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Health Geography and Its Relevance for Future Public Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (15 January 2021) | Viewed by 66657

Special Issue Editors

Prof. Thomas Krafft

E-Mail Website
Guest Editor
CAPHRI School of Public Health and Primary Care, University of Maastricht, Netherlands
Interests: public health surveillance; urban (environmental) health; global health
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Mark Rosenberg

E-Mail Website
Guest Editor
Department of Geography and Planning, Queen's University, Kingston, ON K7L 3N6, Canada
Interests: geographical gerontology; social gerontology; geographies of health and inequalities; access to care
Prof. Dr. Paula Santana

E-Mail Website
Guest Editor
Centre of Studies in Geography and Spatial Planning, Department of Geography and Tourism, University of Coimbra, 3004-531 Coimbra, Portugal
Interests: geography of health; healthy urban planning; health determinants; urban health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

On behalf of IJERPH, the International Geographical Union Commission on Health and the Environment (IGU-CHE) is organizing a Special Issue on health geography and its relevance for public health.

Health geography analyzes health and health systems responses to health needs as complex, open, and dynamic interactions of people and the environment. In this way, health geography encourages, for example, an understanding of the health of local populations as being interconnected to and interdependent with global health. This holistic approach translates into multidisciplinary studies, drawing on concepts and methods from geography, epidemiology, the social sciences, public health, and many other disciplines. For this Special Issue, we would like to invite recent scientific contributions of health geographies to public health.

Below are some topics reflecting the scope of the Special Issue.

  • Health surveillance;
  • Health inequality;
  • Environment and health;
  • Health across borders/cross-border healthcare;
  • Methods for health geography;
  • Spatial analysis for public health;
  • Global health in the Anthropocene.

Prof. Thomas Krafft
Prof. Dr. Mark Rosenberg
Prof. Dr. Paula Santana
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (16 papers)

