The need for the "new health geography" in epidemiologic studies of environment and health

Abstract

Growth during the past decade in what can be broadly referred to as social and environmental epidemiologic research has been an important contributor to an emerging understanding of environment and health relationships. While the incorporation of geographic information systems as well as concepts such as "neighborhoods" might be viewed as evidence of social epidemiology moving closer to health geography, I argue that the two fields are not well aligned. Health geography has much more to contribute to studies of environment and health, and attention by social epidemiologists to those potential contributions could help rectify this misalignment. This paper suggests a number of geographic perspectives on health and environment that could create useful connections between geography and public health, via social epidemiology. To illustrate this potential, I use an ongoing study of a Texas community exposed to a large petrochemical complex-an inquiry constructed in the mode of social epidemiology - as a case in point. I apply several perspectives and concepts from geography to the case study. Cultural ecology, discourse materialized, political ecology, and territoriality are used to assess the Texas City situation and suggest important types of understandings that can enhance the social epidemiology approach to environment and health. I conclude with a discussion of the prospects for a social epidemiology infused with this type of geographic thought and analysis.

Figure 1

Texas City study area

Figure 2

View of Texas City study area (north) and petrochemical complex (grey area to the south).

Figure 3

Memorial Park in Texas City where the 1947 disaster is remembered.

Figure 4

An attempt to counter the industrial landscape that greets those entering Texas City.

Figure 5

Mural on an old school in a predominantly African-American neighborhood near the petrochemical plants.

Figure 6

It is not an exaggeration to say that some live in the shadow of the petrochemical plants.

Figure 7

Some areas adjacent to the industrial complex have been purchased by the petrochemical firms in an effort to create a buffer zone.

Figure 8

Once occupied but now vacant land near the refineries.

Figure 9

Property purchased and territorially marked by BP.

Figure 10

Former property of a survey respondent; the house was razed sometime after the interview was conducted.