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16th Emerging New Researchers in the Geographies of Health & Impairment (ENRGHI) conference

ENRGHI 2012

The 16th Emerging New Researchers in the Geographies of Health & Impairment (ENRGHI) conference took place in London at the beginning of September, jointly organised by University College London and Queen Mary’s University College London.

ENRGHI is a conference run for and by post graduate and early career researchers and provides an innovative and supportive forum for presenting and sharing ideas.  The conference consisted of two days of posters and presentations, as well as opportunities for networking, socialising and a careers Q&A session.

CRESH PhD student Anna Kenyon presented on the socio-spatial distribution of environments that are likely to support walking throughout urban Scotland, concluding that there is little evidence of inequality in the distribution of good walking environments in relation to area deprivation.

The talk sparked debate about which features of urban environments are the most important to include in measures of area walkability. This led to a wider discussion about the balance, when measuring environmental determinants of health behaviours, between the benefits of using a large study area, such as urban Scotland, and the inevitable technical constraints this places on the specificity of measures used.

Other delegates made presentations on a diverse range of topics and attendees voted for the presentation they thought was the best.  Topics of the winning presentations were: Women’s detention and mental health, Environmental and socio economic factors associated with leishmaniasis outbreaks in Saudi Arabia, and Inequalities in the provision of treatment for chronic kidney disease in the UK.

Dr. Maurzio Gibin (Birkbeck University of London) gave a plenary speech on geovisualisation techniques and presenting geographic data to non-expert audiences as well as ingenious methods of presenting geographic data.  Prof. Steve Cummins (Queen Mary University of London) presented on the benefits of using of natural experiments in geography.  Prizes for the best three delegate presentations were presented by Dr Jim Dunn, deputy editor of the Journal of Epidemiology and Community Health.

Postgraduates and postdoctoral researchers travelled from countries including Canada, France, Australia and the Netherlands as well as throughout the UK to attend the conference.

Details of the next ENRGHI conference as well as including photos of the event, posters and prizes from this year can be viewed on the ENRGHI website: http://enrghi2012.wordpress.com/

 

Anna Kenyon

October 2012

Stigma, environments and health inequalities: why should we be interested?

In recent years there has been a great deal of interest amongst health researchers in the role of social stigma in affecting health. Social stigma can be articulated as a majority view that works to spoil the identity of others on the basis of a discriminating characteristic such as race, gender or class. The social stigma associated with some minority groups has been shown to have health salience in terms of providing an obstacle to gaining access health care, housing provision, welfare, employment and other underlying factors affecting health. Groups that have been the subjects of research include disabled, homeless and itinerant populations and this body of work has revealed the multitude of interpersonal and institutional factors linking discrimination with health. Stigma has also been adopted as a deliberate strategy in health promotion initiatives, most notably in tobacco control with recent work beginning to question whether the denormalisation and stigmatisation of smoking (and the smoker) has reached its limit as a public health goal.

Given the long tradition of work on stigma and health, and the importance of stigma for establishing and perpetuating health inequalities, it is perhaps surprising that few researchers have considered the potential significance of place and the environment in establishing, perpetuating and mediating social stigma. In a recent commentary* on a Japanese paper on place-based discrimination published in the journal Social Science and Medicine, I argue that geographers (and others with interests in place, space and health) could productively consider the role of spatial stigma in affecting the health of local residents. Spatial stigma arises in places with notoriety in the public discourse, and that are constructed as ‘no-go zones’ or ‘sink estates’ that require constant policing.  Neighbourhoods such as Toxteth in Liverpool, South Central in Los Angeles or the French banlieues have for instance been prejudiced by deep-rooted geographical discrimination.  Key to the argument in the commentary is that there are a range of consequences for population health of residing in a highly stigmatised community. Yet very few empirical studies have tested the salience of spatial stigma in affecting population health.

So why should researchers with interests in the environment and spatial inequalities in health be concerned with place-based stigma? In the Social Science and Medicine commentary, I suggest that health might be compromised by spatial stigma through a series of (non-mutually exclusive) individualised and institutional pathways, which in turn can exacerbate geographical inequalities in health. These include:

1. Being ‘looked down on’ because of residing in a stigmatised community can detrimentally affect a number of life chances such as education and training opportunities, employment prospects and the prospects of developing interpersonal relationships. These factors have all been implicated in studies of health.

