Apparent and actual disease landscapes. some reflections on the geographical definition of health and disease

Abstract

Like geographical analysis in general, medical geography is based on the assumption that location is the first clue to causal analysis. Against a background of two empirical studies, one dealing with a group of ALS cases and the other with a group of leukaemia cases, this paper argues that it is insufficient to define disease occurrence in spatial terms, referring to patients’ places of residence at the time of onset. Since exposure and effect are related to both time and place, geographical studies of ill health in modern society are complicated by high mobility, long periods of latency and environmental change which might cause a distortion between cause and effect. Therefore a different approach is required.