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Research

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24 pages, 1305 KiB  
Article
“East” in Europe—Health Dimension through the Lens of the UK Daily Mail and Statistical Facts
by Izabella Lecka, Viktoriya Pantyley, Liudmila Fakeyeva and Alexandrina Cruceanu
Int. J. Environ. Res. Public Health 2021, 18(7), 3705; https://doi.org/10.3390/ijerph18073705 - 01 Apr 2021
Cited by 1 | Viewed by 2711
Abstract
The study concerns the relationship between health and geopolitics in the United Kingdom (UK). To demonstrate this relationship, we examined the subject and tone of articles published in the popular media (on the example of tabloid the Daily Mail) in 2006–2020 concerning [...] Read more.
The study concerns the relationship between health and geopolitics in the United Kingdom (UK). To demonstrate this relationship, we examined the subject and tone of articles published in the popular media (on the example of tabloid the Daily Mail) in 2006–2020 concerning health and medical care, and the health and health care practice of Eastern European immigrants belonging to and not belonging to the European Union (EU). There was an increase in media criticism of the behaviour of immigrants in the years 2014–2017, in the period around the referendum in favour of the UK leaving the EU (Brexit). Attention was drawn to the media’s use of a Belief in a Zero-Sum Game (BZSG) narrative at that time. On both sides, “hosts” and the “guests”, a progressive anomy process was observed, degrading the behaviour of individuals and social groups. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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14 pages, 956 KiB  
Article
Conversations in Times of Isolation: Exploring Rural-Dwelling Older Adults’ Experiences of Isolation and Loneliness during the COVID-19 Pandemic in Manitoba, Canada
by Rachel V. Herron, Nancy E. G. Newall, Breanna C. Lawrence, Doug Ramsey, Candice M. Waddell and Jennifer Dauphinais
Int. J. Environ. Res. Public Health 2021, 18(6), 3028; https://doi.org/10.3390/ijerph18063028 - 15 Mar 2021
Cited by 29 | Viewed by 6691
Abstract
Older adults have been described as a vulnerable group in the current context of the COVID-19 pandemic. In Canada, where this study took place, older adults have been encouraged to self-isolate while the rest of the population has been cautioned against in-person contact [...] Read more.
Older adults have been described as a vulnerable group in the current context of the COVID-19 pandemic. In Canada, where this study took place, older adults have been encouraged to self-isolate while the rest of the population has been cautioned against in-person contact with them. Prior to COVID-19, social isolation and loneliness among older adults was considered a serious public health concern. Using a series of semi-structured interviews with 26 community-dwelling older adults (65+) living in rural Manitoba, we explore older adults’ experiences of isolation and loneliness in the initial stages of the pandemic between the months of May and July 2020. Participants identified a loss of autonomy, loss of activities and social spaces (e.g., having coffee or eating out, volunteering, and going to church), and lack of meaningful connection at home as factors influencing their sense of isolation and loneliness. Although these loses initially influenced participants’ self-reported isolation and loneliness, the majority developed strategies to mitigate isolation and loneliness, such as drawing on past experiences of isolation, engaging in physically distanced visits, connecting remotely, and “keeping busy.” Our findings call attention to the role of different environments and resources in supporting older adults social and emotional wellbeing, particularly as they adapt to changes in social contact over time. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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15 pages, 751 KiB  
Article
“They Do Not Care about Us Anymore”: Understanding the Situation of Older People in Ghana
by Joseph Asumah Braimah and Mark W. Rosenberg
Int. J. Environ. Res. Public Health 2021, 18(5), 2337; https://doi.org/10.3390/ijerph18052337 - 27 Feb 2021
Cited by 18 | Viewed by 3457
Abstract
While existing research acknowledges copious challenges faced by older adults (people aged 60 and over) in Ghana and most countries in sub-Saharan Africa, they fail to situate the lived experiences of this vulnerable group within the broader context of health geography and public [...] Read more.
While existing research acknowledges copious challenges faced by older adults (people aged 60 and over) in Ghana and most countries in sub-Saharan Africa, they fail to situate the lived experiences of this vulnerable group within the broader context of health geography and public health. This paper draws insights from ecological systems theory and the “geographies of older people” literature to examine the lived experiences of older people in Ghana. Data for the study were gathered using interviews (42) and sharing circles (10). Our findings reveal a complex mix of experiences consistent with the different levels of the environment. Dominant themes include access to social support, functional impairment and poor health status, social status, poor access to water and sanitation services, food insecurity, economic insecurity, and caregiving burden. These findings support the wide-held notion that the experiences of older people are complex and produced by the interplay of both individual and structural factors. Our findings demonstrate that sociocultural, economic, political, and climatic factors are important consideration in promoting elderly wellbeing and quality of life in Ghana. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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16 pages, 334 KiB  
Article
