The dawn of Structural One Health: a new science tracking disease emergence along circuits of capital.

Many geographers work on matters of great relevance for the issues facing society, but geography is rarely invoked in public debates over matters of contemporary concern. As a result, geographical perspectives are often missing from public discourse, and outmoded conceptions of geography are reinforced. This forum considers the importance and challenge of addressing this state of affairs. Four distinguished geographers who have been involved in different ways with the effort to raise geography's profile consider the possibilities and limitations of enhancing geography's public profile. Consideration is given to the prospects for raising the discipline's visibility in high-profile public venues, the role of geography in organized international research endeavors, the challenge of linking what geographers do to social activism, and the importance of questioning the unproblematized geographical ideas and discursive norms that already circulate in the public arena.

The role of geography in public debate

There has so far been little discussion of the ethics of geographic information systems (GIS), yet they are complex and driven by conflicting goals. This paper argues for an ethical analysis of GIS which goes beyond “intemalist” judgements of good behavior and adherence to accuracy standards to a contextualized “extemalist” one. Only when spatial technologies such as GIS are understood as part of a nexus of relations which includes academia in the commodification of information can GIS practice by fully analyzed. A four-stage sequence of ethical practice is proposed, in which GIS has achieved the second stage. GIS practice and use is a fluctuating, contested area, which, therefore, is not suited to a rigid code of ethics. A better approach is based in the internalist and externalist dialectic.

The Ethics of GIS

As the prelude to a more substantive discussion forthcoming in Worldviews on Evidence-Based Nursing, this article introduces the sub-discipline of health geography to readers. It outlines how convincing arguments that health and health care are impacted heavily by space and place have given health geography increasing profile and legitimacy as well as relevancy as a source of evidence for practice. Building on this introduction, our later article will discuss how beyond the metaparadigm of environment in nursing research, geographical research might fully operationalize space and place, and a range of practice issues that this might usefully inform. The current article outlines key geographical concepts and approaches and introduces a range of geographical perspectives from quantitative research on the distributive features of disease and health care, to qualitative research focused on the dynamic relationship between health and place. The topic of severe acute respiratory syndrome (SARS) is then introduced to indicate how some of these ideas might be applied to an important issue that impacts upon nurses and their work.

Space, Place, and the Evidence Base: Part I—An Introduction to Health Geography

Several recent studies have found that a significant number of HIV+ individuals are engaging in unsafe sexual practices. This study was conducted to explore the correlates of high-risk sex among a sample of 360 HIV+ adults recruited from outpatient medical care facilities. The study showed that 34% of all respondents reported at least 1 occasion of unprotected anal or vaginal intercourse in the previous 6 months. Consistent with other research, there were multiple correlates of high-risk sex: lower income, an elevated number of sexual partners, negative attitudes about condoms, lack of risk avoidance strategies, and recreational and intravenous drug use prior to sex. However, contrary to other research, no association was found between low self-esteem, depression/anxiety, or the use of alcohol with unprotected sex. Unlike most studies that have focused exclusively on gay and bisexual men, this study included an additional sample of women and poorer, ethnically diverse individuals. Although there were some gender and ethnic differences, neither gender nor ethnicity moderated any of the significant relationships between psychosocial variables and sexual behavior, suggesting the commonality of issues confronting people living with HIV/AIDS in maintaining safer sex practices. Implications for designing interventions for HIV+ persons are discussed.

Peter Gould

Papers

The Slow Plague: A Geography of the AIDS Pandemic

On Geography@@@On Human Geography@@@The Geographer at Work