Associate Professor - UWO Geography
Geography 9107 - Environment and Health
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READINGS/HANDOUTS (
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Geography 9107: Environment and Health
See the schedule for dates for each topic. You will need to be using a computer on the UWO network when accessing some of the journal websites - use the proxy server for "off-campus access".
**NEW** You can now obtain all readings by accessing the online READINGS REPOSITORY for the course.username: geog9107
password: envhlth
Readings (see readings repository instructions at top of page)
Evans, R.G. and Stoddart, G.L. 1990. Producing health, consuming health care. Social Science and Medicine, 31, 1347-63.
Krieger, N. 1994. Epidemiology and the web of causation: has anyone seen the spider? Social Science and Medicine, 39, No.7, pp. 887-903.
Mordacci, R. 1998. The desire for health and the promises of medicine. Medicine, Health Care & Philosophy, 1: 21-30.
Le Fanu, J. 1999. The Rise and Fall of Modern Medicine. London: Little, Brown and Co., 312-381.
Wilkinson, R.G. 1996. Unhealthy Societies: the afflictions of inequality. London: Routledge, 13-28.
Design Measurement and Evaulation 1: Design and Method
In these next two sessions we shall look at design, measurement and evaluation issues. This week we concentrate on designs utilized for environment and health research. First, we review basic epidemiologic research strategies. Morgenstern reviews the ecologic method while Hennekens and Buring outline individual respondent-based designs. Engel calls for the need for a new medical model, while Brown makes the case for qualitative environmental health research. The final two papers provide examples of quantitative epidemiologic environment and health research - Hertzman et al. examine the Upper Ottawa landfill impacts - and qualitative research in environmental health - Wakefield and colleagues study air pollution from the point of view of community action, risk perception, social capital and attachment to place.Readings (see readings repository instructions at top of page)
Brown, P. 2003. Qualitative Methods in Environmental Health Research, Environmental Health Perspectives, 111(No. 14 Nov., 2003): 1789-1798Engel, G. 1977. The need for a new medical model: A challenge for biomedicine.
Science 196 pp. 129-136
Hennekens, C. and Buring, J., 1987, Epidemiology in Medicine, Boston: Little Brown, 31-52.
Hertzman, C. et al. 1987. Upper Ottawa Landfill Site health study, Environmental Health Perspectives, 75, 173-195.
Morgenstern, H. 1995. Ecologic studies in epidemiology: Concepts, Principles, and Methods, Annual Reviews of Public Health, 16, 61-81.
Wakefield, S.E. Elliott, S.J. Cole, D. Eyles, J.D. 2001 Environmental risk and (re)action: air quality, health, and civic involvement in an urban industrial neighbourhood, Health & Place, 7(3):163-177
Design Measurement and Evaulation 2: Interpretation and Evaluation of Evidence
In this second session on design measurement and evaluation, we will examine how different methods lead to different types of evidence and assess the ways of guarding against threats to the validity or trustworthiness of that evidence. The readings from last session connect very tightly to this. Hage and Meeker address 'causality' in 'social' research which has relevance for environment and health; while Baum, writing from the point of view of public health practitioners, points out that nature of different sorts of evidence and their philosophical and practical bases. The remaining two papers are concerned with the interpretation and interpretability of epidemiologic evidence more directly and point out the specifiic "biases" of various study designs for making health to environment links - Frank et al. and Ozonoff.Baum,F. (1995) Researching public health: Behind the qualitative-quantitative methodoligical debate. Social Science & Medicine 40(4): 459~.68
Frank, J. W., Gibson, B. et al. 1988. Information needs in epidemiology: detecting the health effects of environmental chemical exposure. In Fowle, C. et al. (eds) Information needs for Risk Management (pp. 129-145). Toronto, Institute for Environmental Studies Monograph No. 8. University of Toronto.
Hage, J. and Meeker, B. 1988. Social Causality. Boston: Unwin Hyman, 1-33.
