Search

This commentary explores historical efforts to diagnose the present and project the future through the specific example of medical manpower planning. To situate this, it draws on work within and across geography exploring the concept of anticipation and considers the discipline's failure to adequately engage with healthcare workers, despite the vibrancy of health geography as a subdiscipline. As it explores, ensuring adequate numbers of staff in a healthcare system has been an issue for as long as there have been healthcare systems. Planning for healthcare system needs is thus a particularly fraught form of anticipation that seeks to project future needs from a contested and often incalculable present as a basis for political decision‐making and resource allocation. As this commentary explores, it is a problem that is global in scope, historically deep and thus rich in analytical possibility. [ABSTRACT FROM AUTHOR]

Over the twentieth century, the concept of the natural experiment has become increasingly prominent across a variety of disciplines, albeit most consequentially in epidemiology and public health. Drawing on an analysis of the scientific and medical literature, we explore the social life of the natural experiment, tracing its changing use, meaning and uptake to better understand the work done by the concept. We demonstrate how the natural experiment became central to the identity of post‐war epidemiology as the discipline professionalised, turned its attention to the prevention of chronic disease and took centre stage in the field of public health. We then turn to its growing significance amid the rise of evidence‐based medicine, and the new meanings natural experiments came to take on in the context of concerns about policy and evidence. Finally, we turn to the newest iteration of the natural experiment in the COVID‐19 era, which saw an explosion of studies drawing on the term, albeit in ways that reveal more about the underlying politics of health than the method itself. Throughout, we illustrate that the concept of the natural experiment has always been fundamentally social and political and tied to disciplinary claims‐making about evidence and what should count as such. [ABSTRACT FROM AUTHOR]

Abdel Omran's epidemiological transition theory has become a convenient heuristic device for explaining shifts in the global distribution of disease. In turn, the temporal and geographic transition from "pandemics of infection" to "degenerative and man-made diseases" (Omran 1971, 161) as countries develop has become part of the mythology of global health. Such myths are powerful not because they are necessarily clearly true or false, but rather for what they naturalize or oversimplify (Essebro 2018). Drawing on the example of the work undertaken over the past three decades to ensure the prioritization of noncommunicable diseases (NCDs) as a problem of and for development within global health agendas, I draw on documentary and interview data to examine the origins and residual power of myths. Within this field, geographic myths (see Blaut 2006) about the social, economic, and spatial distribution of morbidity and mortality are a pervasive and persistent challenge for advocates trying to emphasize the threat of NCDs to the Global South. In examining the myth work undertaken by advocates, this article offers novel geographic perspectives to the critical global health field, while also arguing for the centrality of global health to geography as a discipline. [ABSTRACT FROM AUTHOR]

The alcohol policy debate demands greater critical reflection on the complex and disaggregated nature of the alcohol industries in contrast to their frequent characterization as a coherent, monolithic and singular entity with a common goal. Such reflection is necessary in order to rethink the linked assumption that drinkers are vulnerable victims of the activities of industry and, in so doing, to start moving beyond the UK's current policy development impasse in creative and plausible ways.

As "health" climbs academic, policy, commercial, non-profit and societal agendas, it has become increasingly subject to scrutiny by geographers. Yet, while health geographers may explore the discursive production, operationalization, deployment and management of health; the role of pedagogical practices has been repeatedly overlooked despite the clear intersections between the discipline's ongoing debate over its criticality and critical pedagogical aspirations. This paper explores this omission and its significance for teaching health geography by drawing upon the example and experience of two exercises undertaken with Masters students in a new health geography module--concept mapping and a simple definition exercise. (Contains 9 figures and 3 notes.)