Climate Action at Public Health Schools in the European Region
by Rana Orhan, John Middleton, Thomas Krafft and Katarzyna Czabanowska
Int. J. Environ. Res. Public Health 2021, 18(4), 1518; https://doi.org/10.3390/ijerph18041518 - 05 Feb 2021
Cited by 8 | Viewed by 3536
Abstract
Climate change is putting the achievement of all Sustainable Development Goals at risk and leads to negative impacts on human health and well-being. Consequently, tremendous social responsibility lies with public health professionals and their associations. Therefore, this study addressed the following question: “How [...] Read more.
Climate change is putting the achievement of all Sustainable Development Goals at risk and leads to negative impacts on human health and well-being. Consequently, tremendous social responsibility lies with public health professionals and their associations. Therefore, this study addressed the following question: “How can the Association of Schools of Public Health in the European Region (ASPHER) best support the goals of the European Green Deal through its network of public health schools and departments?” This study looked at the implementation of climate education in public health schools in the European region and climate action taken by these public health schools. An online survey among ASPHER members with a 51% overall response rate (excluding non-European members) shows that 64% of the responding schools provide climate-health educational offerings, while 63% consider these for the future. Additionally, most climate actions taken by the schools were ad hoc actions. These findings show that a systematic approach is missing, and there is a general lack of strategy in most schools. We consequently recommend that schools invest in climate and health education in their curricula and become exemplars for climate action to actively contribute to the achievement of Europe’s climate goals. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
17 pages, 1535 KiB  
Article
Accessibility of Rural Life Space on the Jianghan Plain, China: The Role of Livelihood
by Rongrong Zhuo, Mark Rosenberg, Bin Yu, Xinwei Guo and Mingjie Wang
Int. J. Environ. Res. Public Health 2021, 18(3), 1301; https://doi.org/10.3390/ijerph18031301 - 01 Feb 2021
Cited by 1 | Viewed by 3137
Abstract
This article aims to contribute to the relationship between accessibility of rural life space and rural livelihood capital and transitions in rural central China. Employing data produced from a household survey, we developed a composite index for accessibility of rural life space incorporating [...] Read more.
This article aims to contribute to the relationship between accessibility of rural life space and rural livelihood capital and transitions in rural central China. Employing data produced from a household survey, we developed a composite index for accessibility of rural life space incorporating spatial and temporal attributes of a household’s daily activities and then explored the mediation effect of rural livelihood capital and transitions on accessibility. Results revealed a pattern of diversification in terms of life space accessibility undertaken for daily activities across households. Both livelihood capital and transitions had significant mediation effects on the relationship between socio-economic characteristics of rural households and accessibility of rural life space. The effects of livelihood capital on livelihood transitions also influenced the path on rural households’ accessibility of rural life space. One of the implications of this article is to link rural transformation to the context of urbanization and rural access issues from a perspective of daily activity, and then to figure out the best method for rural development policy and service planning. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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18 pages, 2304 KiB  
Article
Spatial Access Matters: An Analysis of Policy Change and Its Effects on Avoidable Infant Mortality in Portugal
by Morgan Weiland, Paula Santana, Claudia Costa, Julia Doetsch and Eva Pilot
Int. J. Environ. Res. Public Health 2021, 18(3), 1242; https://doi.org/10.3390/ijerph18031242 - 30 Jan 2021
Cited by 6 | Viewed by 3004
Abstract
In 2006, a policy reform restructured the maternal and perinatal healthcare system, including closing smaller maternity units, to further improve care in Portugal. This study aimed to investigate the effects of the 2006 National Program of Maternal and Neonatal Health policy on spatial [...] Read more.
In 2006, a policy reform restructured the maternal and perinatal healthcare system, including closing smaller maternity units, to further improve care in Portugal. This study aimed to investigate the effects of the 2006 National Program of Maternal and Neonatal Health policy on spatial inequalities in access to care and consequently avoidable infant mortality. A thematic analysis of qualitative data including interviews and surveys and a quantitative spatial analysis using Geographic Information Systems was applied. Spatial inequalities were found which may lead to avoidable infant mortality. Inequalities exist in freedom of choice and autonomy in care, within a medicalized system. Changes in approach to and organization of care would further enhance equitable spatial access to care in maternal health and reduce avoidable infant mortality. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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19 pages, 1573 KiB  
Article
Accessibility Assessment of Community Care Resources Using Maximum-Equity Optimization of Supply Capacity Allocation
by Ming-Hseng Tseng and Hui-Ching Wu
Int. J. Environ. Res. Public Health 2021, 18(3), 1153; https://doi.org/10.3390/ijerph18031153 - 28 Jan 2021
Cited by 8 | Viewed by 2511
Abstract