Weldon Library – HM24.H329 1988
Ozonoff, D. 1994. Conceptions and misconceptions about human health impact analysis. Environmental Impact Assessment Review, 14, 499-515.
Social and built environment and health ("Urban Health")
There is mounting conern that the built environment is dramatically affecting health. Much of this work is focused on symptoms or diseases (e.g., obesity, heart disease), but increasingly psychosocial outcomes are also being considered. What is the evidence for such linkages? Galea and Vlahov provides a review of the evidence related to urban health, and the challenges to the study of urban health. Northridge et al presents a conceptual framework for understanding the connections between the built environment and health. Greonimus addresses the role of structural factors on the health of urban populations. Ingrid et al examines the linkages between neigbourhoods and health. This is taken further by Veenstra et al who suggest that who you know and where you live have important influences on your health. Andrulis discusses policy strategies to improve health care access in changing urban environments.
Andrulis, D. P. (2000) Community, Service, and Policy Strategies to Improve Health Care Access in the Changing Urban Environment. American Journal of Public Health, 90(6): 858-862.
Galea, S. & Vlahov, D. (2004) URBAN HEALTH: Evidence, Challenges, and Directions. Annual Rev. Public Health, 26:341–365.
Geronimus, A. T. (2000) To Mitigate, Resist, or Undo: Addressing Structural Influences on the Health of Urban Populations. American Journal of Public Health, 90: 867–872.
Ingrid, G. E., et al., (2001) Neighborhood effects on health: Exploring the links and assessing the evidence. Journal of Urban Affairs, 23(3-4): 391-408.
Northridge, M. E. et al. (2003) Sorting Out the Connections Between the Built Environment and Health: A Conceptual Framework for Navigating Pathways and Planning Healthy Cities. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 80(4): 556-568.
Veenstra, G. et al. (2005) Who you know, where you live:social capital, neighbourhood and health. Social Science & Medicine, 60: 2799-2818.
Impacts of Locally Unwanted Land Uses (LULUs)
Locally unwanted landuses and (potential) environmental pollution often co-occur and there are a variety of approaches to studying their impacts on local communities - including a wide range of both exposure and outcome measures. Exposure to waste sites, for example, has been linked in many studies to negative physical and mental health effects although the strength of evidence to support cause and effect relationships is often debatable. Neutra draws upon studies in California in discussing possible explanations of the higher symptom rates observed around hazardous waste sites. Elliott and colleagues provide two related studies involving multivariate modelling of the determinants of concern and action using survey data. The authors test for the presence and predictors psychosocial effects in populations living near to solid waste disposal facilities in southern Ontario and how these change over time at one of the sites. McGee takes an entirely different approach to researching facility exposure by using face-to-face in-depth interviews to understand how people live with chronic lead contamination in a mining community. Smith and Desvousges provide a economic analysis of the LULUs while Steinheider et al. study the links between odour, odour annoyance and gastic symptoms.
Elliott, S. et al. 1993, Modelling psychosocial effects of exposure to solid waste facilities, Social Science and Medicine, 37(6), 791-804.
Elliott, S. et al. ‘It's not because you like it any better’: Residents' reappraisal of a landfill site, Journal of Environmental Psychology, 17: 229–241
McGee, T. (1999) Private responses and individual action - Community responses to chronic environmental lead contamination, Environment and Behaviour, 31(1): 66-83
Neutra, R. et al. 1991. Hypotheses to explain the higher symptom rates observed around
hazardous waste sites. Environmental Health Perspectives, 94: 31-38.
