tim brown - Academia.edu (original) (raw)
Papers by tim brown
Health & Place
This paper analyses the findings from qualitative interviews conducted as part of a cross-discipl... more This paper analyses the findings from qualitative interviews conducted as part of a cross-disciplinary pilot study into the efficacy of the Friendship Bench for promoting mental health amongst rural women living in Shurugwi District, Zimbabwe. Informed by UNICEF's nurturing care framework, the pilot study hypothesised that women's caring capabilities would be enhanced if a cost-effective intervention could be found for those suffering from common mental disorders (CMD), locally referred to as kufungisisa. Focusing on the women's accounts of their embodiment of kufungisisa, the paper further highlights the important role that gender plays in women's experience of common mental health disorders. More critically, it identifies the ways in which patriarchal social relations may be reinforced through the spaces of global health interventions such as the one reported on here. The paper concludes with a moment of self-reflection. Specifically, it poses the question that our paper, and the global health intervention it reports upon, would look very different if the women's experiences of kufungisisa were considered not only as they appear in the present but at the intersection of social and spatial relations that have much longer histories.
The American Journal of Tropical Medicine and Hygiene, 2021
ABSTRACTStunting (low height for age) affects approximately one-quarter of children aged < 5 y... more ABSTRACTStunting (low height for age) affects approximately one-quarter of children aged < 5 years worldwide. Given the limited impact of current interventions for stunting, new multisectoral evidence-based approaches are needed to decrease the burden of stunting in low- and middle-income countries (LMICs). Recognizing that the health of people, animals, and the environment are connected, we present the rationale and research agenda for considering a One Health approach to child stunting. We contend that a One Health strategy may uncover new approaches to tackling child stunting by addressing several interdependent factors that prevent children from thriving in LMICs, and that coordinated interventions among human health, animal health, and environmental health sectors may have a synergistic effect in stunting reduction.
Social science & medicine (1982), Dec 1, 2017
This paper is based upon findings from the qualitative element of a mixed-methods study on the re... more This paper is based upon findings from the qualitative element of a mixed-methods study on the response of Black women aged 25-50 to a public health intervention related to breast cancer. The focus groups were conducted in the London Borough of Hackney, UK between 2013 and 2016, and were part of an evaluation of the effectiveness of a breast awareness DVD. While the content of the DVD was generally well-received by the participants, the focus group discussions revealed a complex and, at times, contradictory response to the women's construction as an 'at risk' community. As the paper highlights, for many of the women, breast cancer remains a disease of whiteness and the information provided in the DVD prompted a range of emotional responses; from anxiety and fear to a desire to become more knowledgeable and active in the promotion of self-care. As the paper argues, of particular importance to the women was the need to feel a much stronger emotional connection to the infor...
Elsevier eBooks, 2009
Healthcare systems have undergone several phases of restructuring, particularly following the glo... more Healthcare systems have undergone several phases of restructuring, particularly following the global economic slowdown of the mid-1970s. This process has been presented in both deterministic and developmentalist terms and, for some scholars at least, is seen as a technical response to an emerging crisis in welfare provision. However, decisions made by national governments are always politically mediated and a more critical body of explanation identifies the important role played by neoliberalism in helping to frame reform to healthcare systems. Therefore, although not limiting itself to such an explanation, this article draws heavily on research that identifies the ways in which the governmental commitment to neoliberalism has shaped the restructuring process. More specifically, it highlights some of the key processes associated with health services restructuring and makes links back to the principles and values of neoliberal theory. Having achieved this, the articlemoves on to discuss the distinctive contribution that geographers have made to such understanding by focusing on three specific themes: symbolism and sense of place, inequality and rural communities, and new spaces of care.
