Health and Medical Geography

Fourth Edition

Michael Emch, Elisabeth Dowling Root, and Margaret Carrel

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February 20, 2017
ISBN 9781462520060
Price: $65.00
517 Pages
Size: 7" x 10"
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517 Pages
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Why are rainfall, carcinogens, and primary care physicians distributed unevenly over space? The fourth edition of the leading text in the field has been updated and reorganized to cover the latest developments in disease ecology and health promotion across the globe. The book accessibly introduces the core questions and perspectives of health and medical geography and presents cutting-edge techniques of mapping and spatial analysis. It explores the intersecting genetic, ecological, behavioral, cultural, and socioeconomic processes that underlie patterns of health and disease in particular places, including how new diseases and epidemics emerge. Geographic dimensions of health care access and service provision are addressed. More than 100 figures include 16 color plates; most are available as PowerPoint slides at the companion website.

New to This Edition: Pedagogical Features:

“From its new title onwards, the fourth edition of this excellent and engaging text explores the geographical dimensions of both health and medical concerns. New chapters and sections address pressing global issues such as obesity and climate change, as well as novel methods and theoretical perspectives including political ecology, spatial epidemiology, and epigenetics. Geographers will find the book a thought-provoking introduction to the worlds of health and medicine, while public health professionals will find it an accessible entry point to geographic perspectives and methods.”

—Sara L. McLafferty, PhD, Department of Geography, University of Illinois at Urbana–Champaign

“The fourth edition is a major update, with several new chapters covering such topics as political ecology and genetics. The title has been expanded from Medical Geography to Health and Medical Geography, reflecting the important shift to integrated perspectives. The authors present diverse holistic approaches to a broad and complex set of topics. This is arguably the comprehensive volume on health and medical geography—an evolution of a classic text that reflects the dynamic changes in the field. The writing is clear and engaging, and it avoids burying the reader in nonessential terminology or references. Many genuinely interesting historical and contemporary examples—some of them new even to this experienced reader—are included to illustrate the ideas.”

—Andrew C. Comrie, PhD, School of Geography and Development, University of Arizona

“I am very happy with the new additions and updates in the fourth edition. I like the new discussion of genetically based differences in metabolism and the expanded coverage of water pollution as an environmental justice issue. Disease diffusion is now framed in terms of environmental exposures, the mobility transition, and the space–time context. An impressive amount of work went into updating this text, which will be useful for instructors in our field.”

—Sue C. Grady, PhD, Department of Geography, Environment, and Spatial Sciences, Michigan State University

“Comprehensive, well organized, and engaging. One strength of the text is that it provides basic information on geographic concepts, so that students without a geography background will not be 'lost.' It should work well for almost any introductory medical or health geography course, regardless of the instructor’s particular interests—there is something for everyone. The book is well illustrated and presents example studies from all parts of the globe. The references and suggestions for further reading are not only useful for preparing lectures, but also can serve well for students further pursuing medical geographic or epidemiologic study. I will use this book in my course.”

—Anthony J. Dzik, PhD, Department of Social Sciences, Shawnee State University, Ohio

Table of Contents

I. Introduction and Big Ideas

1. What Is Health and Medical Geography?

- What’s in a Name?

- A Brief History of Health and Medical Geography

- Definitions and Terminology

- The Challenge of Health Geography

- References

- Review Questions

2. Ecology of Health and Disease

- Disease Agents and Transmission Processes

- The Triangle of Human Ecology

- Landscape Epidemiology and Vectored Diseases

- Conclusion

- References

- Review Questions

3. Expanding Disease Ecology

- Political Ecology

- The Poverty Syndrome

- Race in the Study of Health Risks

- Gender and Sex: Women’s Health

- Causal Reasoning and Epidemiological Design

- HIV and AIDS: Gender, Mobility, and Political Ecology

- The Precautionary Principle and Some Political Ecology of Research

- Conclusion

- References

- Review Questions

4. Transitions and Development

- Ecologies of Population Change: Multiple Transitions

- Major Impacts of Population Change

- Environmental Exposures, the Mobility Transition, and Time–Space Geography

- Disease Ecologies of the Agricultural Frontier

- Other Development Impacts on Rural Ecologies

- Globalization of Movements

- Conclusion: Emerging Diseases in Your Future

- References

- Review Questions

II. Maps and Methods

5. Maps, GIS, and Spatial Analysis

- Cartography of Health and Disease

- Geographic Information Systems

- Spatial Statistics

- Conclusion

- References

- Review Questions

6. Disease Diffusion

- Diffusion Background

- Epidemiological Background

- Types of Diffusion

- Networks and Barriers

- Modeling Disease Diffusion

- Influenzas

- Conclusion

- References

- Review Questions

7. Emerging Infectious Diseases and Landscape Genetics

- What’s in a Name? Emerging, Reemerging, or Always There

- Why Do Diseases Emerge, Reemerge, or Persist?