Equity in accessible healthcare is crucial for measuring health equity in community care policy. The most important objective of such a policy in Taiwan is empowering people and communities by improving health literacy and increasing access to healthcare resources. Using the nearest-neighbor two-step [...] Read more.
Equity in accessible healthcare is crucial for measuring health equity in community care policy. The most important objective of such a policy in Taiwan is empowering people and communities by improving health literacy and increasing access to healthcare resources. Using the nearest-neighbor two-step floating catchment area method, this study performed an accessibility assessment for community care resources before and after supply capacity optimization. For the target of maximum equity when allocating community care resources, taking maximum values, mean values and minimum values of the distances into consideration, three analytical allocation solutions for supply capability optimization were derived to further compare disparities in geographical accessibility. Three indicators, namely, the Gini coefficient, median minus mean and mean-squared error, were employed to assess the degree of optimization of geographical accessibility scores at the locations of the demand population and to determine the degree of geographic inequities in the allocation of community care resources. Our study proposed a method in which the minimum value of the distance is adopted as the approximate representation of distances between the service point and the locations of demand to determine the minimum value for supply capacity optimization. The study found that the method can effectively assess inequities in care resource allocation among urban and rural communities. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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15 pages, 1237 KiB  
Article
Understanding the Unmet Needs among Community-Dwelling Disabled Older People from a Linkage Perspective
by Danxian Wu, Xiaolu Gao, Zhifei Xie and Zening Xu
Int. J. Environ. Res. Public Health 2021, 18(2), 389; https://doi.org/10.3390/ijerph18020389 - 06 Jan 2021
Cited by 16 | Viewed by 3241
Abstract
One of the challenges in response to population aging is to meet needs for elderly care among older people especially for those who want to age in their homes or communities. However, disabled older people have more challenges due to their restricted mobility [...] Read more.
One of the challenges in response to population aging is to meet needs for elderly care among older people especially for those who want to age in their homes or communities. However, disabled older people have more challenges due to their restricted mobility to access care resources than non-disabled ones. We propose a new framework based on the changing relationship between older people and their environment, in which resource linkage in elderly care utilization is emphasized. We conducted a survey with 139 participants (i.e., older people age 60 years or over with different level of disabilities) in three types of neighborhoods in Beijing, China. By conducting a decision tree analysis under the Person-Environment Link (P-E Link) model, we (1) characterized unmet needs for elderly care (activities of daily living (ADL) and instrumental activities of daily living (IADL) assistance) among community-dwelling disabled older people; (2) found disabled older people had more unmet needs for both ADL and IADL assistance because of a lack in linkages to care resources than non-disabled ones; and (3) characterized the linkages to care resources for better supporting disabled older people to age in place, including family support, social connection, and spatial environment. Our findings help improve the Anderson behavioral model by characterizing enabling environments, which highlights that not only the availability of enabling resources but also linkages to these enabling resources play an important role in meeting needs for care among disabled older people. Our findings can also inform improvements in policy design that are targeted to reduce elderly care inequalities. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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11 pages, 1044 KiB  
Article
Assessing the Health Loss from Kashin-Beck Disease and Its Relationship with Environmental Selenium in Qamdo District of Tibet, China
by Jing Wang, Shengcheng Zhao, Linsheng Yang, Hongqiang Gong, Hairong Li and Cangjue Nima
Int. J. Environ. Res. Public Health 2021, 18(1), 11; https://doi.org/10.3390/ijerph18010011 - 22 Dec 2020
Cited by 17 | Viewed by 2336
Abstract
Kashin-Beck Disease (KBD) is one of major endemic diseases in China. In this study, we estimated the health loss from KBD in Qamdo district of Tibet using the years lived with disability (YLD) metric and investigated the influence of environmental selenium (Se) on [...] Read more.
Kashin-Beck Disease (KBD) is one of major endemic diseases in China. In this study, we estimated the health loss from KBD in Qamdo district of Tibet using the years lived with disability (YLD) metric and investigated the influence of environmental selenium (Se) on it by multiple regression model. The results showed that YLD rates produced a different ranking of health loss of KBD from that produced by prevalence rates between Basu and Luolong County, with higher health loss from KBD (43.61 YLD/1000) but lower prevalence (17.86%) in Basu County. YLD rates in two counites were both highest for the 45–64 years age group. Compared with the prevalence rate, the YLD rate had a closer relation to environmental Se and was significantly negatively correlated with Se in both soil and highland barley. The multiple linear regression further revealed that Se contents in cultivated soil and highland barley were main influencing factors for the health loss of KBD, which could explain 90.5% of the variation in YLD rates. The information obtained highlights the significance of the YLD metric in exploring the environmental etiology of KBD and provides important information on which to base decisions on future prevention and control of endemic diseases. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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16 pages, 4497 KiB  
