The need for the "new health geography" in epidemiologic studies of environment and health.
Growth during the past decade in what can be broadly referred to as social and environmental epidemiologic research has been an important contributor to an emerging understanding of environment and health relationships. While the incorporation of geographic information systems as well as concepts such as "neighborhoods" might be viewed as evidence of social epidemiology moving closer to health geography, I argue that the two fields are not well aligned. Health geography has much more to contribute to studies of environment and health, and attention by social epidemiologists to those potential contributions could help rectify this misalignment. This paper suggests a number of geographic perspectives on health and environment that could create useful connections between geography and public health, via social epidemiology. To illustrate this potential, I use an ongoing study of a Texas community exposed to a large petrochemical complex-an inquiry constructed in the mode of social epidemiology - as a case in point. I apply several perspectives and concepts from geography to the case study. Cultural ecology, discourse materialized, political ecology, and territoriality are used to assess the Texas City situation and suggest important types of understandings that can enhance the social epidemiology approach to environment and health. I conclude with a discussion of the prospects for a social epidemiology infused with this type of geographic thought and analysis.
Cutchin
Malcolm P
MP
Division of Occupational Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 7122, USA. mcutchin@med.unc.edu
D002617:Chemical Industry; D002958:City Planning; D004782:Environmental Health; D004787:Environmental Pollution; D004812:Epidemiologic Methods; D006291:Health Policy; D006304:Health Status; D006801:Humans; D012111:Residence Characteristics / Q000145:classification; D012962:Sociology, Medical / Q000379:methods*; D013781:Texas / Q000453:epidemiology; D019371:Topography, Medical / Q000379:methods*; D014504:Urban Health / Q000706:statistics & numerical data*