Place, space, and health inequalities

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Space, place and (waiting) time: reflections on health policy and politics

AbstractHealth systems have repeatedly addressed concerns about efficiency and equity by employing trans-national comparisons to draw out the strengths and weaknesses of specific policy initiatives. This paper demonstrates the potential for explicit historical analysis of waiting times for hospital treatment to add value to spatial comparative methodologies. Waiting times and the size of the lists of waiting patients have become key operational indicators. In the United Kingdom, as National Health Service (NHS) financial pressures intensified from the 1970s, waiting times have become a topic for regular public and political debate. Various explanations for waiting times include the following: hospital consultants manipulate NHS waiting lists to maintain their private practice; there is under-investment in the NHS; and available (and adequate) resources are being used inefficiently. Other countries have also experienced ongoing tensions between the public and private delivery of universal health care in which national and trans-national comparisons of waiting times have been regularly used. The paper discusses the development of key UK policies, and provides a limited Canadian comparative perspective, to explore wider issues, including whether ‘waiting crises’ were consciously used by policymakers, especially those brought into government to implement new economic and managerial strategies, to diminish the autonomy and authority of the medical professional in the hospital environment.</jats:p

Health, Place, and Space: Adolescent Female Refugees in Palestinian Camps

Female Palestinian refugee adolescents living in camps face enormous challenges that influence their health. Studies have shown the spatial and physical contexts of people's lives — where and how they live — determine their health, meaning that refugee health cannot be fully understood in isolation from the spatial and physical contexts that shape and sustain health conditions and community environment. Chronic disease, mental health issues, health conditions, and behavior are all affected by spatial and physical factors such as neighborhood socioeconomics, social environment, and the physical (built) environment, all of which are amplified inside refugee camps, including Palestinian camps. Place and space take into account the social relations and social construction of a community as well as the personal experience of spatiality, temporality, and materiality that influence the process of shaping the health status of individuals, especially refugees. This study investigates the construct of space in Palestinian camps in Jordan and the West Bank, and its effect on the health of female adolescents living in these camps. We examine how place and space influence and shape the health status of refugees. To do this, we consider the social relations and social construction of these refugee communities as well as individual refugees' personal experiences of spatiality, temporality, and materiality

Developing Nursing Geography with an Ecological Lens

In this paper, we propose that community health nursing is a promising context for ecologically inclusive and “place-sensitive” (Andrews, 2002) nursing practice. With a strong grounding in social justice, we believe that Canadian community health nurses have the power to create a differential space of research and practice for environmental justice and planetary health thereby challenging harmful anthropocentric and biomedical models of health and health care. To do this, we theorize an ‘environmental nursing geography’ including Henri Lefebvre’s idea of the production of space. Lefebvre’s dialectics give us tools to ecologize space and place and further the efforts of CHNs to support the health of all people and the planet through justice and equity

Managing care environments: reflections from research and practice

This chapter considers the role of senior staff in managing the use of space and the physical environment within care settings. These day and residential settings come under the broad umbrella of social work and social care but the care may also be organized from within health. This is a subject that does not appear on the curriculum of many management courses in the UK, but arguably it is critical in relation to social work and social care where managers are involved with residential homes, day centres and other provision where the physical environment can enhance or be detrimental towards service users' wellbeing. In such settings many activities go on under one roof, particularly in group care or when the care is provided in a person's own home. The care environment is complex and can be bounded within space, place, time and behaviour. Activities and time available compete or have different meanings for the participants. Managers have different kinds of relationships with workers and with service users. The environment in which care takes place often frames these

Special Issue : Place, Space, and Mental Health

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Integrating sensor streams in pHealth networks

Personal Health (pHealth) sensor networks are generally used to monitor the wellbeing of both athletes and the general public to inform health specialists of future and often serious ailments. The problem facing these domain experts is the scale and quality of data they must search in order to extract meaningful results. By using peer-to-peer sensor architectures and a mechanism for reducing the search space, we can, to some extent, address the scalability issue. However, synchronisation and normalisation of distributed sensor streams remains a problem in many networks. In the case of pHealth sensor networks, it is crucial for experts to align multiple sensor readings before query or data mining activities can take place. This paper presents a system for clustering and synchronising sensor streams in preparation for user queries

Learning from Morella: the memory of the urban form and the dialogical-historical approach in the contemporary design

From the dialogical models defended by Mijai´l Bajti´n (Bakhtin 1982), GIRAS Research Group has analyzed for years the historical urban form and architecture, trying to clarify how the architect can at the same time, innovate and preserve, understanding that in the specific of each place are the seeds for a good modernization. (Muntañola 2016). To understand the relationships between history and memory and to clarify the types of memory that the architect can use to learn from the city, we use Paul Ricoeur’s theory (Ricoeur 2010) and Space Syntax as a theory as well as a meth- od (Hillier 1996). In the case study of Morella, Spain, we will see that the urban form of the historical city has kept in his memory the existence of an old gate of the wall, in a place that people has forgotten. With historical drawings, plans, written sources, with archaeological exploration and with Space Syntax analysis, it will be shown that the memory of the city is present in the constructed form. In Morella, we will find some interesting examples about how the architect can make bridges between the new design and the history of the profession, of the place and of the society, analyzing two heritage buildings restored in the core of the city, the town hall and a church as a health center, and two new buildings outside the wall, the Primary School designed by Miralles & Pino´s and the Secondary School by Helio Piñón, both of them with international awards. (Beltran 2015)Peer ReviewedPostprint (published version

It’s the talk: A study of involvement initiatives in secure mental health settings

Background: A study of involvement initiatives within secure mental health services across one UK region, where these have been organised to reflect alliances between staff and service users. There is little previous relevant international research, but constraints upon effective involvement have been noted. Objective: To explore and evaluate involvement initiatives in secure mental health settings. Design: A case study design with thematic analysis of qualitative interviews and focus groups. Setting and participants: Data collection was carried out between October 2011 and February 2012 with 139 staff and service users drawn from a variety of secure mental health settings. Findings: Our analysis offers four broad themes, titled: safety and security first?; bringing it all back home; it picks you up; it’s the talk. The quality of dialogue between staff and services users was deemed of prime importance. Features of secure environments could constrain communication, and the best examples of empowerment took place in non-secure settings. Discussion: Key aspects of communication and setting sustain involvement. These features are discussed with reference to Jurgen Habermas's work on communicative action and deliberative democracy. Conclusions: Involvement initiatives with service users resident in secure hospitals can be organized to good effect and the active role of commissioners is crucial. Positive outcomes are optimized when care is taken over the social space where involvement takes place and the process of involvement is appreciated by participants. Concerns over risk management are influential in staff support. This is germane to innovative thinking about practice and policy in this field