Professor Emeritus Richard Morrill and Professor Michael Brown
The Seattle Times has profiled the Geography Department’s new anthology, Seattle Geographies, edited by professor Michael Brown and Emeritus Professor Dick Morrill. The book, which is being unveiled this week at the AAG Conference in Seattle, emphasizes Geography’s unique spatial perspective on the Seattle region’s many “paradoxes”, including:
• Seattle may have a reputation as liberal and tolerant, “but it can also be quite controlling,” Brown says. For example, it has adopted stringent rules about social behavior that give police the authority to exclude people from parks if they violate rules or laws.
• The area has a long-standing fear of big government, but voters seem willing to tax themselves significantly, Morrill says.
• Though Seattle has a reputation as a high-tech mecca, one-third of the local economy is still fueled by manufacturing, notes Professor Emeritus William Beyers.
The book includes article by faculty, graduate students and undergraduates, and addresses such diverse cultural, social and ecnomic isues as voting patterns in presidential elections across the region, to relatively small, such as the politics of locating and building a skateboard park, and what that issue says about social and generational tensions.
The Seattle Times article also talks about the UW Geography Department, pointing to a “renaissance” in the discipline, and emphasizing our accountability to place, field-based research, and community engagement.
The current issue of the American Journal of Public Health has many articles that speak directly to issues of direct relevance to areas of current concern in geography and in population health. “Global Health and the Global Economic Crisis” by Benatar, Gill, and Bakker (pp. 646-653) pursues several arguments, and among them are that 1)global inequities in health reflect inequities in power; 2) the profit driven global economic system is a driver of inequities in health, and of collective poor health; and 3) a new paradigm is needed, versed in ethics, and culturally sensitive, creative, and innovative long term policy.
“The Social Determinants of Tuberculosis” by Hargreaves and colleagues (pp. 654-662) is very close to what I do in Ghana, and brings the understanding of tuberculosis into the realm of social epidemiology, social science, and the movement that has been termed “the social determinants of health” for the past 30 years or so. It is a label that I do not like since it is too—deterministic. I would much rather see “social influences on health.” It does not help to have a biologic determinism and a social determinism competing with one another–the whole problem is that health is not the result of determinism and the underlying causes of either ill-health or good health are not deterministic in nature. Be that as it may….this interesting article reviews the social factors that underlie contemporary TB epidemiology, including mobility and urbanization. In the US, for example, the main driver of TB is the influx of foreign-born individuals, for the simple reason that some are originating from areas that have high rates of TB; thus, percent foreign born, in any area in the US gives that area a high relative risk of having a TB prevalence rate well above the median. One of my recent doctoral graduates in the Department of Epidemiology, Eyal Oren, PhD, discovered a great deal of spatial clustering of incident TB cases in this state, and, based upon chart reviews and medical records, in King County.
The final article that I will mention is a spatial analysis of major trauma and injury in the North America. The article, titled “Trauma in the Neighborhood: A Geospatial Analysis and Assessment of Social Determinants of Major Injury in North America” (pp. 669-677) examines the spatial patterns and clustering of major trauma using GIS and a commonly used clustering algorithm, SatSCan. It is another example of examining health phenomena using the “social determinants” approach. In this case, I would call it the “social correlations” approach. Even if the relationships were deterministic, and they were not, there was no causation established here.
This issue of AJPH is unusually full of interesting articles that will interest geographers in many specialties.
Edward Glaeser uses his NY Times Economix blog to make a fascinating case for the recent transformation of Seattle’s economy chiefly via the consolidation of human capital–a largely local and spatial argument for economic success in a global economy. Citing the UW (along with Microsoft, Starbuck’s, Amazon, etc) as key drivers of the local economy, Glaeser argues that:
A great paradox of our age is that despite the declining cost of connecting across space, more people are clustering together in cities. The explanation of that strange fact is that globalization and technological change have increased the returns on being smart, and humans get smart by being around other smart people.
Dense, smart cities like Seattle succeed by attracting smart people who educate and employ one another.
Edward L. Glaeser: How Seattle Transformed Itself – NYTimes.com.
An article that is forthcoming in The Lancet concludes that there will have been a prevalence of nearly 800,000 cases of cholera in Haiti by the end of November, 2011–nearly double the number projected by WHO. WHO’s estimates have themselves been increasing dynamically and are not based on any knowledge of transmission dynamics–in short, they are educated guesses. The reference paper, posted online on March 16, 2011 (www.thelancet.com) is based upon a detailed knowledge of transmission dynamics and interventions, and is a recursive mathematical model by two well known disease modelers (Andrews JR and Basu S. Transmission dynamics and control of cholera in Haiti: an epidemic model. Lancet DOI:10.1016/S0140-6736(11)60273-0) Geographers and spatial epidemiologists will recognize that the model is a multiregional form of disease model that is based on the number of susceptible people, infected individuals, and recovered individuals (“SIR” models) that have been the basis for growth models for decades. Moreover, and perhaps *most importantly*, anticipated early declines in cholera incidence in the coming months are predicted to be part of the natural course of the epidemic, and not the result of any specific public health interventions.
Cholera is a waterborne bacterial disease, transmitted via the fecal-oral route, that can progress from asymptomatic stages to death within a period of less than 18-24 hours. The only effective treatment is oral or intravenous rehydration using physiologically balanced water/electrolyte solutions–with the electrolytes in clean water only. When available, this can be combined with oral or IV doxycycline, ciprofloxacin, or other appropriate antibiotics. Oral rehydration in this form–a fundamentally simple and low-tech treatment–was devised by Dr. Richard Cash of the Harvard School of Public Health, credited with saving millions of lives.