Article
The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal
by Claudia Costa, Angela Freitas, Ricardo Almendra and Paula Santana
Int. J. Environ. Res. Public Health 2020, 17(22), 8517; https://doi.org/10.3390/ijerph17228517 - 17 Nov 2020
Cited by 9 | Viewed by 3565
Abstract
There is considerable evidence pointing to the existence of a socioeconomic gradient in mortality, which tends to be steeper in urban areas. Similar to other European cities, Lisbon is far from homogeneous since considerable geographical inequalities exist between the more advantaged and the [...] Read more.
There is considerable evidence pointing to the existence of a socioeconomic gradient in mortality, which tends to be steeper in urban areas. Similar to other European cities, Lisbon is far from homogeneous since considerable geographical inequalities exist between the more advantaged and the more deprived neighborhoods. The main goals of this study are to describe the geographical pattern of premature deaths (before 65 years old), avoidable deaths (preventable and amenable to healthcare) and cause-specific mortality (HIV/AIDS and suicide) in Lisbon, at the lower administrative level (civil parish, in Portuguese: Freguesia), and analyze the statistical association between mortality risk and deprivation, before (1999–2003) and during the economic crisis (2008–2012). Smoothed Standardized Mortality Ratios (sSMR) and Relative Risk (RR) with 95% credible intervals were calculated to identify the association between mortality and deprivation. The analysis of the geographical distribution of cause-specific mortality reveals that civil parishes with high sSMR in the first period continued to present higher mortality rates in the second. Moreover, a significant statistical association was found between all the causes of death and deprivation, except suicide. These findings contribute to understanding how social conditions influence health outcomes and can offer insights about potential policy directions for local government. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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18 pages, 3971 KiB  
Article
Modelling Potential Geographical Access of the Population to Public Hospitals and Quality Health Care in Romania
by Liliana Dumitrache, Mariana Nae, Gabriel Simion and Ana-Maria Taloș
Int. J. Environ. Res. Public Health 2020, 17(22), 8487; https://doi.org/10.3390/ijerph17228487 - 16 Nov 2020
Cited by 16 | Viewed by 3824
Abstract
The geographical accessibility to hospitals relies on the configuration of the hospital network, spatial impedance and population distribution. This paper explores the potential geographic accessibility of the population to public hospitals in Romania by using the Distance Application Program Interface (API) Matrix service [...] Read more.
The geographical accessibility to hospitals relies on the configuration of the hospital network, spatial impedance and population distribution. This paper explores the potential geographic accessibility of the population to public hospitals in Romania by using the Distance Application Program Interface (API) Matrix service from Google Maps and open data sources. Based on real-time traffic navigation data, we examined the potential accessibility of hospitals through a weighted model that took into account the hospital competency level and travel time while using personal car transportation mode. Two scenarios were generated that depend on hospitals’ level of competency (I–V). When considering all categories of hospitals, access is relatively good with over 80% of the population reaching hospitals in less than 30 min. This is much lower in the case of hospitals that provide complex care, with 34% of the population travelling between 90 to 120 min to the nearest hospital classed in the first or second category of competence. The index of spatial accessibility (ISA), calculated as a function of real travel time and level of competency of the hospitals, shows spatial patterns of services access that highlight regional disparities or critical areas. The high concentration of infrastructure and specialised medical personnel in particular regions and large cities limits the access of a large part of the population to quality health services with travel time and distances exceeding optimal European level values. The results can help decision-makers to optimise the location of health services and improve health care delivery. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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20 pages, 7495 KiB  
Article
A Perspective on Inhabited Urban Space: Land Use and Occupation, Heat Islands, and Precarious Urbanization as Determinants of Territorial Receptivity to Dengue in the City of Rio De Janeiro
by Jefferson Pereira Caldas Santos, Nildimar Alves Honório, Christovam Barcellos and Aline Araújo Nobre
Int. J. Environ. Res. Public Health 2020, 17(18), 6537; https://doi.org/10.3390/ijerph17186537 - 08 Sep 2020
Cited by 8 | Viewed by 3373
Abstract
Introduction: Rio de Janeiro is the second-largest city in Brazil, with strong socio-spatial segregation, and diverse and heterogeneous land use, occupation, and landscapes. The complexity of dengue requires the construction of surveillance and control tools that take into account the historical, social, economic, [...] Read more.
