Size matters: the role of scale in geographies of health

Procter, Kimberley L; Smith, Dianna

doi:10.1111/j.1475-4762.2008.00833.x

Cited by 4 publications

(5 citation statements)

References 9 publications

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“…Areas of high and low rates of disease may give clues regarding causation 2. The choice of spatial scale for these analyses is important,3 as it may be that variables that illuminate variation in disease at one scale may not be relevant at a different scale 4. For example, government spending on health may influence the different disease prevalence figures seen at the national scale, whereas, within a small region (areas subject to equivalent levels of government health expenditure) variations in prevalence may be due to environmental or social factors.…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional study examining the pattern of childhood obesity in Leeds: affluence is not protective

Edwards

Cade

Ransley

et al. 2009

Archives of Disease in Childhood

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Section: Introductionmentioning

confidence: 99%

A cross-sectional study examining the pattern of childhood obesity in Leeds: affluence is not protective

Edwards

Cade

Ransley

et al. 2009

Archives of Disease in Childhood

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“…Procter and Smith (2008) suggest that by considering a multitude of spatial scales, knowledge can be maximised. In the context of the present analysis, attentiveness to the use of scalar categories by respondents has confirmed this, resulting in the identification of spatial nuances and offering a new perspective on the findings of this applied, evaluative study.…”

Section: Resultsmentioning

confidence: 99%

“…It is found that respondents framed their knowledge of this programme (and related experiences) in scalar ways without being prompted to do so, thus building on arguments that scale is indeed a relevant concept not only to the canon of human geography, but also to people's everyday lives more generally (e.g. Delaney and Leitner 1997; Jonas 2006; Kaiser and Nikiforova 2008; Masuda and Crooks 2007; Procter and Smith 2008; Wiles and Rosenberg 2009). By examining this finding we not only broadly offer an empirical perspective on the explanatory use of scale, but in doing so we make two specific contributions:…”

Section: Introductionmentioning

confidence: 99%

Scale as an explanatory concept: evaluating Canada's Compassionate Care Benefit

Giesbrecht

Crooks

Williams

2010

Area

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The concept of 'scale' and usage of this term have raised much debate within human geography over the past 25 years. At the same time, these very debates have developed the concept dramatically by offering new considerations of its use. Building on notions that scale is experienced and that scalar concepts offer a vocabulary to articulate complex phenomena, this analysis aims to explore the relevance of scale as an explanatory concept used by informal family caregivers and front-line health and social care workers when discussing their experiences with a Canadian social programme, the Compassionate Care Benefit (CCB). The goal of the CCB is to provide income assistance and job security to those who take temporary leave from employment to care for a terminally ill family member. As part of a larger evaluative study on the CCB, semi-structured interviews with 57 family caregivers and 50 front-line health and social care workers from across Canada were conducted and transcripts were thematically analysed. Emerging from analysis of both datasets was the common usage of scalar concepts, specifically 'region' , 'community' and 'home' . Respondents employed these scalar categories to reference both differences and relationships in highly spatial and comparative ways, and also to organise and articulate their thoughts in ways meaningful to them and their lives in place. Based upon these scalar categories and issues highlighted by respondents, particular spatial challenges and inequities are illuminated, and implications for the CCB and its administration are identified. These findings provide insight into the complex ways family caregivers and front-line health and social care workers make sense of their world and more specifically, understand how federal programmes like the CCB operate. By considering how such programmes are experienced in scalar ways, knowledge can be maximised and thus, informed decision-makers can more effectively meet the needs of programme users.

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“…In this direction, it is noted also that the nutritional environment has been investigated in order to deepen the understanding of the widespread prevalence of obesity, including the study of local availability, access to health food and environmental conditions (42)(43)(44)(45) . These data support the importance of focusing on places in addition to the individuals who live in those places.…”

Section: Discussionmentioning

confidence: 99%

“…Although we had a lack of environmental information such as food supply and access to parks, we could identify an association between RMC and areas with certain sociodemographic characteristics which corroborates the consensus reported by the US Institute of Medicine (14) stating that the environmental factors play a role and that environmental solutions are required to address the epidemic of obesity (15) . In this direction, it is noted also that the nutritional environment has been investigated in order to deepen the understanding of the widespread prevalence of obesity, including the study of local availability, access to health food and environmental conditions (42)(43)(44)(45) . These data support the importance of focusing on places in addition to the individuals who live in those places.…”

Section: Discussionmentioning

confidence: 99%

Spatial distribution of the risk for metabolic complications: an application in south-east Brazil, 2006–2007

Nucci

Zangirolani

Mafra

et al. 2012

Public Health Nutr.

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Objective: To identify spatial variation in the risk for metabolic complications (RMC) by means of a semi-parametric approach for multinomial data. Design: Cross-sectional study. Setting: We visited 730 households selected in the first of a two-stage sample in South health district in Campinas, São Paulo, Brazil, 2006-2007. Subjects: We interviewed 651 individuals and obtained their respective anthropometric measures and geographical coordinates of their house location. They were classified according to a combination of BMI and abdominal circumference as having no risk, increased, high or very high RMC. Results: Gender, age and schooling were associated with RMC. Crude spatial risk for the three levels of RMC in relation to the absence of risk suggested different patterns in each level. Adjusted spatial risk for the RMC showed smaller significant areas, but the pattern remained similar to crude risk. Conclusions: Spatial point analysis with a multinomial approach improves the understanding of differences in RMC found, as we could identify specific areas in which to intervene. The public health significance of these findings may lie in the additional evidence provided that spatial location and its features can influence patterns of RMC. Keywords Obesity Epidemiology Spatial risk Metabolic complicationsThe recent increase in the prevalence of obesity is widely recognized as constituting a major threat to health in most countries as obesity has reached epidemic proportions (4) . In Brazil in 2002-2003, the prevalence was 8?9 % for men and 13?1 % for women (5) . Although developed countries present higher levels of obesity, developing countries also show increasing overweight prevalence, mainly as a consequence of the nutrition transition they are experiencing (6) . Brazil has continental dimensions and inequality is present all over the country. Trends show a shift in the prevalence from the higher to the lower socio-economic level in Brazil (7) and this change has contributed to the coexistence of an overweight person with an underweight person in the same household, called the 'dual burden' of disease (8)(9)(10) .The number of studies on obesity has increased significantly in the last decade, mainly due to the high risk that this condition leads to patients with other chronic diseases, such as diabetes and hypertension (11)(12)(13) . Although several individual-level risk factors for obesity have been identified, population rates of obesity are determined by a complex interplay of biological, social, environmental, behavioural and cultural factors, which collectively have created over decades an adverse environment for maintaining a healthy weight. A comprehensive understanding of how these factors interact is currently lacking (14,15) . Age, sex, socio-economic status, sedentary lifestyle and co-morbidities such as diabetes and hypertension have traditionally been studied as risk factors for overweight or obesity. However, investigations on the risk of obesity and its association with factors other than...

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Size matters: the role of scale in geographies of health

Cited by 4 publications

References 9 publications

A cross-sectional study examining the pattern of childhood obesity in Leeds: affluence is not protective

A cross-sectional study examining the pattern of childhood obesity in Leeds: affluence is not protective

Scale as an explanatory concept: evaluating Canada's Compassionate Care Benefit

Spatial distribution of the risk for metabolic complications: an application in south-east Brazil, 2006–2007

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