2. Stigma relating to particular places may act as ‘badge of dishonour’ that results in local residents taking actions such as concealing their address, avoiding receiving visitors or providing excuses to others for where they live. These feelings of shame can work to spoil, manipulate and mediate individual identities and social relations and affect health (e.g. health behaviours or mental health).

3. Place-based stigma affects the levels investment and disinvestment of public and private resources put into the local community. Progressive social policy is undermined by the lack of investment in the local infrastructure, housing and other services that provide the opportunities for healthy living.

4. Social networks, community social bonds and collective efficacy are affected by residents’ withdrawal from the public realm in response to the perceived threats associated with spatial stigma (e.g. crime). The breakdown of these community ties is detrimental to physical and mental health outcomes of local populations.

In short, there is plenty of evidence from the urban sociology and urban geography literature that through a variety of intersecting pathways place-based stigmatisation is harmful to the life chances of local residents. The population health consequences of place-based stigma are however less well established; understanding these pathways is an important challenge for researchers with an interest in the environment and health. This challenge is particularly important during a period of austerity with major reductions in state investment in a range of health related infrastructure. A likely consequence of this retrenchment is the heightened stigmatisation of many socially disadvantaged communities with potentially disastrous implications for public health and health inequalities.

Jamie Pearce, August 2012

jamie.pearce@ed.ac.uk

 *Library access required; if you are unable to get hold of the paper then I’d be please to email you a copy (jamie.pearce@ed.ac.uk). .

Neighbourhood built environment related to transport and leisure physical activity

A new study involving CRESH researchers on neighbourhood built environments and  transport and leisure physical activity has recently been published in the journal Environmental Health Perspectives. The New Zealand study collected data on the urban built environment (destination access, street connectivity, dwelling density, land-use mix and streetscape quality) and surveyed 2,033 adults who lived in 48 New Zealand neighbourhoods. The findings suggested associations of neighbourhood destination access, street connectivity, and dwelling density with self-reported and objectively measured PA were moderately strong.  You can find the paper here: http://dx.doi.org/10.1289/ehp.1104584

Financial crisis, austerity policies and geographical inequalities in health

Is austerity good for our health?

A collection of papers published in a recent issue of Social Science and Medicine considered the implications of the recent crisis in the financial sector and subsequent austerity policies for population health. The conclusions were equivocal. On the one hand the direct impact of the financial crisis (e.g. unemployment) on health is clearly detrimental to the individual concerned and their immediate family. For instance, the incidence of suicide, drug abuse and domestic violence might be expected to rise.

Yet at the same time economic downturns may lead to an improvement in the overall health of populations.  But what explains this apparent contradiction? One possibility is that population health may be enhanced during periods of economic downturn because of a reduction in unhealthy ‘affluent behaviours’ such as the over consumption of food and alcohol or a fall in road traffic accidents. What is clear is that the longer term implications of the recent financial crisis are difficult to predict.

Geography matters

An important omission from this discussion of the health implications of the financial crisis is a consideration of geography.  This seems surprising as the health consequences of economic retrenchment are unlikely to be evenly shared across all parts of the country. In the UK for example, the financial crisis and subsequent austerity are likely to affect people living in Glasgow rather differently to folks from London. The health impacts will be most detrimental for people in the least socially advantaged places. It is feasible that in the most prosperous regions of the country, health will be unaffected…..or even enhanced. In short, geographical inequalities in health in the UK could rise substantially in response to the ‘austerity agenda’.

Financial crisis & geographical inequalities in health

So what are the processes linked to the deficit reduction strategies that are likely to affect geographical inequalities in health in the UK? In this CRESH blog we outline four (non-exhaustive and inter-related) reasons for why we might expect health to become geographically polarised.