Smith V. and Desvousges W. (1986) The value of avoiding a LULU: Hazardous waste disposal sites, Review of Economics and Statistics, 68(2): 293-299
Steinheider B, Both R, and Winneke G (1998) Field studies on environmental odors inducing annoyance as well as gastric and general health-related symptoms, Journal of Psychophysiology, 12(supl 1): 64-79
Pesticide and Health Risk
There has been much debate about the health risks to humans from pesticide use, particularly so-called "cosmetic" uses in yards. This set of readings covers a wide array of approaches to understanding the issue. Two of the studies, Gorell et al. (1998) and Krieger et al. (1994), involve traditional epidemiologic studies on the links between Parkinson's disease and pesticides and breast cancer and pesticides repectively. Guillette et al. (1998) are also interested in human health effects, but take a very non-traditional approach to the problem that adapts to the research situation. Arya (2005) provides a review of evidence in support of banning pesticide use in Canada. Roche (2002) is interested in the information available to the public concerning pesticide health risks when they must be traded off against the health risks of west nile virus. He reviews hundreds of print media articles to understand how effectively risk is communicated. Robbins and Sharp (2008) are lilkewise less interested in studying the health risks per se and instead provide analysis of the cultural rootedness of the lawn and how difficult it may be to prevent exposure to pesticides.
Arya, N. (2005) Pesticides and Human Health: Why Public Health Officials Should Support a Ban..., Canadian Journal of Public Health 96(2): 89-92
Gorell J., Johnson C., Rybicki B., Peterson E., Richardson R. (1998) The risk of Parkinson’s disease with
exposure to pesticides, farming, well water, and rural living, Neurology, 50 (May): 1346-50.
Guillet E., Meza M., Aquilar M., Soto A, Garcia I. (1998) An Anthropological Approach to the Evaluation of Preschool Children Exposed to Pesticides in Mexico, Environmental Health Perspectives, 106(6): 347-53
Krieger N., Wolff M., Hiatt R., Rivera M., Vogelman J., Orentreich N. (1994) Breast cancer and serum organochlorines: A prospective study among white, black, and asian women Journal of the National Cancer Institute, 86(8): 589-99Robbins P. and Sharp J. (2008) Producing and consuming chemicals: The moral economy of the American lawn, Urban Ecology, 181-205
Roche, J (2002) Print media coverage of risk-risk tradeoffs associated with west nile encephalitis and pesticide spraying, Journal of Urban Health, 79(4): 482-90
Environmental Cancer
Numerous studies have investigated possible links between environmental factors and human cancer. Doll and Peto (1981) provide an excellent, but now somewhat dated, review of the evidence related to exposures in both occupational and environmental settings and estimate the attributable risk from environmental factors relative to life-style determinants. Coyle (2004) and Brophy et al. (2006) provide empirical studies of the links between environmental exposures and breast cancer. Walter et al. (1994) take a distinctly spatial approach by using registry data on cancer incidence in Ontario to describe spatial variation at the county level. Several years ago, an environmental alarm resulted from the release of US reports suggesting a causal link between exposure to electromagnetic fields and cancer. Both Taubes (1994) and Burger (1990) argue for some caution when attempting to make scientific links between enviornmental exposures and cancer and the latter suggests that health (including cancer) issues are often used to justify environmental actions in ways which the scientific evidence is insufficient, or perhaps incapable, to support.
Burger, E. J. (1990) Health as a surrogate for the environment. Daedelus, 114 (4): 133-153.
Coyle, Y. M. (2004) The effect of environment on breast cancer risk. Breast Cancer Research and Treatment 84: 273–288.
Brophy, J. T., Keith, M., Gorey, K. Luginaah, I., Laukkanen, E., Yellyer, D., Reinhartz, A., Watterson, A., Abu-Zahra, H., Maticka-Tyndale, E., Schneider, K. Beck, M. and Gilbertson, M. (2006) Occupational and environmental histories of breast cancer patients: A Canadian case study. Annals of the New York Academy of Sciences. 1076: 765–777.
Taubes, G. (1994) Fields of fear. Atlantic Monthly, November, 94-108.
Walter, S. et al. 1994. Geographic variation of cancer incidence in Ontario. Journal of American Public Health Association, 84(3). 367-376.
Environmental Justice
The last two decades have involved rapid expansion of literature that addresses the interconnected issues of: environmental racism, environmental justice and envionmental equity. This literature supports a presidential executive order that all government activities in the U.S. must address any attendant environmental justice issues in the work that they do (e.g., environmental assessment). We have no such legal framework in Canada. What is the evidence in support of environmental justice policy? What evidence is required and what role does/should health play? The set of readings this week will help address these overarching questions.