Health & Place, 2016
In this paper, we explore the emergence of non-communicable diseases (NCDs) as an object of polit... more In this paper, we explore the emergence of non-communicable diseases (NCDs) as an object of political concern in and for countries of the global South. While epidemiologists and public health practitioners and scholars have long expressed concern with the changing global distribution of the burden of NCDs, it is only in more recent years that the aetiology, politics and consequences of these shifts have become an object of critical social scientific enquiry. These shifts mark the starting point for this special issue on 'The Politics of NCDs in the Global South' and act as the basis for new, critical interventions in how we understand NCDs. In this paper, we aim not only to introduce and contextualise the six contributions that form this special issue, but also to identify and explore three themesproblematisation, care and culture that index the main areas of analytical and empirical concern that have motivated analyses of NCDs in the global South and are central to critical engagement with their political contours.
Canadian Geographies / Géographies canadiennes, 2014
In recent years, food crises have heightened awareness of food security vulnerabilities even in r... more In recent years, food crises have heightened awareness of food security vulnerabilities even in rich nations. However, the extent to which various issues related to food security (such as consistent access to nutritious food in conditions which maintain human dignity) have been incorporated into Canadian policy and practice is not well documented. This article draws on a number of sources—including policy documents and media reports—to explore how food security is being conceptualized in Canada, particularly at the national level. The article chronicles changes in food security discourse over time, suggesting that recognition of food security as a “Canadian” problem has been partial and contested, and reflects persistent geographic imaginaries of Canada (e.g., as a land of agricultural abundance) and unrelenting social and cultural exclusions (e.g., of Canada's Aboriginal people).
Social science & medicine (1982), 2007
In May 2004 the World Health Organization (WHO) officially launched the 'Global Strategy on D... more In May 2004 the World Health Organization (WHO) officially launched the 'Global Strategy on Diet, Physical Activity and Health'. Lying at its heart is the recognition that many of the risk factors associated with non-communicable diseases, particularly poor diet and physical inactivity, have begun to move beyond the confines of the West. It was this apparent shift in the epidemiological boundaries of such diseases, along with fears over the so-called 'double burden' that they presented to some nations, that finally prompted the WHO to develop such a far reaching strategy. This paper adds to the on-going debate surrounding this important issue by drawing on the concepts of medicalisation, governmentality and the spatiality of scientific knowledge to explore one particular element of it: namely, the identification of nature as a setting for the promotion of physical activity. We adopt this perspective because we are concerned to understand the ways in which the knowled...
The Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and Society, 2014
Geographers have recently begun to make a considerable contribution to global health. Most notabl... more Geographers have recently begun to make a considerable contribution to global health. Most notably, this contribution has involved unpicking the national and international response to the problem of global health and submitting it to critical scrutiny. Such work not only requires paying close attention to the differing ways in which global health is imagined (historically as well as in the contemporary period) but also considering the effects of such imaginings on the material, lived experiences of those most affected. Keywords: geography; globalization; health
The Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and Society, 2014
Similarly to scholars in other disciplines allied with the arts, humanities, and social sciences,... more Similarly to scholars in other disciplines allied with the arts, humanities, and social sciences, geographers have explored the ways in which particular kinds of bodies have been represented as diseased and/or healthy in both the past and the present. Foucault's work on the body as a site of particular regimes of knowledge and power relations has been pivotal in shifting focus towards the kinds of technologies utilized in producing such understandings. Following his analyses, geographers acknowledge, though not entirely without criticism, that one of the key ways of studying social parameters of normativity and the mechanisms for enforcing them is to look at representations of sick bodies. Here “sick” does not mean simply images or understandings of bodies that are diseased; rather, it refers to a much more expanded investigation of bodies depicted as undesirable, impure, or deviant at various moments in time and place. Keywords: disease; geography; representation
Social Science & Medicine, 2000
This paper considers the discursive properties of public health literature produced around AIDS i... more This paper considers the discursive properties of public health literature produced around AIDS in the 1980s and early 1990s. Attention is focused upon the role of health promotion in the UK government's response to the epidemic and on the language used in the educational campaigns conducted by the Health Education Council and its replacement the Health Education Authority. Using an analytical approach influenced by the work of Michel Foucault, the paper argues that the knowledges of AIDS produced by these various public health institutions constructed discursive boundaries between the idea of 'normal' and 'abnormal' behavioural practices. The notion of risk, produced as it is from epidemiological knowledge, is a central mechanism in this process. It is through the production, articulation and normalisation of 'at risk' groups that society is fragmented and hence subject to the governance strategies of late-modern liberal economies.
