Understanding and representing ‘place’ in health research: A relational approach

Steven Cummins, Sarah Curtis, Ana V. Diez-Roux & Sally Macintyre

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Cummins, S. , Curtis, S. , Diez-Roux, A. V. & Macintyre, S. (1). Understanding and representing ‘place’ in health research: A relational approach. Social Science & Medicine, 65(9), 1825–1838. http://dx.doi.org/10.1016/j.socscimed.2007.05.036

Geography , Neighborhood Effects , Place , Relational Theory , Space

Epidemiology, sociology, and geography have been successful in re-establishing interest in the role of place in shaping health and health inequalities. However, some of the relevant empirical research has relied on rather conventional conceptions of space and place and focused on isolating the ‘‘independent’’ contribution of place-level and individual-level factors. This approach may have resulted in an underestimate of the contribution of ‘place’ to disease risk. In this paper we argue the case for extensive (quantitative) as well as intensive (qualitative) empirical, as well as theoretical, research on health variation that incorporates ‘relational’, views of space and place. Specifically, we argue that research in place and health should avoid the false dualism of context and composition by recognising that there is a mutually reinforcing and reciprocal relationship between people and place. We explore in the discussion how these theoretical perspectives are beginning to influence empirical research. We argue that these approaches to understanding how place relates to health are important in order to deliver effective, ‘contextually sensitive’ policy interventions. r 2007 Elsevier Ltd. All rights reserved.

Main finding
The results suggest that there is indeed a direct reciprocal relationship between people and place. Secondly, the authors argue that it is essential to incorporate that the "context" and the " place" can vary with time, and therefore have different impacts on different people at various times. Finally, the study highlights that it is crucial to taken into account the "scales", from local to global - and that there needs to be "contextualized" policy intervention with regards to health. There are health promoting places and health damaging environments - and these can be at the source of health inequalities.

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