Classifying high-prevalence neighborhoods for cardiovascular disease in Texas

Cardiovascular disease (CVD) is the number one cause of death in the state of Texas. In order to develop effective healthcare policies to combat CVD, it is essential to understand what types of communities are most affected. In this paper, we develop a classification scheme to segment high-prevalence communities based on selected social and demographic characteristics. We find that while many high-prevalence areas reflect traditional relationships between socioeconomic deprivation and poor health outcomes, a subset of more affluent communities in Texas are also affected. This suggests the importance of tailored approaches to prevention that account for this diversity among high-prevalence neighborhoods.     

Using simulated data to investigate the spatial patterns of obesity prevalence at the census tract level in metropolitan Detroit

Obesity is a serious public health problem in the United States. It is important to estimate obesity prevalence at the local level to target programmatic and policy interventions. It is challenging, however, to obtain local estimates of obesity prevalence because national health surveys such as the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) are not designed to produce direct estimates at the local levels (e.g. census tracts) due to small population samples and the need to preserve individual confidentiality. In this study we address the problem of estimating local obesity prevalence rates by implementing a spatial microsimulation modeling technique to proportionally replicate the demographic characteristics of BRFSS respondents to census tract populations in metropolitan Detroit. Obesity prevalence rates are examined for high and low spatial clusters and studied in relation to the U.S. Department of Agriculture's (USDA) measures of low-income neighborhoods and local food deserts and CDC's measure of healthy and less healthy food environments currently used to target obesity reduction initiatives. This study found that obesity prevalence was largely clustered in the City of Detroit extending north into contiguous suburbs. The spatial patterns of highest obesity prevalence tracts were most similarly aligned with USDA-defined low-income tracts and CDC's less healthy food tracts. The locations of USDA's food desert tracts rarely overlapped with the highest obesity prevalence tracts. This study demonstrated a new methodology by which to assess local areas in need of future obesity interventions.     

Satellite monitoring of urbanization and environmental impacts—A comparison of Stockholm and Shanghai

This study investigates urbanization and its potential environmental consequences in Shanghai and Stockholm metropolitan areas over two decades. Changes in land use/land cover are estimated from support vector machine classifications of Landsat mosaics with grey-level co-occurrence matrix features. Landscape metrics are used to investigate changes in landscape composition and configuration and to draw preliminary conclusions about environmental impacts. Speed and magnitude of urbanization is calculated by urbanization indices and the resulting impacts on the environment are quantified by ecosystem services. Growth of urban areas and urban green spaces occurred at the expense of cropland in both regions. Alongside a decrease in natural land cover, urban areas increased by approximately 120% in Shanghai, nearly ten times as much as in Stockholm, where the most significant land cover change was a 12% urban expansion that mostly replaced agricultural areas. From the landscape metrics results, it appears that fragmentation in both study regions occurred mainly due to the growth of high density built-up areas in previously more natural/agricultural environments, while the expansion of low density built-up areas was for the most part in conjunction with pre-existing patches. Urban growth resulted in ecosystem service value losses of approximately 445 million US dollars in Shanghai, mostly due to the decrease in natural coastal wetlands while in Stockholm the value of ecosystem services changed very little. Total urban growth in Shanghai was 1768 km² and 100 km² in Stockholm. The developed methodology is considered a straight-forward low-cost globally applicable approach to quantitatively and qualitatively evaluate urban growth patterns that could help to address spatial, economic and ecological questions in urban and regional planning.     

Juggling multiple dimensions in a complex socio-ecosystem: The issue of targeting in payments for ecosystem services

Proponents of payments for ecosystem services (PES) schemes advocate targeting payments to geographical areas that can: (a) maintain or enhance ecosystem services, (b) permit economically efficient arrangements and (c) address poverty objectives. The location of these efficient, effective and equitable (or triple-win) solutions is viewed as the ‘holy grail’ of PES and is often sought in isolation to broader socio-economic pressures, political relationships, or local cultural conditions. While the plethora of PES design perspectives often follow the concepts of efficiency and effectiveness, they seldom relate to pluralistic value systems and may disparage local self-determination for influencing the form and terms of negotiation. This paper critically analyses the assumptions underpinning the design of PES schemes which seek to optimise or target efficient, effective and poverty objectives. Using a case study for a proposed PES initiative in the Kathmandu Valley of Nepal, we employ spatial analysis to geographically visualise the discrepancy between the location for a typology of targeted objectives and actual preferences which support local perceptions of natural resource use and conservation. The case study highlights the inequity inherent in targeting payments under a neoliberal framing. Instead, spatially differentiating incentives according to socially determined priorities and collective management is suggested.     

Shifting production/shifting consumption: A political ecology of health perceptions in Kumaon,India

Despite rapid economic growth, India has not seen the improvements in food and nutritional security that other developing countries have had. This “Asian enigma” has generated a wealth of economistic analyses seeking to explain the persistence of poor nutrition, yet few studies have looked at everyday experiences of changing food systems, and how this impacts nutritional practices as well as the processes of subject formation. In this paper, I draw on qualitative research conducted in Uttarakhand, North India and examine how state-led shifts in agricultural production have resulted in changing food consumption practices and diminished perceptions of health. Villagers link this decreased health to increased chemicals in home-produced food, greater dependence on the market for food purchases, and generational changes in dietary preferences. Despite villagers’ cognizance of the negative health effects of these practices, they largely view these byproducts of capitalistic development with an air of inevitability. Following Mansfield (2011) this paper contributes to the political ecology of health literature by employing the concept of food as a “vector of intercorporeality” (Stassart and Whatmore, 2003:449) and bringing this into conversation with a poststructuralist understanding of subjectivity. I argue that within shifting landscapes of agriculture production and food consumption, notions of diminished health are indicative of the complex and always incomplete processes of subject formation. I view shifting health perceptions as intimate bodily resistances to agricultural development, and conclude that within agricultural development programs a focus on bodily health and well-being is a fecund platform for further experimental research that seeks to imagine development differently.     