A Companion to Health and Medical Geography
Recent media images of SARS, AIDS, and avian fl u have made more apparent than ever the critical ... more Recent media images of SARS, AIDS, and avian fl u have made more apparent than ever the critical role representations of bodies play in our understandings of disease, and by default, of health. Photographs of Chinese tourists to Toronto, Vietnamese chicken farmers, or urban gay communities signal transmission routes of pathogens through mobile bodies, the role of social and economic practices in epidemics, and the kinds of bodies at risk for particular diseases. Yet many scholars inside and out of geography in recent years have critiqued such images for lending as much misunderstanding as understanding to diseases, populations, and geographic regions by providing selective information or perpetuating stereotypes of people and places in the midst of documenting pathogenic transmission. In this chapter, we examine representations of diseased and healthy bodies over time and place as a means of situating wellbeing or its absence within a set of social, ideological, and geopolitical relations. Representing particular kinds of bodies as diseased or healthy is not new to recent epidemics. Historians of colonial medicine have pointed out that constructing " native " bodies as either more or less susceptible to disease and as less hygienic, formed important foundations for subsequent colonial policies regulating labor, settlement patterns, and health care in areas of Africa and Asia (Packard 1989 ; Arnold 1993 ; Anderson 1996). Other historians and historical geographers have analyzed examples within the United States and Europe of ascriptions by public health authorities and others of disease or deviance to particular communities, paying close attention to the impact these representations have on perceptions of populations and the places in which they reside (Cresswell 1996 ; Brown 1997 ; Craddock 2000 ; Shah 2001). Another line of inquiry examines notions and representations of healthy bodies and how these have changed over time. What is revealed in this area of inquiry are the ways in which ideas regarding the " normal, " healthy body are presented alongside, and are interwoven with,
A Companion to Health and Medical Geography
As an opening to this volume, we believe that it would be useful for readers to be aware both of ... more As an opening to this volume, we believe that it would be useful for readers to be aware both of the rationale that underpins it and, perhaps a little more unusually, of the process that led to its production; especially the critical role played by the academic reviewers of the original proposal. The former is important because the idea for the volume materialized out of the recognition that debates regarding the constitution of the sub-discipline had reopened (for an extensive review see Andrews & Evans 2008). In reality this debate has been ongoing since Kearns ' (1993 : 144) decisive intervention in the early 1990s, which saw the sub-discipline rupture (albeit productively) along the now familiar lines of " health " and " medical " geography. However, although most commentators agree that the scope and scale of research conducted by scholars on both sides of this divide has expanded considerably and areas of intersection have increased, few agree upon the nomenclature under which this endeavor takes place. Are we health geographers, medical geographers, post-medical geographers, or something else entirely? This volume was initially conceived as a prime opportunity to refl ect upon this expansion, to highlight the variety of research that is conducted by scholars associated with the sub-discipline, and also as an opportunity to refl ect further on the key debates that had been taking place. This ambition is clearly demonstrated in the opening paragraphs of the proposal that we submitted to the publishers for possible inclusion in the Blackwell (now Wiley-Blackwell) Companions to Geography series: The global strength of the sub-discipline is in part related to the shift away from its traditional focus on disease ecology, disease mapping, and health service provision. This change followed substantial debate regarding the sub-discipline ' s apparent overreliance on positivism and quantitative methods, which was argued to limit its ability to engage with themes important to theoretically minded human geographers: most notably those infl uenced by the " cultural " turn. Arguably the result of this debate is a more nuanced sub-discipline, one that is concerned with questions of culture and difference, inequality and power, representation and meaning. At the same time, health
A Companion to Health and Medical Geography
... together into a personalized strategy that iden-tifies and minimizes their exposure to harm ... more ... together into a personalized strategy that iden-tifies and minimizes their exposure to harm (O ' Malley ... of the self and the arts of government, because neo - liberal rule, through the emphasis ... on the subject of risk, and its emergence as a technique for governing the actions ...