COVID‐19 is a multi‐spectral crisis that has added an acute layer over a panoply of complex emergencies across the world. In the process, it has not only exposed actually‐existing emergencies, but also exacerbated them as the global gaze has turned inward. As a crisis, COVID‐19 straddles and challenges the boundaries between humanitarianism, development, and global health—the frames and categories through which emergencies are so often understood and intervened upon. Reflection on these fundamental categories is, we argue, an important geographical endeavour. Drawing on Geoffrey Bowker's analytical lens of the 'infrastructural inversion', we explore how humanitarianism has been upended by COVID‐19 along two axes that are of core concern to geographers: (1) the spatial and (2) the temporal. We first contextualise current debates on the humanitarian endeavour and its future within recent geographical research. We then set out the complex structure by which COVID‐19 has been both imagined and intervened upon as a humanitarian emergency. In so doing, we then pave the way for a deeper empirical analysis of the spatial and temporal inversions that have been brought forth by COVID‐19. The paper concludes by examining the conceptual value of the 'inversion' in developing geographical research agendas better attuned to the increasing porosity of humanitarianism, development, and global health. [ABSTRACT FROM AUTHOR]

The movement to decolonise global health is gathering pace. In its concern with the fundamental, distal causes of inequality and its call for social justice, the decolonisation movement forces us to question how global health works, for whom, where it is located, its funding practices, power asymmetries, cultures of collaboration and publication. This paper uses a new book by Harvard-based physician-anthropologist Eugene T. Richardson, Epidemic Illusions, as a point of departure for a broader analysis of the nature of global health knowledge, science, authorship, research and practice. Written in a 'carnivalesque' style, the book proceeds through a series of 'ironic (re)descriptions' to argue that global public health is an 'apparatus of coloniality'. In so doing, the book is generative of four ironic turns that we explore through the themes of guilt, humility, privilege and ambiguity. In locating these ironic turns within the broader landscape of global health, we reflect on whether the means of such a book achieve the ends of decolonisation. [ABSTRACT FROM AUTHOR]

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-9566.2008.01121.x Byline: Clare Herrick (1) Keywords: obesity; policy; public health Abstract: Abstract This paper examines how and why health has become a Corporate Social Responsibility (CSR) strategy for the global food and drink industry (FDI) in the context of current governmental and public calls to address mounting obesity rates. It argues that, despite the current prominence of health within CSR, there has not been a reciprocal interest by those adopting sociological approaches to the study of health and illness in the implications of this strategic uptake of health or in the viability and legitimacy of the state's own public health role. This omission is addressed through an empirical exploration of three contentions: first, that health and wellbeing may be used to secure brand value and consumer goodwill at a time when mounting obesity rates demand new levels of accountability from the FDI. Secondly, that the food industry, through CSR, may promote a narrow epidemiological understanding of obesity, shifting blame from 'foods' to 'diet' and from 'diet' to 'sedentarism'. Thirdly, that CSR reporting and its associated practices have enabled the food industry to assume some responsibility for obesity prevention, thereby problematising the state's role in addressing its own 'public health' crisis. Author Affiliation: (1)Department of Geography, King's College London Article note: Address for correspondence: Clare Herrick, Department of Geography, King's College London, Strand, London WC2R 2LS e-mail: clare.herrick@kcl.ac.uk

It has long been recognised that human health is indelibly shaped by a variety of factors. These include pathogens such as bacteria and viruses, but also broad-ranging social, economic and political forces operating at different spatial scales. In seeking to understand the nature and effects of these forces, two concepts have become particularly influential: the 'social determinants of health' and 'structural violence'. In this paper, we critically examine their origins, tracing their 'prehistory' and little-recognised intersections, based on searches of both concepts in PubMed and Google Scholar, and a critical reading of the range of texts our searches produced. This forms the groundwork from which we examine their similarities and differences, and their potentialities and limitations. We demonstrate that both concepts operate largely as black boxes. Their usage has thus become tied to disciplinary and methodological projects, with attendant implications for their wider usage – especially given the respective statuses of the fields of medical anthropology and social epidemiology in public health. We conclude that structural violence and the social determinants of health have both been influential in research and policy, but have struggled to effect the kinds of political change that their moral commitment to social justice promises and that further dialogue between them is required. [ABSTRACT FROM AUTHOR]