Introduction: Rio de Janeiro is the second-largest city in Brazil, with strong socio-spatial segregation, and diverse and heterogeneous land use, occupation, and landscapes. The complexity of dengue requires the construction of surveillance and control tools that take into account the historical, social, economic, and environmental processes mediated in the territory as a central axis of public policy. In this context, this study aimed to stratify the city into areas of receptivity to dengue, using innovative “territorial indicators” because they are built based on the actual occupation of the territory. Methods: We designed and constructed 17 indicators that sought to characterize the transformed and inhabited space according to receptivity to dengue. We used data on land use and occupation, connectivity, climate, and landscape. We developed the dengue receptivity through principal component analysis (PCA), using multiple criteria analysis and map algebra integrated in a GIS platform. Results: The most receptive areas were concentrated in the transition between the north and west zones of the city, a region of unconsolidated urban sprawl. The areas of greatest receptivity had the highest incidence and density of Aedes eggs during the study period. The correlation between receptivity index and incidence rate was positive in the epidemic years. Conclusion: The proposed set of indicators was able to identify areas of greater receptivity, such as regions of disorderly urban sprawl, with a concentration of social and environmental processes that are related to the occurrence of dengue outbreaks and high vector density. On the other hand, population immunity plays an important role in the spatial distribution of dengue during non-epidemic years. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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17 pages, 616 KiB  
Article
Impact of Gender Inequalities in the Causes of Mortality on the Competitiveness of OECD Countries
by Beata Gavurova, Viera Ivankova, Martin Rigelsky and Ladislav Suhanyi
Int. J. Environ. Res. Public Health 2020, 17(10), 3698; https://doi.org/10.3390/ijerph17103698 - 24 May 2020
Cited by 3 | Viewed by 2675
Abstract
The aim of the present study is to quantify the relations between gender inequalities in mortality by selected causes of mortality and between competitiveness of Organisation for Economic Co-operation and Development (OECD) countries. Data for the analyses were obtained from OECD databases and [...] Read more.
The aim of the present study is to quantify the relations between gender inequalities in mortality by selected causes of mortality and between competitiveness of Organisation for Economic Co-operation and Development (OECD) countries. Data for the analyses were obtained from OECD databases and the World Economic Forum (Global Competitiveness Index), for the years 2011–2016, for all 36 countries. The methods of descriptive analysis, analysis of differences in causes of mortality by gender characteristics, regression analysis, relationship analysis of gender inequalities in causes of mortality and competitiveness, and cluster analysis were used for the statistical data processing. Based on the research findings, it can be concluded that gender inequality occurs in most of the examined mortality groups of diagnoses, while it was most significant in the case of mortality due to neoplasms. The impacts of mortality on competitiveness are significant. In assessing gender inequalities in causes of mortality, significant impacts were seen in most mortality causes, but the most significant impact was identified within mortality due to neoplasms. Emphasis should be placed on men when reducing inequalities. Health and health equity should be supported by national governments, and health equity should be one of the key performance indicators of the country. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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17 pages, 714 KiB  
Article
Dengue Surveillance System in Brazil: A Qualitative Study in the Federal District
by Marco Angelo, Walter Massa Ramalho, Helen Gurgel, Nayara Belle and Eva Pilot
Int. J. Environ. Res. Public Health 2020, 17(6), 2062; https://doi.org/10.3390/ijerph17062062 - 20 Mar 2020
Cited by 10 | Viewed by 4980
Abstract
Dengue’s increasing trends raise concerns over global health and pose a challenge to the Brazilian health system, highlighting the necessity of a strong surveillance system to reduce morbidity, mortality, and the economic burden of this disease. Although the Brazilian surveillance system reports more [...] Read more.
Dengue’s increasing trends raise concerns over global health and pose a challenge to the Brazilian health system, highlighting the necessity of a strong surveillance system to reduce morbidity, mortality, and the economic burden of this disease. Although the Brazilian surveillance system reports more dengue cases than any other country, recent studies suggest that non-reported cases are the majority. The aim of the study is to explore the strengths and weaknesses of the Brazilian surveillance system, particularly looking at the functioning of data collection and reporting. This was done through qualitative semi-structured interviews with 17 experts in dengue surveillance, supported by quantitative data from the official notification system. To select the interviewees, purposive and theoretical sampling were used. Data were analyzed through thematic analysis. The research highlighted that a lack of human and technological resources in healthcare units and surveillance departments slows down the notification process and data analysis. Due to a lack of integration in the private sector, the surveillance system fails to detect the socioeconomic profile of the patients. Investments in public healthcare, human and technological resources for surveillance and better integration in the private healthcare system, and vector surveillance may improve dengue surveillance. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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Review