Anderton D., Anderson A. and Oakes J. (1994) Environmental equity: The demographics of dumping, Demography, 31(2): 229-48.
Been V., and Gupta F. (1997) Coming to the nuisance or going to the barrios? A longitudinal analysis of environmental justice claims, Ecology Law Quarterly, 24(1):1-56
Mohai P. and Saha R. (2006) Reassessing racial and socioeconomic disparities in environmental justice research, Demography, 43(2): 383-99
Pulido L. (2000) Rethinking environmental racism: White privilege and urban development in southern California, Annals of the Association of American Geographers 90(1): 12-40.
Policy Analysis and Policy Argument
With this week's readings we leave the treatment of research as research and confront the nature of the policy-making process. Pal (chapter 2 and 3) provides a basic outline of policy analysis from a theoretical and evaluative standpoint. Torgerson extends the argument by arguing that there is not one but three types of policy analysis, all being based on a different relationship between knowledge and politics. Dunn identifies different types of policy argument. A policy argument is the way in which information is transformed into policy claims. But information can be treated in different ways by different stakeholders leading to conflicting definitions and explanation.
Dunn, W.N. 1994. Public policy analysis: An introduction. Prentice-Hall, Englewood Cliffs,
Chapter 4
Pal, L.A. 1992. Public Policy Analysis: An Introduction. Nelson, Scarborough
Chapter 2,
Chapter 3
Torgerson, D. (1986) Between Knowledge and politics: three faces of policy
Analysis. Policy Sciences, 19, 33-59.
Evidence, Policy and Policy Learning
Throughout the course, we have often found reference to equivocal evidence and decision-making under uncertainty. In this session, we examine the problematic relationship between science and politics. Harrison discusses this in the context of dioxin risk as seen by Canada and the United States. Aronson sees science as a claims-making activity. Sabatier takes a slightly different, and somewhat more optimistic, approach to policy analysis than many in his advocacy coalition framework which emphasizes the idea of policy learning. Flueler provides an example of how that framework relates to the issue of radioactive waste disposal, an issue with provide environment and health implications.
Aronson, N. 1994. Science as a claims-making activity: Implications for social problems research, J. Schneider and J. I. Kitsuse (eds.) Studies in the Sociology of Social Problems. Norwood, NJ: Ablex. 1-30.
Flueler T (2001) Options in radioactive waste management revisited: A proposed framework for robust decision making, Risk Analysis, 21(4): 787-79
Harrison, K. 1991. Between science and politics: assessing the risks of dioxins in Canada and the United States. Policy Sciences, 24, 367-88.
Sabatier, P.A. 1987. Knowledge, policy-oriented learning and policy change. Knowledge: Creation, Diffusion, Utilization, 8, 649-92.
Policy Narratives and Policy Framing
In this session, we explore the issues of contextualizing policy arguments and analyses through narrative and framing. Roe provides a structure for seeing policy debates as narratives, exemplified by global warming. This is taken on by Garvin and Eyles in their analysis of claims made to produce a sun safety metanarrative. Cook et al. demonstrate how context frames policy responses while Jasanoff extends the argument through highlighting cross-national differences in policy implementation.
Cook, B.J., Ernel, J.L. and Kasperson, R.E. 1991. A problem of politics or technique?
Insights from waste-management strategies in Sweden and France. Policy Studies Review,10(4), 103-110. Photocopy # 3485
Garvin, T. and Eyles, J. 1997. The sun safety metauarrative. Policy Sciences, 30, 47-70.
Jasanoff, S. 1991. Cross-national differences in policy implementation. Evaluation
Review, 15, 103-19. Call #: HM1.E8.
Roe, E. 1994. Narrative Policy Analysis: Theory and Practice.. Duke UP, Durham, Introduction and chapters 2 and 6. Call #: H97.R638 1994
