British Columbia in a Global Context Chapter 7 Health Geography in British Columbia

. HEALTH GEOGRAPHY IN BRITISH COLUMBIA Learning Objectives . Develop an understanding of the great diversity of perspectives within the of health geography . Develop an understanding of how health is related to the spatial distribution of people and resources . Think critically about of health and place . Define The Golden Hour and describe the implications of it . Describe different types of health . 129 . Health Geography in British Columbia

Introduction Health geography emerged as a separate of Geography in the out of a desire to return to a study of place and landscape on experiences of health and ill health . It is focused on the experience of health and the role of place including , but not limited to , the study of disease ecology and mapping , health service provisions , therapeutic landscapes , public health policy , health in the workplace , patient experience , experience of disease , experience of disability , of care and responsibility and of mental ( ill ) health ( Brown , Moon , 2004 ) On a perspective , social of health influence the levels of health experienced by populations . These include Income levels and social status Social support networks Education conditions Social environments Physical environments Personal health practices and coping skills Healthy child development Gender Culture As we have learned in other sections of this book , British come from a variety of backgrounds and enjoy living in urban , suburban and rural settings . The spatial distribution of people , or where citizens live , will greatly affect their health and access to health care . For example , a person living in an urban area is likely to walk more often than someone living in a rural setting . The air quality will vary from urban to rural settings as well . A person health also influences his or her experience of a place . The study of health geography investigates all of these issues . Introduction 130

Types of Health Health is understood as the physical , mental and in some cases the spiritual state of a person or population . It is more that just the absence of sickness or disease the notion encompasses individual and community perception of good or bad heath . The right to health , which Health Canada and all provincial health services ascribe to , was set out in the United Nations Universal Declaration of Human Rights , incorporated in 1948 . Everyone has the right to a standard of living adequate for the health and of himself and of his family , including food , clothing , housing and medical care and necessary social services , and the right to security in the event of unemployment , sickness , disability , widowhood , old age or other lack of livelihood in circumstances beyond his control . Declaration of Human Rights 25 ( 1948 Health affects entire populations and is a key determinate to our , the overall individual and social state of wellness , and quality of life . Thus , it is monitored by provincial and local health authorities in Canada . To better monitor health conditions and access to health care , public health surveillance systems need to be in place . Public health surveillance is the collection , analysis , interpretation and dissemination of data on public health issues and its social and environmental . These data are collected in order to better understand spatial epidemiology , which is the study of patterns , causes and effects of health and diseases among certain populations . A geographic information systems ( GIS ) can be used to monitor and track health information for the study of epidemiology and for health surveillance purposes . GIS is not just a technological fix for health and mobility problems but rather a device that has the capability of informing and the public about where needs exist . For example , GIS has been used to offer decision support for health catchment areas for planning health resources in dispersed populations in rural ( Randall , 2011 ) applications allow physicians to provide care at a distance and provide a promising and unique means to provide health care and health education to dispersed populations . Northern portions of British Columbia may benefit from communication with a physician or nurse through the use of communication technologies . These technologies make it possible to communicate despite great distances that separate doctors and their patients . Read more about the uptake of in British Columbia in this Globe and Mail about , a provider in ) Mobile health ( is an emerging field it is the practice of medicine and public health supported by mobile devices . can be used for data collection for monitoring patients , informing diagnosis , organizing electronic medical records and for data dissemination by presenting health care resources , recommendation and education from doctors to patients using the mobile devices . Other health in include investigating of care in rural and northern communities , health inequities , Aboriginal health , child and family care , palliative and other types of care giving , medical tourism , and of mental health and addictions , and the intersection of of health and aging . These health are often concerned with access , equity , experience and outcomes . For example , First Nations people in . United Nations Universal Declaration of Human Rights en documents . Connecting doctors with patients with article from the Globe and Mail 131 Types of Health