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14 pages, 1230 KiB  
Review
Geospatial Analysis of COVID-19: A Scoping Review
by Munazza Fatima, Kara J. O’Keefe, Wenjia Wei, Sana Arshad and Oliver Gruebner
Int. J. Environ. Res. Public Health 2021, 18(5), 2336; https://doi.org/10.3390/ijerph18052336 - 27 Feb 2021
Cited by 68 | Viewed by 8569
Abstract
The outbreak of SARS-CoV-2 in Wuhan, China in late December 2019 became the harbinger of the COVID-19 pandemic. During the pandemic, geospatial techniques, such as modeling and mapping, have helped in disease pattern detection. Here we provide a synthesis of the techniques and [...] Read more.
The outbreak of SARS-CoV-2 in Wuhan, China in late December 2019 became the harbinger of the COVID-19 pandemic. During the pandemic, geospatial techniques, such as modeling and mapping, have helped in disease pattern detection. Here we provide a synthesis of the techniques and associated findings in relation to COVID-19 and its geographic, environmental, and socio-demographic characteristics, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology for scoping reviews. We searched PubMed for relevant articles and discussed the results separately for three categories: disease mapping, exposure mapping, and spatial epidemiological modeling. The majority of studies were ecological in nature and primarily carried out in China, Brazil, and the USA. The most common spatial methods used were clustering, hotspot analysis, space-time scan statistic, and regression modeling. Researchers used a wide range of spatial and statistical software to apply spatial analysis for the purpose of disease mapping, exposure mapping, and epidemiological modeling. Factors limiting the use of these spatial techniques were the unavailability and bias of COVID-19 data—along with scarcity of fine-scaled demographic, environmental, and socio-economic data—which restrained most of the researchers from exploring causal relationships of potential influencing factors of COVID-19. Our review identified geospatial analysis in COVID-19 research and highlighted current trends and research gaps. Since most of the studies found centered on Asia and the Americas, there is a need for more comparable spatial studies using geographically fine-scaled data in other areas of the world. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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26 pages, 1811 KiB  
Review
A Scoping Review on Air Quality Monitoring, Policy and Health in West African Cities
by Celia Mir Alvarez, Renaud Hourcade, Bertrand Lefebvre and Eva Pilot
Int. J. Environ. Res. Public Health 2020, 17(23), 9151; https://doi.org/10.3390/ijerph17239151 - 07 Dec 2020
Cited by 13 | Viewed by 4912
Abstract
Ambient air pollution is a global health threat that causes severe mortality and morbidity from respiratory, cardiovascular, and other diseases. Its impact is especially concerning in cities; as the urban population increases, especially in low- and middle-income countries, large populations risk suffering from [...] Read more.
Ambient air pollution is a global health threat that causes severe mortality and morbidity from respiratory, cardiovascular, and other diseases. Its impact is especially concerning in cities; as the urban population increases, especially in low- and middle-income countries, large populations risk suffering from these health effects. The Economic Community of West African States (ECOWAS) comprises 15 West African countries, in which many cities are currently experiencing fast growth and industrialization. However, government-led initiatives in air quality monitoring are scarce in ECOWAS countries, which makes it difficult to effectively control and regulate air quality and subsequent health issues. A scoping study was performed following the Arksey and O’Malley methodological framework in order to assess the precise status of air quality monitoring, related policy, and legislation in this region. Scientific databases and gray literature searches were conducted, and the results were contrasted through expert consultations. It was found that only two ECOWAS countries monitor air quality, and most countries have insufficient legislation in place. Public health surveillance data in relation to air quality data is largely unavailable. In order to address this, improved air quality surveillance, stricter and better-enforced regulations, regional cooperation, and further research are strongly suggested for ECOWAS. Full article
(This article belongs to the Special Issue Health Geography and Its Relevance for Future Public Health)
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