Appetite, 2015
Picky eaters are defined as those who consume an inadequate variety of food through rejection of ... more Picky eaters are defined as those who consume an inadequate variety of food through rejection of a substantial amount of food stuffs that are both familiar and unfamiliar. Picky eating is a relatively recent theoretical concept and while there is increasing concern within public health over the lack of diversity in some children's diets, adult picky eaters remain an under researched group. This paper reports on the findings of a qualitative study on the routine food choices and practices of 26 families in Sandwell, West Midlands, UK. Photo elicitation and go-along interview data collection methods were used to capture habitual food related behaviours and served to describe the practices of nine individuals who self identified or were described as picky eaters. A thematic analysis revealed that those with the food related identity of picky eater had very restricted diets and experienced strong emotional and physical reactions to certain foods. For some this could be a distressing...
Gender, Place & Culture, 2014
This paper introduces the articles that comprise the themed section ‘bodies across borders’ which... more This paper introduces the articles that comprise the themed section ‘bodies across borders’ which investigates how the social and spatial dynamics of healthcare provision are being transformed by both neo-liberalization and globalization. The articles demonstrate how the central tenets of neoliberalism: the promotion of individual autonomy as realized through the instrument of consumer choice, the privatization, outsourcing and off-shoring of core competencies and service provision, the production of highly ‘flexible’ labour are at work in re-shaping access to, and delivery of, services in the domains of reproductive health, organ donation and globalized healthcare. In paying special attention to the ways in which these practices are cut across by class, gender and ethnicity, these accounts will hopefully encourage us to reject totalizing and homogeneous narratives of medical travel in favour of those that offer more nuanced understandings of the positionality of the individuals at the heart of them.
Transactions of the Institute of British Geographers, 2000
There have been few studies of spatialized discourse within contemporary healthcare policy-making... more There have been few studies of spatialized discourse within contemporary healthcare policy-making. This paper addresses this omission, focusing on the governmental presentation of the little-studied measures that consolidated the post-1989 reforms of the NHS in England and Wales, and culminated in the Health Authorities Act 1995. A short section places these measures in context and outlines their main components. An analysis of key documents and parliamentary exchanges is then used to show how spatialized language was central to the presentation of policy and its debate in parliament. In particular, the paper demonstrates how nuanced conceptions of space-and territorially-led service management provide a flexible basis for presenting notions of power and control. This 'spatio-linguistic strategy' is located theoretically within the concept of govemmentality.
Social Science & Medicine, 2008
During the last decades of the twentieth century it became increasingly apparent that the interre... more During the last decades of the twentieth century it became increasingly apparent that the interrelationship between globalisation and health is extremely complex. This complexity is highlighted in debates surrounding the re-emergence of infectious diseases, where it is recognised that the processes of globalisation have combined to create the conditions where once localised, microbial hazards have come to pose a threat to many western nations. By contrast, in an emerging literature relating to the epidemic of non-communicable diseases, and reflected in the WHO 'Global strategy on diet, physical activity and health', it is the so-called 'western lifestyle' that has been cast as the main threat to a population's health. This paper explores critically global responses to this development. Building on our interest in questions of governance and the ethical management of the healthy body, we examine, whether the global strategy, in seeking to contain the influence of a 'western lifestyle', also promotes contemporary 'western-inspired' approaches to public health practices. The paper indicates that a partial reading of the WHO strategy suggests that certain countries, especially those outside the West, are being captured or 'enframed' by the integrative ambitions of a western 'imperial' vision of global health. However, when interpreted critically through a post-colonial lens, we argue that 'integration' is more complex, and that the subtle and dynamic relations of power that exist between countries of the West/non-West, are exposed.
