Placing health:
It is well evident that place can create
inequalities in health. The discipline of geographical research in present days
is mostly concerned about exploring this relationship between place and health.
Although the variation in health and wellbeing of the people may be mostly
explained by the individual characteristics (i.e. who lives here?), there is a
significant contribution of the contextual factors (i.e.
what is the place like?). Apart from the individual
compositional factors (such as demographic, behavioural and psychosocial), the
contextual factors (such as social, physical and institutional environments)
also determine the health outcomes of the people. When exploring the
environmental mechanism of place on health, it is imperative to investigate the
distribution and concentration of the “pathogenic”
(health-damaging) and “salutogenic” (health-promoting)
factors in the neighbourhood. Existing evidence suggests a skewed distribution of these
attributes—affluent neighbourhoods enjoying the influx of salutogenic attributes
while the poorer areas are oftentimes drowned in pathogenic environment.
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| The density of geocoded media captured during the trip |
In
October last year, along with colleagues from SHLC, I got
a chance to visit New Delhi, the capital of India. During the week-long stay, I
used my hat of a ‘Health Geographer’ to see the type and distribution of
visually evident health-impacting environmental factors in different types of neighbourhoods.
We walked (see the fate of my shoes in one of the pictures) through the
different types of neighbourhoods—from slums to planned and gated areas. While
out, I used my GPS enabled smartphone to record the track and took pictures
with geocodes. The map below shows the density of geocoded media collected
during the whole trip. Using the rich data that was gathered then, this post
tries to present the trip in an interactive visual way.
Using the interactive map: Please zoom in to see the different routes we took and click on the images to see my impression.
As previous indications, a clear divide in environmental
attributes was visible based on the type of neighbourhood we visited. While
slums and areas of urban sprawls had a higher concentration of health-damaging
environmental factors, areas in planned settlements had better facilities in
their doorsteps. Litter, open sewage, unhygienic trade of food, over-crowding,
narrow streets and dusty air (roads too) were the common sights in poorer
neighbourhoods. In contrast, greenery, wider streets, managed parks, stand-by
security staffs were the views in more affluent neighbourhoods. Interestingly,
the encroachment of the street was a common sight in all types of
neighbourhoods. Parking motor vehicles in the pavement or vending in those
spaces was pushing the pedestrian into the main street. A stark difference was
in the availability and access to open/green space.
The trip was
informative and offered me the first-hand experience of the environmental
injustice prevalent in different types of neighbourhoods. There was,
however, no opportunity to link this observation with the level of health
divides between these neighbourhoods. I expect that the next stage of research
within SHLC will elucidate the role of these environmental attributes in the
geographical inequalities in health.
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