What’s in a name? Epistemic perspectives and Payments for Ecosystem Services policies in Nicaragua

As Payments for Ecosystem Services (PES) continues to gain attention as a policy tool for securing efficient and effective environmental governance, a rising tide of criticism warns of the potentially detrimental social–ecological consequences of nature commodification and ‘green neoliberalism’. These concerns are also expressed at international policy fora, where the market rhetoric has met with political resistance from countries belonging to the ‘Bolivarian Alliance for the Peoples of Our America’ (ALBA). But despite this ideological opposition, some ALBA countries are increasingly integrating PES into their environmental policies. In this article we consider the reasons underlying this apparent contradiction and relate it to the notion of ‘epistemic circulation’. On the basis of a study on the evolution of PES-thinking in Nicaragua (an ALBA member) and a reassessment of the supposed ‘success’ of an influential pilot project, we shed light on the forces driving the adoption of particular PES modes and contextualise practical difficulties to endorsing more critical approaches to the tool. Instead of either ideologically rejecting PES as a neoliberal evil or embracing it uncritically as the new panacea, we argue that it is precisely through the socio-political processes surrounding environmental governance debates that the application of PES is shaped. In practice, it may either contribute to an imposed and dispossessing form of capitalism, or tend towards a more negotiated and socio-culturally embedded version of it. Only through its reconceptualisation based on political–cultural primacy rather than market-fetishism can PES achieve its true potential within a broader strategy towards improved environmental governance.     

Urban green commons: Insights on urban common property systems

The aim of this paper is to shed new light on urban common property systems. We deal with urban commons in relation to urban green-space management, referring to them as urban green commons. Applying a property-rights analytic perspective, we synthesize information on urban green commons from three case-study regions in Sweden, Germany, and South Africa, and elaborate on their role for biodiversity conservation in urban settings, with a focus on business sites. Cases cover both formally established types of urban green commons and bottom-up emerged community-managed habitats. As our review demonstrates, the right to actively manage urban green space is a key characteristic of urban green commons whether ownership to land is in the private, public, the club realm domain, or constitutes a hybrid of these. We discuss the important linkages among urban common property systems, social–ecological learning, and management of ecosystem services and biodiversity. Several benefits can be associated with urban green commons, such as a reduction of costs for ecosystem management and as designs for reconnecting city-inhabitants to the biosphere. The emergence of urban green commons appears closely linked to dealing with societal crises and for reorganizing cities; hence, they play a key role in transforming cities toward more socially and ecologically benign environments. While a range of political questions circumscribe the feasibility of urban green commons, we discuss their usefulness in management of different types of urban habitats, their political justification and limitation, their potential for improved biodiversity conservation, and conditions for their emergence. We conclude by postulating some general policy advice.     

Assessing the institutional capacity to adapt to climate change: a case study in the Cambodian health and water sectors

Institutional capacity is an important element for climate change adaptation (CCA) and the development of such capacity is a great challenge in a Least Developed Country like Cambodia where resources are limited. An important first step to increasing capacity is via an understanding of the level of existing capacity; future priorities can then be subsequently identified. This study aimed to assess the capacity of organizations to implement climate change activities in Cambodia in order to provide such a basis for building capacity. Four elements of capacity were investigated in this research: (1) financial resources, (2) cooperation and coordination of stakeholders, (3) availability and quality of information on vulnerability and adaptation to climate change, and (4) the level of understanding of climate change vulnerability and adaptation. The data were collected through semistructured interviews with a wide range of government and non-government informants across a number of sectors. Results of the study showed that informants perceived capacity for CCA to be very constrained, especially in terms of financial resources and cooperation, and addressing these factors was ranked as the highest climate change capacity priority. Institutional capacity constraints were considered to relate more generally to weak governance of CCA. In light of our research findings, the absence of local higher education institutions in CCA activities should be addressed. The support of such institutions would provide an important mechanism to progress both capacity development as well as partnerships and coordination between different types of organizations and relevant sectors.

Policy relevance

Capacity for CCA within Cambodian health and water sectors was perceived to be very constrained across a range of interdependent factors. Increasing funding was ranked as the highest priority for building capacity for CCA; however, governance factors such as ‘improved cooperation’ were also ranked highly. Improving stakeholders' awareness of the availability of adaptation funds and resources, and their responsiveness to funding criteria, is an important implication of our research, as is improving the mobilization of local resources and the private sector. To address the issue of weak cooperation among stakeholders, improving the coordination function of the National Climate Change Committee (NCCC) regarding stakeholder engagement and capacity building is crucial. Ensuring that CCA activities are based on sound information and knowledge from across different disciplines and, importantly, include the perspectives of vulnerable people themselves, ultimately underpins and supports the realization of the above priorities.     

CLINICALLY APPLIED MEDICAL GEOGRAPHY: ITS ROLE IN TRAVEL MEDICINE

Medical geography frequently contributes to public health, but rarely are medical geographic concepts applied in clinical settings. This article describes the application of medical geographic concepts to an academic travel and tropical medicine clinical service at University Hospital in Seattle, and reviews the role of a medical geographer in this particular clinical setting. Applied concepts of medical geography improve the quality of patient care for overseas travellers and recent immigrants to the United States.