How Place Matters to Health

How does Place Matter to the health of the public and the health of an individual?

I have a catch-phrase answer I use that says simply “Because Everything Happens Somewhere.”  This deceptively simplistic response actually hides a fair amount of complexity.  Where a person lives, where they spend many hours working during a year, and how they travel to and from their home and work all greatly impact their health and well-being.  Let’s look at a few examples.

Environmental Hazards

 Air quality can impact individual and population health.  Fine particles from automobiles, power plants, wood burning, industrial processes, and diesel powered vehicles such as buses and trucks may adversely impact air quality.  Research suggests deleterious effects including asthma, bronchitis, acute and chronic respiratory symptoms such as shortness of breath and painful breathing, and premature deaths (EPA).

HealthLandscape Community HealthView Data for Particulate Matter

Another example is a remnant of the Cold War and a byproduct of the Nuclear Arms race.  The U.S. has hundreds of factories and research facilities with potentially hazardous nuclear waste, the true health impact of which will not be known for many years.  You can learn more about these “Waste Lands” in this project of the Wall Street Journal.

Access to Healthcare Providers

Not everyone has equal access to health care providers, including primary care physicians, specialists, hospitals, specialty services, and pharmacies.  The HealthLandscape Healthcare Workforce Mapper can be used to learn where there are shortages of physician and non-physician providers.

Family Medicine Population to Provider Ratio, by County

Thinking Beyond the Individual

Place and the environmental can also have indirect, long-term effects on the health of people through the cascading impact on the food chain.  You may remember recent stories from the town of  Ribeauville in France, where beekeepers found their hives were producing blue and green and various colored honey.  It was discovered that the bees had begun feeding on waste from a local candy factory that was producing treats dyed in colors of bright red, blue, green, and yellow.  These dyes had been collected by the bees and deposited in the honey.  This colorful episode was not considered an immediate health concern — though the honey was an economic loss because of the unnatural coloring.  However, it provides stark evidence of the impact environmental conditions miles away may have on the food chain and subsequently the health of people who consume that food.

Learning to Think Spatially

OK, so, how do I orient my thinking to recognize the possibilities of space and place on health?  Learning to think spatially is an ongoing process, but there are a few concepts that will help you start down the path to lifetime learning.

As a start, you should always consider What (Location), Where (Patterns among multiple Locations), and When (Temporal Relations — how those Location(s) and Patterns changes over time).

  • What is the population you are studying?  Are you interested in individual congestive heart failure patients, failing students, older homes likely to have used lead-based paints?
  • Where are they in relation to one another and related locations?  How close are patients to clinics or hospitals, what is the travel (time or distance) to the nearest primary care provider, is there suitable public transportation in areas where households are less likely to have cars or areas of high traffic congestion?
  • How have these conditions changed over time?  What is the impact of the opening (or closing) of a primary care office, the loss of adequate bus transportation, the loss of specialized equipment or treatment services in a section of the city?

Learning to THINK spatially is an ongoing process, and we haven’t even talked about how to use Geographic Information Systems, or GIS, to help wrangle some of these concepts and ideas into manageable analysis and meaningful visualizations.  Take an opportunity to visit us at HealthLandscape (and sign up for one of our webinars) to see how GIS can help you understand how Place Matters to the health of your community.

Mark Carrozza

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