Noncommunicable diseases (NCDs) are a complex category composed of five diseases and five behavioural and environmental risk factors. These are, in turn, represented by multiple constituencies and communities of expertise and interest. This fractured landscape is evidenced by and magnified through an abject lack of conferences devoted to the category of NCDs. One of the very few is the NCD Alliance Forum, most recently held in February 2020 in Sharjah, United Arab Emirates. With the first Forum held in 2015 and another in 2017, these events offer powerful insight into the key actors, advocacy strategies, debates and aspirations of those working in the 'NCD space'. Using the Forum as its object of research and analysis, this paper critically reflects on two persistent questions facing NCD advocates. First, how might NCDs be more like infectious diseases in cultivating a sense of urgency and action? Second, is NCD advocacy a 'movement' or a 'community' of loosely connected actors? Set against the emerging COVID-19 outbreak, which at the time of the Forum was limited to China and a handful of other countries, the Forum offered a unique opportunity to reflect upon the significant challenges facing NCD advocates across global north and south. COVID-19 only highlights how rising rates of NCDs have made global populations vulnerable to emerging infectious diseases. Yet, as the paper concludes, with the COVID-19 pandemic continuing to rage, the future of NCD advocacy and funding looks ever more fragile even as evidence of its need continues to grow. [ABSTRACT FROM AUTHOR]

Until recently, the noncommunicable disease (NCD) category was composed of four chronic diseases (cancer, cardiovascular disease, diabetes and chronic respiratory disease) and four shared, 'modifiable' behavioural risk factors (smoking, diet, physical activity and alcohol). In late 2018, the NCD category was expanded to include mental health as an additional disease outcome and air pollution as an explicit environmental risk factor. The newly‐expanded NCD category connects behavioural and environmental readings of risk and shifts attention from individual acts of consumption to unequal and inescapable conditions of environmental exposure. It thus renders the increasing 'toxicity' of everyday life amid ubiquitous environmental contamination a new conceptual and empirical concern for NCD research. It also, as this paper explores, signals a new 'optics' of a much‐maligned disease category. This is particularly significant as chronic disease research has long been siloed between public and environmental health, with each discipline operationalising the notion of the 'environment' as a source of disease causation in contrasting ways. Given this, this paper is positioned as a significant contribution to both research on NCDs and environmental risk, bringing these interdisciplinary domains into a new critical conversation around the concept of toxicity. [ABSTRACT FROM AUTHOR]

Geographers have long been concerned with the spaces, scales, and conceptual significance of volunteering. They have, however, been slower to engage with the global surge in medical volunteering, whether in times of everyday or acute emergency. Volunteering is a crucial component of the architectures of global health and humanitarianism, but it remains marginal to the concerns of both health and development geographers. This paper seeks to address this lacuna through drawing on the case study of the 2013–2016 Ebola outbreak in Sierra Leone. When the outbreak was belatedly declared a Public Health Emergency of International Concern in 2014, volunteers flowed into Sierra Leone to aid in the response. In drawing on qualitative research with volunteers from a small, Freetown‐based NGO, we aim to close two explicit theoretical gaps. First, we draw out the geographical significance of volunteering during an outbreak of such exceptionality that the modalities, methods and architectures of global health and humanitarianism closed in on one another. Second, we explore how the act and experience of volunteering during the Ebola outbreak helped those involved apprehend what global health might mean and be. In so doing, we also reflect on the instrumental use of humanitarianism within a global health field whose professional contours are often remarkably difficult to navigate. In empirical terms, this intervention is rendered even more significant given the discipline's wider neglect of the Ebola outbreak as a crucial moment where the failures of global health were exposed and the toolkits of humanitarian intervention were pushed to their limits. This paper explores the 2013–2016 Ebola outbreak in Sierra Leone to examine (1) the geographical significance of volunteering during an exceptional outbreak and (2) how the act and experience of volunteering helped those involved apprehend what global health might mean and be. In so doing, we reflect on the instrumental use of humanitarianism within a global health field whose professional contours are often remarkably difficult to navigate. [ABSTRACT FROM AUTHOR]

The Ebola virus is unparalleled in its charismatic ability to ignite fear, anxiety and disgust at a scale grossly disproportionate to the number of lives it claims. As an archetypal 'Emerging Infectious Disease' (EID), this designation and the politics that have encircled it have provided Ebola with a conceptual space in which epidemiology and geography to splice together in the genesis and maintenance of its charismatic valence. Even before the West African outbreak of 2013–2016, Ebola was an 'exceptional' and 'master status' disease around which media attention mobilised to an unparalleled degree and effect. This paper argues that even if never directly conceptualised as such, Ebola is uniquely charismatic among EIDs and, more, this charisma can be understood geographically. To do so, the paper proceeds in three parts to explore how Ebola's geographic charisma emerges from: (i) it being fixed 'in place' as something innately African; (ii) fears about the virus moving 'out of place' and (iii) its 'potential energy' or the persistent unease generated by the uncertainty of when and where the virus's potential geographies will become actual. [ABSTRACT FROM AUTHOR]

