Health as an interdisciplinary construction: The dialogue between geography, health, and territory

Discussion
By Jeanne-Marie Amat-Roze
English

It is common to confuse health and medicine, but this comparison is far too limited to promote health. Health is related to the living conditions of the individual, from all points of view: food, education, housing, work, travel, and health care. Obviously the latter is part of it, but is just one link in a long chain. A health condition is the result of a system of multiple interactive components at a given time and in a given place: endogenous factors (physical, biological, genetic) and exogenous ones (political, economic, social and cultural environments, features of the living conditions). The discrepancies are the results of different combinations of these factors. Some contexts associate a series of health-protecting factors, whereas others are associated with factors of vulnerability. There has always been a dialogue between, on the one hand, medicine and, on the other hand, sociology, anthropology, and economy. It dates back to antiquity for geography (cf: Hippocrates’ treatise On air, waters, and places) but it disappeared during Pasteur’s revolution. The twentieth century marks the return of geography. In 2009, a French law took hold of one of its key words, “territory.” Why? What are the contributions of this discipline? Maps are a powerful image of this discipline, which cannot be limited to this production. Geography also contributes to the laws of distance, polarity, and flows, and to the notions of scale, accessibility, network, basin, space for living, territorial dynamics. We have here a very good opportunity to establish a dialogue between health and geography. Indeed, the perception of the territorial dimension of health issues is being reinforced both through the reading of epidemics such as SARS and flu, and through discrepancies in the health conditions. This reinforcement is related to territorialization procedures. In the field of health care, the tools of this discipline provide us with decision-making diagnoses necessary for the promotion of a greater territorial equity. At the time of the implementation of the HPST (Hospitals, Patient, Health, and Territory) and ARS (Regional Agency for Health) laws, and the debates on health territories, the emphasis will be put on the French health care system.

Keywords

  • geography
  • space
  • territory
  • scales
  • health
  • sanitary planning
  • health care system
  • town and country planning
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