Health & Place
This paper analyses the findings from qualitative interviews conducted as part of a cross-discipl... more This paper analyses the findings from qualitative interviews conducted as part of a cross-disciplinary pilot study into the efficacy of the Friendship Bench for promoting mental health amongst rural women living in Shurugwi District, Zimbabwe. Informed by UNICEF's nurturing care framework, the pilot study hypothesised that women's caring capabilities would be enhanced if a cost-effective intervention could be found for those suffering from common mental disorders (CMD), locally referred to as kufungisisa. Focusing on the women's accounts of their embodiment of kufungisisa, the paper further highlights the important role that gender plays in women's experience of common mental health disorders. More critically, it identifies the ways in which patriarchal social relations may be reinforced through the spaces of global health interventions such as the one reported on here. The paper concludes with a moment of self-reflection. Specifically, it poses the question that our paper, and the global health intervention it reports upon, would look very different if the women's experiences of kufungisisa were considered not only as they appear in the present but at the intersection of social and spatial relations that have much longer histories.
The American Journal of Tropical Medicine and Hygiene, 2021
ABSTRACTStunting (low height for age) affects approximately one-quarter of children aged < 5 y... more ABSTRACTStunting (low height for age) affects approximately one-quarter of children aged < 5 years worldwide. Given the limited impact of current interventions for stunting, new multisectoral evidence-based approaches are needed to decrease the burden of stunting in low- and middle-income countries (LMICs). Recognizing that the health of people, animals, and the environment are connected, we present the rationale and research agenda for considering a One Health approach to child stunting. We contend that a One Health strategy may uncover new approaches to tackling child stunting by addressing several interdependent factors that prevent children from thriving in LMICs, and that coordinated interventions among human health, animal health, and environmental health sectors may have a synergistic effect in stunting reduction.
Social science & medicine (1982), Dec 1, 2017
This paper is based upon findings from the qualitative element of a mixed-methods study on the re... more This paper is based upon findings from the qualitative element of a mixed-methods study on the response of Black women aged 25-50 to a public health intervention related to breast cancer. The focus groups were conducted in the London Borough of Hackney, UK between 2013 and 2016, and were part of an evaluation of the effectiveness of a breast awareness DVD. While the content of the DVD was generally well-received by the participants, the focus group discussions revealed a complex and, at times, contradictory response to the women's construction as an 'at risk' community. As the paper highlights, for many of the women, breast cancer remains a disease of whiteness and the information provided in the DVD prompted a range of emotional responses; from anxiety and fear to a desire to become more knowledgeable and active in the promotion of self-care. As the paper argues, of particular importance to the women was the need to feel a much stronger emotional connection to the infor...
Elsevier eBooks, 2009
Healthcare systems have undergone several phases of restructuring, particularly following the glo... more Healthcare systems have undergone several phases of restructuring, particularly following the global economic slowdown of the mid-1970s. This process has been presented in both deterministic and developmentalist terms and, for some scholars at least, is seen as a technical response to an emerging crisis in welfare provision. However, decisions made by national governments are always politically mediated and a more critical body of explanation identifies the important role played by neoliberalism in helping to frame reform to healthcare systems. Therefore, although not limiting itself to such an explanation, this article draws heavily on research that identifies the ways in which the governmental commitment to neoliberalism has shaped the restructuring process. More specifically, it highlights some of the key processes associated with health services restructuring and makes links back to the principles and values of neoliberal theory. Having achieved this, the articlemoves on to discuss the distinctive contribution that geographers have made to such understanding by focusing on three specific themes: symbolism and sense of place, inequality and rural communities, and new spaces of care.