Canada have higher rates of morbidity , trauma , illness , suicide , addiction , mental health issues and unwanted teenage pregnancy . Understanding how to address those issues from a comprehensive health promotion perspective is being explored on various fronts . Political health of in have also been an active area of inquiry . More recently in health geography , the comprehensive understandings of health and place that are promoted has lead to a focus on , which is an approach that prioritizes the of gender , class , race and ethnicity and other social divisions and seeks to understand how power relations structure these relationships . As it is applied to health geography , also considers these with spatiality , or the way that place also factors into this complex system that contributes to a state of health . Types of Health 132

Case Study The Golden Hour and Access to Health Care A significant , but often overlooked , public health concern that could benefit from public health surveillance is that of injury . Although injury does transcend status , age , sex and other dimensions of difference , noticeable variations do exist . Analysis of injury data has revealed that particular age groups , social classes , and geographic locations are disproportionately suffering injuries . Through injury surveillance it is possible to identify causes of injury and appropriate injury prevention efforts to be implemented that may target the affected population group or location ( Cinnamon , 2013 ) Professor Nadine and her research group have made great strides in injury surveillance research . and her colleagues ( 2006 ) created a model to show hospital catchment areas in rural . Their model implemented spatial road network analysis combined with population data to represent access to care services and travel time for the population . The model shows the spatial distribution of the golden hour . In acute trauma , receiving medical treatment within one golden hour will greatly increase an individual chance of survival . This model takes into account the unique geographic features in such as mountains and large water bodies that influence the time it takes to get to a hospital in rural areas of . mi Ill mum . I In an Road Network a mo Figure service areas for all hospitals in rural British . Figure . service areas for all hospitals in rural British Columbia by , Professor Nadine gis 133 Case Study The Golden Hour and Access to Health Care

and ( content ) used under license ( licenses ) Case Study The Golden Hour and Access to Health Care 134 Case Study Urban Heat Islands , Health and Spatial Technologies Air temperature is greatly influenced by , and urban areas have disproportionately higher temperatures due to the thermal properties of materials , lower vegetation cover and less , as well as complex surface morphology that traps outgoing radiation . Being able to map the intensity and extent of urban heat islands with existing data enables mitigation of the negative ramifications for heat risk ( Chapman , Baker , 2011 ) Hung Chak Ho and Anders , researchers from Simon University , are combining weather data collected by volunteers , government weather stations and remotely sensed data to understand and predict temperature variability in Vancouver , These researchers are most interested in summer months because of the changes in climate because significantly higher temperatures in the summer increase health risks , especially for certain populations such as the elderly and others with social and emotional vulnerability ( 2008 ) Daily Maximum An ) 10 , mam to lo A . Figure 72 Daily maximum air temperature relative to Vancouver Their analysis found large ( temperature variability across the urban landscape , with hotspots located in areas with low vegetation cover , few water bodies and dense urban development far from the coast . The unique methodology incorporating remote sensing , citizens and weather stations helps identify not only such hotspots but also sheds light on the factors that influence local temperature variability . Combined with information on the location of vulnerable populations , this information can help health authorities guide emergency response during extreme heat events , and can inform of urban greening and cooling initiatives . Figure Daily maximum air temperature Hung Chak Ho Anders 135 Case Study Urban Heat Islands , Health and Spatial Technologies

Summary Summary In this chapter we learned to develop an understanding of the diversity of perspectives within the of health geography . Health geography is the study of health and ill health in relationship to place . It is concerned with the study of disease ecology and mapping , health service provisions , therapeutic landscapes , public health policy , health in the workplace , patient experience , experience of disease , experience of disability , of care and responsibility and of mental ( ill ) health . To better understand the diversity of health , it is important to think about how health is related to the spatial distribution of people and resources . This is done by bringing attention to the social of health , epidemiology including mapping incidence of disease and a focus on access to health services . There are great opportunities to improve health surveillance intuitiveness through the use of GIS technologies . health system is based on ethical obligations of providing all people access to health services and ensuring that all citizens can realize their right to health . New approaches to providing this kind of access include mobile and options for people in rural communities . As we can see from the case study on the golden hour , the significant rural settlements in provide diverse challenges to accessing healthcare , especially in the case of acute trauma . Recently health have been drawing on an approach to understanding the complex of health and place . Summary 136

