| Background |
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| Research Interests |
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My interests center on the geography of health and how to communicate strategic
and practical health-related information to various publics. Geography is an
attractive rallying point for health inquiry as a population’s well-being is a
synthesis of numerous social, economic, and environmental processes at multiple
scales, ranging from the household to the global. I am particularly interested
in the Health For All (HFA) movement, which advocates a universal HFA value system,
makes health central to
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development, and recognizes the importance of sustainable
health systems. I am currently pursuing these interests in a number of concurrent
projects as well as in classes I teach.
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Since the early 1990s I have been studying the efforts of a U.S.-based
non-governmental organization (NGO) to develop a church-based health program
in Chilimarca, Bolivia. My early work focused on the utilization of the project’s
primary care clinic. I completed a systematic data analysis of various clinic
records and a community household survey to ascertain the nascent provision of
health services. Findings identified numerous access barriers typical of
utilization studies in a multicultural setting, like
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distance decay, language
spoken, cost, hours of service, and availability of medicines. In addition,
it showed the importance of employing political economy at the micro scale.
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Recently, I have expanded my work to include the role of experienced place.
This involves understanding the process that situates health delivery in the
simultaneously tangible, negotiated, and experienced realities of place. In
such an analysis, the Chilimarca Clinic is not studied as an objectively defined
locale with the sole purpose of treating patients. Rather, it is a place with
bundles of social relations and practices, producing various experiences and
meanings for all associated individuals. I found
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that the increasing use of the
clinic by community outsiders reproduced the class tensions found in broader
society so that Chilimarca residents felt like the ones who were out of place
at the clinic. Experienced place, therefore, had become an access barrier for
the very people the facility was ostensibly meant to serve.
A second foci centers on communicating strategic and practical health-related
data to various publics. Automated cartography and geographic information
systems (GIS) has transformed the ways in which many people think about and
handle spatial information by renewing the importance of the visual image. I
have worked on four monographs with the Missouri Department of Health with the
goal of improving the accessibility of epidemiological data to the general
public. My contribution has been the production and analysis of maps and graphs
that visualize the nature of the health problem being addressed. Two of these
monographs have already had a wide circulation, with one being used at a national
conference sponsored by the U.S. Centers for Disease Control as a prototype for
other state health agencies.
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