- Where Can We Expect These Diseases to Emerge/Reemerge?

- How Will These Diseases Behave?

- Landscape Genetics

- Conclusion

- References

- Review Questions

III. What We Eat and Where We Live

8. Food, Diet, and the Nutrition Transition

- From Hunter-Gatherers to Farmers

- The Columbian Exchange

- Modern Agricultural Systems

- The Green Revolution

- The Nutritional Transition

- Commercial Agriculture and the Nutrition Transition

- Direct and Indirect Health Effects of Agricultural and Dietary Changes

- Conclusion

- References

- Review Questions

9. Neighborhoods and Health

- The Concept of Neighborhood Health

- Social Context and Health

- Effects of the Built Environment on Health

- Opportunities and Challenges in Neighborhood Effects Studies

- Conclusion

- References

- Review Questions

10. Urban Health

- Cities and Urbanization

- A Brief History of Cities

- Large Cities in the Modern Era

- Developing World Cities: Dickens or a Dream?

- Traffic

- Disappearing Cities?

- Conclusion

- References

- Review Questions

IV. Environments and Climates

11. Environment and Health

- Toxic Hazards

- Outdoor Air Pollution

- Indoor Air Pollution

- Water Pollution

- Sources and Health Effects of Lead

- Risk Assessment and Prevention

- Globalization and the Perception of Health Hazards

- Hazards, Power, Policy, and Environmental Justice

- Healthy Environments

- Conclusion

- References

- Review Questions

12. Climate and Health

- Direct Biometeorological Influences

- The Influences of the Weather

- Seasonality of Death and Birth

- Physical Zonation of Climates and Biomes

- Climate Change and Health

- Conclusion

- References

- Review Questions

V. Health Care and Final Thoughts

13. Health Services and Access to Care

- What Is Access?

- The Provision of Medical Care

- Cultural Alternatives and Perceptions

- Conclusion: Transforming the Health Service Landscape

- References

- Review Questions

14. Concluding Words

- Review Questions

- Glossary

About the Authors

Michael Emch, PhD, is Professor and Chair of Geography at the University of North Carolina at Chapel Hill (UNC). He is also Professor of Epidemiology at UNC, a Fellow of the Carolina Population Center, and Director ofthe Spatial Health Research Group. Dr. Emch has published widely in the subfield of disease ecology, primarily on infectious diseases of the tropical world. He is an associate editor of Health & Place and an advisory editor for the international journal Social Science and Medicine.

Elisabeth Dowling Root, PhD, is Associate Professor of Geography at The Ohio State University. She is also Associate Professor of Epidemiology in the College of Public Health and a research affiliate at the Institute for Population Research. Dr. Root's work evaluates the short- and long-term impacts of public health interventions—including vaccination campaigns, maternal and child health and family planning programs, and health systems changes—in low-income countries. She is also interested in the long-term effects of neighborhood social and structural environments on child and adolescent health.

Margaret Carrel, PhD, is Assistant Professor of Geographical and Sustainability Sciences at the University of Iowa. She is also Assistant Professor of Epidemiology in the College of Public Health. Dr. Carrel focuses primarily on the geography of infectious disease, with emphasis on how human-environment interactions influence the evolution of pathogens. She is also interested in understanding the impact of food production, particularly of livestock, on human health.


Students and instructors in geography, public health, and medical anthropology; also of interest to researchers in these fields.

Course Use

Serves as a text in advanced undergraduate- and graduate-level courses on health and/or medical geography, geography of diseases, epidemiology, and medical anthropology.
Previous editions published by Guilford:

Third Edition, © 2010
ISBN: 9781606230169

Second Edition, © 2000
ISBN: 9781593851606

First Edition, © 1988
ISBN: 9780898627817
New to this edition: