The Geography of Health Risks

This book has so far provided an introduction to GIS in terms of its use as part of a community health program. Subsequent chapters will describe a selection of more detailed GIS techniques and approaches. This chapter can be considered as an interlude, an attempt to set the scene by painting a backcloth of risks facing many city neighborhoods and the pregnant women living in them. Of course, at the risk of repeating oneself, there have been whole books written about single risk factors, so the task of compressing all risks into a single chapter is extremely difficult. This is made even harder because many of the situations described are not directly related to pregnancy outcomes, but instead are classed as neighborhood risks, contributing to the overall vulnerability of a person living in these environments. Although some may question why not concentrate solely on pregnancy-related risks, a more holistic understanding of the social environment can help place context into data, a movement away from the earlier criticized “structural functionalism” approach (Litva & Eyles, 1995). At this point it might be worth briefly mentioning that debate continues within the field of medical geography as to the degree in which pure analytical approaches ignore the social relevance of actions (a political economy approach), or how an individual’s experience shapes his or her actions (Dorn & Laws, 1994). For a review of these critical literatures in association with infant mortality see Gesler, Bird, and Oljeski, (1997).