and Place (v.3, 1997);
- C. Gatrell, Geographies of Health: An Introduction (Blackwell, 2002);
- W. Gesler, “Therapeutic Landscapes: Medical Issues in the Light of the New Cultural Geography,” Social Science and Medicine (v.34, 1992);
- W. Gesler, Healing Places (Rowman and Littlefield, 2003);
- W. Gesler and R. Kearns, Culture/Place/Health (Routledge, 20002);
- Shaw, R. Mitchell, and D. Dorling, Health, Place and Society (Prentice Hall, 2002);
- S.E.L. Wakefield and Poland, “Family, Friend or Foe? Critical Reflections on the Relevance and Role of Social Capital in Health Promotion and Community Development,” Social Science and Medicine (v.60, 2005).