  1. Perhaps most obviously, the ‘social geography’ of the UK is likely to be heavily affected by the current and forthcoming austerity strategies which in turn can be expected to undermine some key social determinants of health. Austerity measures could well widen the geographical discrepancy in social markers at various different scales, particularly between regions of the country. For example, places with a larger proportion of workers employed in the public sector will be particularly vulnerable to unemployment and job insecurity.  Similarly income disparities between regions are likely to grow. Unemployment, job insecurity and income inequality are causally related to health. One response to the changing socio-economic map of the UK is likely to be heightened regional inequalities in health.
  1. Job insecurity, unemployment and changes to welfare including a cap on housing benefits are likely to ‘disrupt’ patterns of mobility and lead to new forms of migration and mobility streams that are health selective. As job markets stagnate or contract, it is feasible that migration from north to south may lessen and/or become increasingly socially selective. There is also the worrying prospect of low income (and less ‘healthy’) families being displaced from their homes by the cap on housing benefits. This policy change is likely to see a movement of low income (and less ‘healthy’) individuals away from more prosperous suburbs into more ‘affordable’ neighbourhoods, as well as the entrapment of others in less healthy places.
  1. Austerity measures are already leading to a reprioritisation of public services provided by local authorities and other organisations. Which services will continue to receive resources and where there will be disinvestment is starting to become clear. As a recent blog argues, the middle classes are skilled in resisting cuts in services and new (unwanted) developments, an advantage that may lead to further disinvestment in disadvantaged communities during periods of fiscal tightening. At the same time, the Westminster government is looking to deregulate various environmental regulations that were often implemented to protect vulnerable communities from the health effects of various types if disamenities. The re-prioritisation of investment in public services and changes to environmental legislation is likely to lead to greater environmental disparities across regions in the UK. Environments that support health and well-being may well become just as disparate, raising environmental justice concerns and negatively affecting area-level health inequalities.
  1. Much academic research and policy initiatives have been concerned with ‘place-based’ determinants of health. The premise here is that factors relating to geographical (often local) context are fundamental to understanding social and geographical differences in health outcomes and behaviours. Place-based factors such as neighbourhood social capital, local norms, access to shops and services, social networks, concentration of poverty and a whole host of other factors have been implicated.  Austerity measures are likely to undermine efforts to improve local infrastructure (see above) as well as disrupt local community networks. Similarly, earlier CRESH work suggests that ‘problem’ health behaviours such as smoking, drinking and gambling may be reinforced in disadvantaged settings during tightened financial times.

We would be delighted to hear your comments and suggestions. What are other mechanisms that might affect geographical inequalities in health?  What are the key concerns outside the UK?

Jamie Pearce. April 2012.

@CRESHnews @jamie0pearce

ESRC-SG PhD studentship available at CRESH: forests and health

ESRC-Scottish Government/ Forestry Commission Scotland Studentship

Designing and managing forests for health

Applications are sought from suitably qualified candidates for a joint ESRC-Scottish Government PhD three-year (‘+3’) studentship. The project entitled ‘Designing and Managing Forests for Health’ has been developed in collaboration with the Forestry Commission Scotland and seeks to examine the links between forestry and community health across Scotland. Further details on the project can be found here.

The successful candidate will be based in the Centre for Research on Environment, Society and Health (CRESH) in the School of GeoSciences, University of Edinburgh. They will also be active members of the university’s OPENspace Research Centre and the Human Geography Research Group.

Applications will be particularly welcome from candidates with a social science / environmental background (e.g. geography, landscape architecture, sociology, environmental science), and quantitative methods will be emphasised in project and training plans. Applicants must have a Masters degree or equivalent in an appropriate field. A working knowledge in GIS would be advantageous.

Start Date: September 2012

Applicants should submit the following documentation through the University of Edinburgh online system:

– A recent CV

– A cover letter explaining their interest in the project.

– A completed Equal Opportunities Monitoring form (available here for download)

The deadline for submission is 27th April 2012. Interviews will take place during May 2012.

Applicants may discuss the project with any member of the supervisory team: Professor Jamie Pearce (jamie.pearce@ed.ac.uk), Professor Catharine Ward Thompson (c.ward-thompson@ed.ac.uk) or Dr Niamh Shortt (niamh.shortt@ed.ac.uk).

CRESH call for papers – RGS-IBG: Environment, justice & health inequalities

CRESH are organising a conference session at the RGS-IBG and look forward to receiving abstracts.
The conference runs from 3-5 July 2012 and is being held at the University of Edinburgh

Environment, justice & health inequalities
In recent years the dominant discourse in environmental justice research has been concerned with notions of distributive justice. Studies adopting this utilitarian perspective have tended to consider the socio-spatial distribution of environmental ‘goods’ and ‘bads’. A common conclusion is that low socio-economic, ethnic minority and other vulnerable groups and places are often disadvantaged in terms of the availability of environmental resources or contact with environmental burdens. More recently, environmental justice scholars have challenged the dominance of the distributional approach. They have called for a reorientation that includes a consideration of (i) the processes underlying the maldistribution of resources and (ii) how the distribution of resources affects health and well-being. To date, despite its obvious potential, there has been little geographical work at the intersection of the fields of environmental justice and health inequalities.