Global health volunteering is premised on a comparative understanding of development: hospitals in developing countries are 'behind' modern institutions in developed nations, and sharing volunteers' skills will enable the latter to 'catch-up'. We argue for a 'relational comparison' in development studies, which draws upon a geographical conception of inequality premised on understanding places in relation to one another rather than reifying differences between countries. We place a particular hospital within a dialectical totality of combined and uneven development. Health workers' experiences of volunteering in Sierra Leone demonstrate that local problems, including staff shortages and corruption, are enveloped within global processes. [ABSTRACT FROM AUTHOR]

Global health partnerships (GHPs) are the conceptual cousin of partnerships in the development sphere. Since their emergence in the 1990s, the GHP mode of working and funding has mainly been applied to single-disease, vertical interventions. However, GHPs are increasingly being used to enact Health Systems Strengthening and to address the global health worker shortage. In contrast to other critical explorations of GHPs, we explore in this article how the fact, act, and aspiration of binding different actors together around the ideology and modes of partnership working produces the perpetual state of being in a bind. This is an original analytical framework drawing on research in Sierra Leone and London. We offer new insights into the ways in which GHPs function and are experienced, showing that along with the successes of partnership work, such arrangements are often and unavoidably tense, uncomfortable, and a source of frustration and angst. [ABSTRACT FROM AUTHOR]

Lencucha and Thow's paper offers an important addition and corrective to the burgeoning body of work in public health on the 'commercial determinants of health' in the context of non-communicable diseases (NCDs). Rather than tracing the origins of incoherence across policy sectors to the nefarious actions of industry, they argue that we need to be better attuned to the neoliberal ideologies that underpin these policies. In this commentary I explore two aspects of their argument that I find to be problematic: First, the suggestion that neoliberalism itself has some kind of deterministic or explanatory capacity across vastly different social, spatial, economic and political contexts. Second, I explore their concept of 'product-based NCD risk,' a perspective that disembodies and detaches risk from the social and structural conditions of their making. [ABSTRACT FROM AUTHOR]

The UN-HABITAT III conference held in Quito in late 2016 enshrined the first Sustainable Development Goal (SDG) with an exclusively urban focus. SDG 11, as it became known, aims to make cities more inclusive, safe, resilient and sustainable through a range of metrics, indicators, and evaluation systems. It also became part of a post-Quito ‘New Urban Agenda’ that is still taking shape. This paper raises questions around the potential for reductionism in this new agenda, and argues for the reflexive need to be aware of the types of urban space that are potentially sidelined by the new trends in global urban policy. [ABSTRACT FROM AUTHOR]

This paper explores the tensions between UN calls for private sector engagement in the post-2015 landscape and public health opposition to those 'harm industries' that are 'corporate vectors of disease' for the mounting global non-communicable disease burden. The UN's support for public-private partnership has provided industries with 'vested interests' in the propagation of unhealthy behaviours with new opportunities for the strategic alignment of their corporate social responsibility ( CSR) endeavours with the post-2015 sustainable development agenda. This has galvanised public health advocates to place pressure on the World Health Organisation to formalise their ambiguous stance towards private sector involvement in public policy formation and the resultant 'conflicts of interest'. This paper critically examines the 'gathering storm' between this 'anti-corporate movement' and the alcohol industry in the increasingly politicised domain of CSR. Drawing on the example of SABMiller's Tavern Intervention Program, the paper argues that CSR represents a profound threat to the sanctity and moral authority of the public health worldview. Questions therefore need to be asked about whether the public health-led path of industry non-association will necessarily result in health improvements or just a further retrenchment of the ideological faultlines explored in the paper. [ABSTRACT FROM AUTHOR]

