title: Connecting the Dots Between Health, Poverty and Place in Accra, Ghana.
abstract: West Africa has a rapidly growing population, an increasing fraction of which lives in urban informal settlements characterized by inadequate infrastructure and relatively high health risks. Little is known, however, about the spatial or health characteristics of cities in this region or about the spatial inequalities in health within them. In this article we show how we have been creating a data-rich field laboratory in Accra, Ghana, to connect the dots between health, poverty, and place in a large city in West Africa. Our overarching goal is to test the hypothesis that satellite imagery, in combination with census and limited survey data, such as that found in demographic and health surveys (DHSs), can provide clues to the spatial distribution of health inequalities in cities where fewer data exist than those we have collected for Accra. To this end, we have created the first digital boundary file of the city, obtained high spatial resolution satellite imagery for two dates, collected data from a longitudinal panel of 3,200 women spatially distributed throughout Accra, and obtained microlevel data from the census. We have also acquired water, sewerage, and elevation layers and then coupled all of these data with extensive field research on the neighborhood structure of Accra. We show that the proportional abundance of vegetation in a neighborhood serves as a key indicator of local levels of health and well-being and that local perceptions of health risk are not always consistent with objective measures.
authors.affiliation: Department of Geography, San Diego State University.
authors.forename: John R
authors.initials: JR
authors.lastname: Weeks
authors.affiliation: Department of Geography, San Diego State University.
authors.forename: Arthur
authors.initials: A
authors.lastname: Getis
authors.affiliation: Department of Geography, San Diego State University.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Stow
authors.affiliation: Department of Global Health and Population, Harvard School of Public Health.
authors.forename: Allan G
authors.initials: AG
authors.lastname: Hill
authors.affiliation: Department of Geography, George Washington University.
authors.forename: David
authors.initials: D
authors.lastname: Rain
authors.affiliation: Department of Geography, George Washington University.
authors.forename: Ryan
authors.initials: R
authors.lastname: Engstrom
authors.affiliation: Department of Geography, San Diego State University.
authors.forename: Justin
authors.initials: J
authors.lastname: Stoler
authors.affiliation: Department of Geography, San Diego State University.
authors.forename: Christopher
authors.initials: C
authors.lastname: Lippitt
authors.affiliation: Department of Geography, San Diego State University.
authors.forename: Marta
authors.initials: M
authors.lastname: Jankowska
authors.affiliation: Department of Geography, San Diego State University.
authors.forename: Anna Carla
authors.initials: AC
authors.lastname: Lopez-Carr
authors.affiliation: Department of Geography, San Diego State University.
authors.forename: Lloyd
authors.initials: L
authors.lastname: Coulter
authors.affiliation: Department of Geography, George Washington University.
authors.forename: Caetlin
authors.initials: C
authors.lastname: Ofiesh
keywords: Africa; Ghana; health; neighborhood; remote sensing