Health & Place, 2016
In this paper, we explore the emergence of non-communicable diseases (NCDs) as an object of polit... more In this paper, we explore the emergence of non-communicable diseases (NCDs) as an object of political concern in and for countries of the global South. While epidemiologists and public health practitioners and scholars have long expressed concern with the changing global distribution of the burden of NCDs, it is only in more recent years that the aetiology, politics and consequences of these shifts have become an object of critical social scientific enquiry. These shifts mark the starting point for this special issue on 'The Politics of NCDs in the Global South' and act as the basis for new, critical interventions in how we understand NCDs. In this paper, we aim not only to introduce and contextualise the six contributions that form this special issue, but also to identify and explore three themesproblematisation, care and culture that index the main areas of analytical and empirical concern that have motivated analyses of NCDs in the global South and are central to critical engagement with their political contours.
Canadian Geographies / Géographies canadiennes, 2014
In recent years, food crises have heightened awareness of food security vulnerabilities even in r... more In recent years, food crises have heightened awareness of food security vulnerabilities even in rich nations. However, the extent to which various issues related to food security (such as consistent access to nutritious food in conditions which maintain human dignity) have been incorporated into Canadian policy and practice is not well documented. This article draws on a number of sources—including policy documents and media reports—to explore how food security is being conceptualized in Canada, particularly at the national level. The article chronicles changes in food security discourse over time, suggesting that recognition of food security as a “Canadian” problem has been partial and contested, and reflects persistent geographic imaginaries of Canada (e.g., as a land of agricultural abundance) and unrelenting social and cultural exclusions (e.g., of Canada's Aboriginal people).
Social science & medicine (1982), 2007
In May 2004 the World Health Organization (WHO) officially launched the 'Global Strategy on D... more In May 2004 the World Health Organization (WHO) officially launched the 'Global Strategy on Diet, Physical Activity and Health'. Lying at its heart is the recognition that many of the risk factors associated with non-communicable diseases, particularly poor diet and physical inactivity, have begun to move beyond the confines of the West. It was this apparent shift in the epidemiological boundaries of such diseases, along with fears over the so-called 'double burden' that they presented to some nations, that finally prompted the WHO to develop such a far reaching strategy. This paper adds to the on-going debate surrounding this important issue by drawing on the concepts of medicalisation, governmentality and the spatiality of scientific knowledge to explore one particular element of it: namely, the identification of nature as a setting for the promotion of physical activity. We adopt this perspective because we are concerned to understand the ways in which the knowled...
The Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and Society, 2014
Geographers have recently begun to make a considerable contribution to global health. Most notabl... more Geographers have recently begun to make a considerable contribution to global health. Most notably, this contribution has involved unpicking the national and international response to the problem of global health and submitting it to critical scrutiny. Such work not only requires paying close attention to the differing ways in which global health is imagined (historically as well as in the contemporary period) but also considering the effects of such imaginings on the material, lived experiences of those most affected. Keywords: geography; globalization; health
The Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and Society, 2014
Similarly to scholars in other disciplines allied with the arts, humanities, and social sciences,... more Similarly to scholars in other disciplines allied with the arts, humanities, and social sciences, geographers have explored the ways in which particular kinds of bodies have been represented as diseased and/or healthy in both the past and the present. Foucault's work on the body as a site of particular regimes of knowledge and power relations has been pivotal in shifting focus towards the kinds of technologies utilized in producing such understandings. Following his analyses, geographers acknowledge, though not entirely without criticism, that one of the key ways of studying social parameters of normativity and the mechanisms for enforcing them is to look at representations of sick bodies. Here “sick” does not mean simply images or understandings of bodies that are diseased; rather, it refers to a much more expanded investigation of bodies depicted as undesirable, impure, or deviant at various moments in time and place. Keywords: disease; geography; representation
Social Science & Medicine, 2000
This paper considers the discursive properties of public health literature produced around AIDS i... more This paper considers the discursive properties of public health literature produced around AIDS in the 1980s and early 1990s. Attention is focused upon the role of health promotion in the UK government's response to the epidemic and on the language used in the educational campaigns conducted by the Health Education Council and its replacement the Health Education Authority. Using an analytical approach influenced by the work of Michel Foucault, the paper argues that the knowledges of AIDS produced by these various public health institutions constructed discursive boundaries between the idea of 'normal' and 'abnormal' behavioural practices. The notion of risk, produced as it is from epidemiological knowledge, is a central mechanism in this process. It is through the production, articulation and normalisation of 'at risk' groups that society is fragmented and hence subject to the governance strategies of late-modern liberal economies.