This paper explores the intersections between the newly agreed urban and health Sustainable Development Goals (SDGs 3 and 11). It argues that while burgeoning studies theorizing cities of the global South have thus far largely failed to engage with the formative role of health in the experience of urban life and politics, concern with "global" health (health in the global South) has been slow to engage with the specific importance of urban issues. As these two interlinked domains skirt past each other, the potentially unifying field of urban health remains arguably marginal and under-theorized within both biomedicine and social science. The paper therefore asserts that a reinvigorated urban heath is crucial not only to realize the urban and health SDGs, but also to capitalize on new, emergent research and opportunities that may emerge as global health work shifts to better reflect the contours of the SDGs. [ABSTRACT FROM AUTHOR]

Consensus is fast building in the public health community around the need to research and address the ‘industrial epidemics’ of non-communicable disease across both Global North and South. However, while it is agreed that the effects of corporate behaviour on health are serious, there have been limited attempts to map out what a ‘science’ of these interrelationships might be. To do this requires actively engaging with the ways in which corporate actors generate and shape risk behaviours, public perceptions and influence policy. Moving forward, this ‘science’ will inevitably require critical reflection on the consequences of the deepening ‘ideological schism’ within the public health community in its attitudes towards industry. To date, of all the ‘unhealthy commodities industries’, alcohol has arguably received the least empirical attention from researchers. This gap is even more significant given the growing adversity between the public health community and the industry from the national scale to that of the WHO. This paper explores the nature of the ideological schism within alcohol research and its significance for the future development both of a ‘science’ of the effects of corporate behaviour on health and the advocacy that will be needed to change future regulatory and business environments in more health-promoting ways. [ABSTRACT FROM PUBLISHER]

This commentary explores how household economic necessity and the public health aspirations set out in the WHO’s global strategy to reduce the harmful use of alcohol might be reconciled in the context of alcohol control in developing countries. The ‘ambiguity’ of alcohol’s role in social and economic development is clear, but, as yet, little progress has been made on how best to integrate alcohol control within development policies in low- and middle-income countries. Without this holistic thinking, alcohol control efforts are likely to be thwarted by liquor’s allure as an accessible micro-enterprise opportunity. Similarly, developmental efforts will be undermined by the severity of alcohol-related harms that now disproportionately affect middle-income countries. Drawing on the example of South Africa, this short commentary explores the complexities of controlling the supply of alcohol when its sale represents a major livelihood strategy amid conditions of high unemployment and constrained access to formal employment markets. The policy preference for closing illegal bars or shebeens in South Africa does not address the ‘causes of the causes’ of why people drink, and therefore why its sale continues to be an attractive livelihood choice. It also does little to provide alternative leisure or employment opportunities, which ultimately threatens the longer term sustainability of policy. We need to better appreciate why selling alcohol is a seductive business opportunity and the potential consequences of this for realising public health aspirations. [ABSTRACT FROM PUBLISHER]

Recent African urbanist scholarship has suggested the need to delve deeper into our understanding of the everyday lived experiences in African cities. While this is essential for our understanding of African cities, researching lived experiences is fraught with methodological and ethical challenges. This is true for any topic when the researcher–subject gap is shaped by differences in nationality, class, race, norms and education, but especially so for the study of sensitive topics such as violence, sexuality, HIV/AIDS and xenophobia. Geographers have begun considering the ethics of researching particular sensitive issues, but not yet fully engaged with the international literature on the ethical and methodological challenges of researching such topics. To begin filling this gap, we reflect on experiences researching the lived experience and policy engagement with alcohol in Cape Town. We seek to apply and adapt the literature on sensitive topics specifically to the South African context. Our paper examines challenges which arose during the fieldwork and strategies developed to mitigate these. We emphasize how examining a topic with strong normative associations, which is bound up with illegality and community divisions, creates a need for particular attentiveness to research methods. [ABSTRACT FROM AUTHOR]

This paper examines, on one hand, the current regulatory environment in relation to alcohol retailing and consumption in South Africa's Western Cape. On the other, it explores how stakeholders of such regulations formulate, comprehend and act upon the ‘problem’ of drinking. As a result, the paper aims to tease out the discrepancies between what issaid(of alcohol by policy-makers) and what isdone(about alcohol within policy) through the conceptual lens of alcohol as ‘nuisance’. It does this in order to: (1) deepen current empirical engagements with alcohol control policies in South Africa and the Global South; (2) explore what stakeholders ‘know’ or believe about the drinking practices that they seek to regulate and (3) highlight the dynamic tensions between what is said and what is done. In so doing, the paper contributes novel empirical data to the growing cannon of geographical engagements with drinking practices and policies by situating its analysis in the context of the Western Cape. As a result, the paper marks out an original contribution to the multidisciplinary field of critical alcohol studies, as well as South African geographical research. [ABSTRACT FROM AUTHOR]