Key Terms Key Terms Geographic information system ( GIS ) A computer system designed to capture , store , manipulate , analyze , manage and present all types of geographical data . The acronym GIS is sometimes used for geographical information science or information studies to refer to the academic discipline or career of working with geographic information systems and is a large domain within the broader academic discipline of . An approach that prioritizes the of gender , class , race and ethnicity and other social divisions and seeks to understand how power relations structure these relationships . Mobile health ( The emerging field of the practice of medicine and public health supported by mobile devices . can be used for data collection for monitoring patients , informing diagnosis , organizing electronic medical records and for data dissemination by presenting health care resources . recommendations and education from doctors to patients using mobile devices . Public health surveillance The collection . analysis , interpretation and dissemination of data on public health issues and its social and environmental . Right to health A concept . which Health Canada and all provincial health services ascribe to , that was set out in the United Nations Universal Declaration of Human Rights , incorporated in 1948 . Social of health Those things that the levels of health experienced by populations . These include income levels and social status . social support networks , education , working conditions . social environments , physical environments , personal health practices and coping skills , healthy child development . gender and culture . Spatial epidemiology The study of patterns , causes and effects of health and diseases among certain populations . Technical applications that allow physicians to provide care at a distance a promising and unique means to provide health care and health education to dispersed populations . 137 Key Terms

Suggested Activities Su i tics Activity I Choose a current newspaper article that deals with a health issue in your home town or region . Write a page reflection on how this issue affects you and the community of which you are a part . Using a geographic perspective , highlight the role of place in this health issue . Share your reflection with a member of your community , and have a discussion about shared and divergent experiences with this issue . Activity Look at the map of in Case Study . Calculate how far you live from a trauma centre . Consider what other health care options are close to you for the provision of primary and traumatic care . With current resource levels of your community in mind , consider some possible steps that could be taken to increase your community access to care . Discuss with your family , a community group , or a local health care professional about the possibilities you have come up with . Activity Mental health is essential to people overall . Everyone has mental health , and experiences it at different levels . Research and practise three ways of maintaining or improving your own mental health over a period of one week each . Keep a journal during this time reflecting on how you think each method of mental health maintenance is working Which one works best for you ?

Consider the spatial implications of this . Questions could include , for example . Do you prefer to do 15 minutes of yoga or stretching in your home , or do you prefer to meet a close friend at a cafe ?

Is this an embodied or social form of mental health maintenance ?

Does where you practise each method of maintenance matter to the techniques effectiveness ?

Suggested Activities 138 References and Resources References Brown , Moon , 2010 , Introduction to Health and Medical Geography in A to Health and Medical Geography , Brown , Moon , Publishing , West , Brown , Moon , 2004 , A Companion to Health and Medical Geography , Publishing , West . Cinnamon , 2013 , Geographic Injury Surveillance in Lou ) Settings , Simon University , 2008 , Heat Stress and Public Health A Critical Review , Annual Review of Public Health , vol . 29 , National Team . Nations Regional Longitudinal Health Survey ( Results for adults , youth , and children living in First Nations communities , ON , Canada Assembly of First Nations Information Governance Committee . 2006 . Defining rational hospital for areas based on . International Journal of Health Geographics , Randall , 2011 , A spatial decision support tool for estimating population to aid rural and remote health service allocation planning , Health Journal , vol . 17 , no . Chapman , Baker , 2011 , Including the urban heat island in spatial heat health risk assessment strategies a case study for Birmingham , UK , International Journal of Health , vol . 10 , no . 42 . Resources Health Services Locator App Interactive map British Columbia health . Institute for Research and Policy Canadian Mental Health Association Ways of Maintaining Mental Health Social of Health 139 References and Resources