The aim of this session is to bring together papers from an interdisciplinary group of researchers concerned with issues of environmental justice and health. This session, organised by the Centre for Research on Environment Society and Health (CRESH), seeks papers which address the following non exhaustive list of possible topics including climate change, health behaviours, salutogenic environments and vulnerability.

Deadline for submitting abstracts is Friday 2nd of December.
Please send abstracts up to a maximum of 250 words, proposed titles and 5 keywords (clearly stating name, institution, and contact details) to Niamh Shortt (niamh.shortt@ed.ac.uk), Jamie Pearce (Jamie.pearce@ed.ac.uk), Richard Mitchell (Richard.Mitchell@glasgow.ac.uk) and Elizabeth Richardson (e.richardson@ed.ac.uk)

CRESH MRC success (falls, ageing and resilience)

A team of researchers from a range of disciplines, including Professor Jamie Pearce from CRESH, has been successful in an application to the Medical Research Council (MRC) for a Strategic Grant to undertake pilot work on the outdoor environment and older people’s resilience to falls. The study, titled Go Far (Going Outdoors: Falls, Ageing & Resilience), will be a year-long project linking into Lifelong Health and Wellbeing (LLHW): a major cross-council initiative supporting research into healthy ageing and wellbeing in later life. The study is led by the SURFACE Inclusive Design Research Centre at theUniversityofSalford. The CRESH contribution will be to consider socio-spatial patterns in falls among the elderly in the UK.

Smoking Symposium at Durham University

Prof Jamie Pearce was an invited commentator at the inugural symposium of the Smoking Interest Group at Durham University’s Centre for Medical Humanities. This one day workshop, led by Professor Jane Macnaughton and Dr Andrew Russell established a fascinating dialogue between policy makers, practitioners and social science researchers with an interest in smoking and tobacco. The event is likely to lead to a number of new and exciting research collabrations in the field of tobacco control.

New ERC funding

A new CRESH project funded by the European Research Council commenced on 1st October 2011. Funded for 1.4 million euros over 5 years, this international study is considering how existing secondary datasets might be utilised to answer important questions about the pathways linking the environment to to health. The work commenced on 1st October 2011 and is led by Prof Jamie Pearce, Dr Niamh Shortt and Prof Richard Mitchell. We are delighted to be able to  appoint three members of staff Dr Elizabeth Richardson, Esther Rind, Dr Helena Tunstall. More details on our progress with this project will be posted on the CRESH webpage.

2 Postdoctoral Research Positions: Available Now!

Two postdoctoral research positions are available from 1st October at the Centre for Research on Environment, Society and Health (CRESH) (based at the University of Edinburgh).  Funded through a European Research Council grant, these positions are excellent opportunities for Postdoctoral Researchers in the field of Health and the Environment. Both posts are available from 1st October 2011 for 5 years.

The successful candidates will play key roles in the development of CRESH.

For further details:
http://www.jobs.ed.ac.uk/vacancies/index.cfm?fuseaction=vacancies.detail&vacancy_ref=3014472
Closing date: 29th July 2011

For informal enquiries please contact:
Dr Jamie Pearce (jamie.pearce@ed.ac.uk)
Dr Niamh Shortt (Niamh.Shortt@ed.ac.uk)
Prof Richard Mitchell (Richard.Mitchell@glasgow.ac.uk)

Funding Success: European Research Council

The CRESH team have been successful in securing a grant from the European Research Council entitled ‘Physical Built Environments and Health Inequalities’. The named investigators on the project are Dr Jamie Pearce, Dr Niamh Shortt and Prof Richard Mitchell. The project is funded for five years (2011-16) for €1,399,570.

Job Opportunity: Postdoctoral Research Associate

We are seeking to appoint a Postdoctoral Research Assistant in the field of Health and the Environment. Based at the School of GeoSciences, University of Edinburgh you will join the Centre for Research on Environment, Society and Health (CRESH) which is a virtual centre joining scientists from the Universities of Edinburgh and Glasgow. Our research is focused on exploring how physical and social environments can influence population health, for better and for worse.

The successful candidate will work with an active research team based in Edinburgh and Glasgow on two research projects. First, they will play a key role in an ESRC funded project that will investigate whether aspects of the physical environment exert an influence on physical activity levels at the individual-level. Second, complete a pilot study to investigate the role of the local physical and social environment in understanding inequalities in health amongst children and adolescents. Both roles will involve working with large social survey, health and environmental datasets, the application of statistical techniques to the data, interpretation of the results, dissemination of findings and developing new research proposals.

Closing date: 7th March 2011

For more information and details on how to apply click here.