A Companion to Health and Medical Geography
Recent media images of SARS, AIDS, and avian fl u have made more apparent than ever the critical ... more Recent media images of SARS, AIDS, and avian fl u have made more apparent than ever the critical role representations of bodies play in our understandings of disease, and by default, of health. Photographs of Chinese tourists to Toronto, Vietnamese chicken farmers, or urban gay communities signal transmission routes of pathogens through mobile bodies, the role of social and economic practices in epidemics, and the kinds of bodies at risk for particular diseases. Yet many scholars inside and out of geography in recent years have critiqued such images for lending as much misunderstanding as understanding to diseases, populations, and geographic regions by providing selective information or perpetuating stereotypes of people and places in the midst of documenting pathogenic transmission. In this chapter, we examine representations of diseased and healthy bodies over time and place as a means of situating wellbeing or its absence within a set of social, ideological, and geopolitical relations. Representing particular kinds of bodies as diseased or healthy is not new to recent epidemics. Historians of colonial medicine have pointed out that constructing " native " bodies as either more or less susceptible to disease and as less hygienic, formed important foundations for subsequent colonial policies regulating labor, settlement patterns, and health care in areas of Africa and Asia (Packard 1989 ; Arnold 1993 ; Anderson 1996). Other historians and historical geographers have analyzed examples within the United States and Europe of ascriptions by public health authorities and others of disease or deviance to particular communities, paying close attention to the impact these representations have on perceptions of populations and the places in which they reside (Cresswell 1996 ; Brown 1997 ; Craddock 2000 ; Shah 2001). Another line of inquiry examines notions and representations of healthy bodies and how these have changed over time. What is revealed in this area of inquiry are the ways in which ideas regarding the " normal, " healthy body are presented alongside, and are interwoven with,
A Companion to Health and Medical Geography
As an opening to this volume, we believe that it would be useful for readers to be aware both of ... more As an opening to this volume, we believe that it would be useful for readers to be aware both of the rationale that underpins it and, perhaps a little more unusually, of the process that led to its production; especially the critical role played by the academic reviewers of the original proposal. The former is important because the idea for the volume materialized out of the recognition that debates regarding the constitution of the sub-discipline had reopened (for an extensive review see Andrews & Evans 2008). In reality this debate has been ongoing since Kearns ' (1993 : 144) decisive intervention in the early 1990s, which saw the sub-discipline rupture (albeit productively) along the now familiar lines of " health " and " medical " geography. However, although most commentators agree that the scope and scale of research conducted by scholars on both sides of this divide has expanded considerably and areas of intersection have increased, few agree upon the nomenclature under which this endeavor takes place. Are we health geographers, medical geographers, post-medical geographers, or something else entirely? This volume was initially conceived as a prime opportunity to refl ect upon this expansion, to highlight the variety of research that is conducted by scholars associated with the sub-discipline, and also as an opportunity to refl ect further on the key debates that had been taking place. This ambition is clearly demonstrated in the opening paragraphs of the proposal that we submitted to the publishers for possible inclusion in the Blackwell (now Wiley-Blackwell) Companions to Geography series: The global strength of the sub-discipline is in part related to the shift away from its traditional focus on disease ecology, disease mapping, and health service provision. This change followed substantial debate regarding the sub-discipline ' s apparent overreliance on positivism and quantitative methods, which was argued to limit its ability to engage with themes important to theoretically minded human geographers: most notably those infl uenced by the " cultural " turn. Arguably the result of this debate is a more nuanced sub-discipline, one that is concerned with questions of culture and difference, inequality and power, representation and meaning. At the same time, health
A Companion to Health and Medical Geography
... together into a personalized strategy that iden-tifies and minimizes their exposure to harm ... more ... together into a personalized strategy that iden-tifies and minimizes their exposure to harm (O ' Malley ... of the self and the arts of government, because neo - liberal rule, through the emphasis ... on the subject of risk, and its emergence as a technique for governing the actions ...
