Search

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 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]

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]

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]

Health geography has emerged from under the "shadow of the medical" to become one of the most vibrant of all the subdisciplines. Yet, this success has also meant that health research has become increasingly siloed within this subdisciplinary domain. As this article explores, this represents a potential lost opportunity with regard to the study of global health, which has instead come to be dominated by anthropology and political science. Chief among the former's concerns are exploring the gap between the programmatic intentions of global health and the unintended or unanticipated consequences of their deployment. This article asserts that recent work on contingency within geography offers significant conceptual potential for examining this gap. It therefore uses the example of alcohol taxation in Botswana, an emergent global health target and tool, to explore how geographical contingency and the emergent, contingent geographies that result might help counter the prevailing tendency for geography to be sidestepped within critical studies of global health. At the very least, then, this intervention aims to encourage reflection by geographers on how to make explicit the all-too-often implicit links between their research and global health debates located outside the discipline. [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]

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]