In the past decade, a sense of urgency has started to pervade alcohol regulation in South Africa. The burden of alcohol-related mortality and morbidity is among the highest in the world, and its effects are made worse by persistent socio-economic and structural inequalities. Moreover, alcohol is also a principle risk factor for infectious and chronic diseases, as well as a tenacious barrier to the achievement of the Millennium Development Goals. Its consumption and negative externalities have therefore become a public health and development crisis. This is despite alcohol's significant contribution to the South African national economy and individual livelihoods signalling an entrenched site of tension in alcohol regulation. However, while liquor has indubitably pernicious consequences, it does also provide a critical vantage point to further geographical engagements with the South African city and contemporary development debates. In so doing, the novel empirical and conceptual agendas set out in the papers also contribute to a broader engagement with the cultural contexts, meanings and settings of drinking practices in rapidly changing urban spaces of the Global South. [ABSTRACT FROM AUTHOR]

Media coverage of the "problems" associated with alcohol is widespread in countries of the global North and now, increasingly, in those of the global South. However, despite this mounting ubiquity, there have been very few analyses either of newspaper coverage of alcohol or of media coverage of alcohol policy, especially outside Europe and North America. This article argues that given international concern with the long-term health, economic, social, and developmental consequences of risky drinking in the global South, an exploration of newspaper coverage of nascent alcohol policy in such a context is both timely and valuable. Indeed, such analyses bring to the fore the deeply contextual and contingent nature of alcohol's problematization in politics, policy, and public life. To examine these assertions, we explore the "attention allocation" processes of two South African alcohol control policies-the Western Cape Liquor Bill and the city of Cape Town's liquor bylaws-in two regional English-language newspapers between 2007 and 2011. In so doing, the article highlights the particularities of the political valence of alcohol in the South African context. Furthermore, it also draws out the tensions between alcohol as a source of livelihoods in a context of endemic unemployment and chronic poverty and alcohol as a causal factor in poverty, crime, violence, and social disintegration. In contrast to media coverage of alcohol policy in Europe and North America, this analysis of the South African press suggests that liquor consumption is far less likely to be framed as an express health risk, forcing us to question how preventative policy efforts should best proceed. [ABSTRACT FROM AUTHOR]

Recent liquor legislation has centred on shebeens as conduits for crime and violence. In contrast to this perspective, we argue that shebeens form part of a complex constellation of relationships influencing alcohol-related violence. Drawing on a survey of shebeen owners in one community in Cape Town, this article explores how their experiences of crime and police raids are reshaping the dynamics of the liquor trade amid conditions of poverty. It argues that inconsistent and often arbitrary policing is driving many shebeens into adopting covert strategies to manage the risks of closure, fines, temporary imprisonment and bribes demanded by the police. In so doing, liquor law enforcement may have inadvertently precipitated new types of violence in township drinking environments. The paper explores the broader implications of these processes for efforts to address alcohol and violence in sustainable and equitable ways that improve quality of life and wellbeing for all. [ABSTRACT FROM AUTHOR]

The alcohol policy debate demands greater critical reflection on the complex and disaggregated nature of the alcohol industries in contrast to their frequent characterization as a coherent, monolithic and singular entity with a common goal. Such reflection is necessary in order to rethink the linked assumption that drinkers are vulnerable victims of the activities of industry and, in so doing, to start moving beyond the UK's current policy development impasse in creative and plausible ways. [ABSTRACT FROM AUTHOR]

As 'health' climbs academic, policy, commercial, non-profit and societal agendas, it has become increasingly subject to scrutiny by geographers. Yet, while health geographers may explore the discursive production, operationalization, deployment and management of health; the role of pedagogical practices has been repeatedly overlooked despite the clear intersections between the discipline's ongoing debate over its criticality and critical pedagogical aspirations. This paper explores this omission and its significance for teaching health geography by drawing upon the example and experience of two exercises undertaken with Masters students in a new health geography module-concept mapping and a simple definition exercise. [ABSTRACT FROM AUTHOR]