Appetite, 2015
Picky eaters are defined as those who consume an inadequate variety of food through rejection of ... more Picky eaters are defined as those who consume an inadequate variety of food through rejection of a substantial amount of food stuffs that are both familiar and unfamiliar. Picky eating is a relatively recent theoretical concept and while there is increasing concern within public health over the lack of diversity in some children's diets, adult picky eaters remain an under researched group. This paper reports on the findings of a qualitative study on the routine food choices and practices of 26 families in Sandwell, West Midlands, UK. Photo elicitation and go-along interview data collection methods were used to capture habitual food related behaviours and served to describe the practices of nine individuals who self identified or were described as picky eaters. A thematic analysis revealed that those with the food related identity of picky eater had very restricted diets and experienced strong emotional and physical reactions to certain foods. For some this could be a distressing...
Gender, Place & Culture, 2014
This paper introduces the articles that comprise the themed section ‘bodies across borders’ which... more This paper introduces the articles that comprise the themed section ‘bodies across borders’ which investigates how the social and spatial dynamics of healthcare provision are being transformed by both neo-liberalization and globalization. The articles demonstrate how the central tenets of neoliberalism: the promotion of individual autonomy as realized through the instrument of consumer choice, the privatization, outsourcing and off-shoring of core competencies and service provision, the production of highly ‘flexible’ labour are at work in re-shaping access to, and delivery of, services in the domains of reproductive health, organ donation and globalized healthcare. In paying special attention to the ways in which these practices are cut across by class, gender and ethnicity, these accounts will hopefully encourage us to reject totalizing and homogeneous narratives of medical travel in favour of those that offer more nuanced understandings of the positionality of the individuals at the heart of them.
Transactions of the Institute of British Geographers, 2000
There have been few studies of spatialized discourse within contemporary healthcare policy-making... more There have been few studies of spatialized discourse within contemporary healthcare policy-making. This paper addresses this omission, focusing on the governmental presentation of the little-studied measures that consolidated the post-1989 reforms of the NHS in England and Wales, and culminated in the Health Authorities Act 1995. A short section places these measures in context and outlines their main components. An analysis of key documents and parliamentary exchanges is then used to show how spatialized language was central to the presentation of policy and its debate in parliament. In particular, the paper demonstrates how nuanced conceptions of space-and territorially-led service management provide a flexible basis for presenting notions of power and control. This 'spatio-linguistic strategy' is located theoretically within the concept of govemmentality.
Social Science & Medicine, 2008
During the last decades of the twentieth century it became increasingly apparent that the interre... more During the last decades of the twentieth century it became increasingly apparent that the interrelationship between globalisation and health is extremely complex. This complexity is highlighted in debates surrounding the re-emergence of infectious diseases, where it is recognised that the processes of globalisation have combined to create the conditions where once localised, microbial hazards have come to pose a threat to many western nations. By contrast, in an emerging literature relating to the epidemic of non-communicable diseases, and reflected in the WHO 'Global strategy on diet, physical activity and health', it is the so-called 'western lifestyle' that has been cast as the main threat to a population's health. This paper explores critically global responses to this development. Building on our interest in questions of governance and the ethical management of the healthy body, we examine, whether the global strategy, in seeking to contain the influence of a 'western lifestyle', also promotes contemporary 'western-inspired' approaches to public health practices. The paper indicates that a partial reading of the WHO strategy suggests that certain countries, especially those outside the West, are being captured or 'enframed' by the integrative ambitions of a western 'imperial' vision of global health. However, when interpreted critically through a post-colonial lens, we argue that 'integration' is more complex, and that the subtle and dynamic relations of power that exist between countries of the West/non-West, are exposed.