Health and Place

This study was to identify hysterectomy prevalence across urban, rural and remote areas of Australia and across states, to separate geographic variation from the effect of sociodemographic influences, and also to compare the quality of life of women who have and have not had hysterectomy. Data were collected from 14,072 women aged 45-50 years participating in the baseline survey of the Australian Longitudinal Study on Women's Health. The estimated prevalence of hysterectomy was 22%. Factors significantly associated with hysterectomy included living in a rural or remote area, state of residence, having private health insurance, lower levels of education, being married and having more than two children, having had other gynaecological and non-gynaecological surgical procedures, and more visits to general practitioners. Compared with women who had not had hysterectomy, women who had had hysterectomy had significantly poorer physical and mental health as measured by the SF-36 quality of life profile (adjusted mean PCS=45.7 vs 49.3, p<0.0001; adjusted mean MCS=46.9 vs 48.2, p<0.0001).

Racial health disparities continue to be a serious problem in the United States and have been linked to contextual factors, including racial segregation. In some cases, including breast cancer survival, racial disparities appear to be worsening. Using the Home Mortgage Disclosure Act (HMDA) database, we extend current spatial analysis methodology to derive new, spatially continuous indices of (1) racial bias in mortgage lending and (2) redlining. We then examine spatial patterns of these indices and the association between these new measures and breast cancer survival among Black/African American women in the Milwaukee, Wisconsin metropolitan area. These new measures can be used to examine relationships between mortgage discrimination and patterns of disease throughout the United States.

This paper articulates how political ecology can be a useful tool for asking fundamental questions and applying relevant methods to investigate structures that impact relationship between neighborhood and health. Through a narrative analysis, we identify how political ecology can develop our future agendas for neighborhood-health research as it relates to social, political, environmental, and economic structures. Political ecology makes clear the connection between political economy and neighborhood by highlighting the historical and structural processes that produce and maintain social inequality, which affect health and well-being. These concepts encourage researchers to examine how people construct neighborhood and health in different ways that, in turn, can influence different health outcomes and, thus, efforts to address solutions.

This study explores the neglected issue of how families engage with beach environments in their local areas and use them in health promoting ways. Fifteen families with children aged 8-11 years living in coastal regions in Southwest England participated in individual semi-structured interviews. The findings indicate that beaches encouraged families to be physically active. Although families valued the opportunities for physical activity and active play afforded by beaches, the key health benefits emphasised were psychological, including experiencing fun, stress relief and engagement with nature. Increased social and family interaction was also highlighted as benefits. Despite perceiving health benefits, not all families regularly visited the beach. Barriers to visits included parents having limited time, cost of parking, lack of car access and cold weather. Parents played a key role in enabling visits by choosing to share these environments with their children. The social dimension of visits also encouraged families to make regular trips. The findings support the use of beach environments to promote families' health and wellbeing and positive relationships with nature.

This thesis sets out to generate fresh insights into the potential underlying causes of the ‘Scottish Effect’, by developing a theoretically-grounded, interdisciplinary and qualitative approach to the problem.  The ‘Scottish Effect’ describes the excess mortality that exists in Scotland, in comparison to that in England and Wales, after statistical adjustment for age, sex and levels of area-based deprivation.  The ‘Scottish Effect’ grew substantially during the 1980s, so that Scottish mortality rates were 8% higher than in those in England and Wales by 2001, even after accounting for Scotland’s higher rates of poverty (Hanlon et al., 2005).  While a number of hypotheses as to the underlying causes of the ‘Scottish Effect’ have been put forward, it has yet to be explained (McCartney et al., 2011a).
In response to these hypotheses, this study attempts to unpick the impacts of the rapid and largely unmitigated process of deindustrialisation that began in the 1960s in Britain, but which took on an arguably more damaging character from 1979 under the neoliberal Conservative government (Collins and McCartney, 2011).  Drawing on concepts from geography and social theory, and in particular Ann Swidler’s (1986; 2003) concepts of cultured capacities, cultural toolkits and strategies of action, this analysis explores the ways in which this process of socio-political change may have impacted differently on health in different places.  By conceptualising place as a ‘lens’ that shapes the flow of many different kinds of resources through space, this thesis examines the political, economic and social processes that could partially underlie the spatial patterning of unexplained mortality.
This approach is deployed by way of a case study of the town of Clydebank in west central Scotland, which focuses on the period 1970 - 2010 and draws upon data from oral history interviews and photovoice projects.  It explores the potential for as yet unmeasured economic, social, political and symbolic resources to be implicated in the emergence and growth of ‘Scottish Effect’.  In so doing, it identifies several processes through which the experience of neoliberalism in (west central) Scotland could have led to the erosion of these health-protective resources and how this, in turn, may have impacted differentially upon health there.  It concludes by suggesting a number of avenues for future, comparative research in light of these theoretically-grounded insights.

The aim of this review is to bring the phenomenological sense of place approach together with current results from neuroscience. We searched in neuroscientific literature for ten dimensions which were beforehand identified to be important in a phenomenological sense of place/place identity model: behaviour, body, emotion, attention, perception, memory, orientation, spirituality, meaning/value and culture/sociality. Neuroscience has identified many neurobiological correlates of phenomenological observations concerning sense of place. The human brain comprises specific and specialised structures and processes to perceive, memorise, link, assess and use spatial information. Specific parts (hippocampus, entorhinal, parahippocampal and parietal cortex), subregions (parahippocampal place area, lingual landmark area), and cells (place cells, grid cells, border cells, head direction cells) have been identified, their specific function could be understood and their interaction traced. Neuroscience has provided evidence that place constitutes a distinct dimension in neuronal processing. This reinforces the phenomenological argumentation of human geography and environmental psychology.

Although therapeutic itineraries have been studied in a variety of contexts, little research has investigated care-seekers’ quests for traditional medical treatments outside their own ethnic boundaries. The present study investigated 19 Igbo women seeking traditional cures from Ibibio indigenous healers in Akwa Ibom State, Nigeria. Emerging data show that these Igbo women were uptaking Ibibio indigenous treatments primarily for health

Visiting favourite natural settings may serve as a resource for regulating negative feelings and coping with perceived stress. The authors investigated the association between perceived health, the selection and experiential qualities of favourite places in four residential areas; 211 respondents (average age 40 years) responded to the questionnaire. Respondents with a certain amount of health complaints, such as headaches, chest or stomach pains, and faintness or dizziness, were more likely to select natural favourite places than those with few complaints. Respondents with health complaints benefited more in emotional terms from their visits to the favourite place although they did not visit their places more frequently than others. The change toward positive feelings was associated in particular with natural favourite places and relaxing in them. The results give impetus to research on the self-regulation of mood and neighbourhood context in health.

Many epidemiological studies have found that people living in environments with more green space report better physical and mental health than those with less green space. However, the association between visits to green space and mental health has seldom been studied. The current study explored the associations between time spent in green spaces by purposeful visits and perceived mental health and vitality in four different European cities, and to what extent gender, age, level of education, attitude towards nature and childhood nature experience moderate these associations. Data was gathered using a questionnaire administered in four European cities (total n=3748). Multilevel analyses showed significant positive associations between time spent visiting green spaces and mental health and vitality in the pooled data, as well as across the four cities. Significant effect modification was found for level of education and childhood nature experience. The findings confirm the hypothesis...