The Dictionary of Human Geography

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to lose our bearings, it disturbs and destabilizes,

he argued, precisely because it exceeds our

experience or comprehension of the world.

Viewed in this way, accounting for the dis-

astrous dimensions of hazards calls for some-

thing more than simply the extension of our

rational understanding of causes and conse-

quences. It invites us to contemplate the limits

of our knowledge and how we might respond

intellectually, politically and ethically, to such

limits. The terrorist attacks of 11 September

2001 prompted Judith Butler to reconsider

the precariousness of human life, and to

muse on ‘the emergence and vanishing of the

human at the limits of what we can know’

(2004, p. 151). For her, such a disaster impels

us to reassess the way we address others who

have suffered, and to think deeply about the

role of loss and mourning in modern life

(seeethics). This is not to make light of

the achievements of apprehending hazard as

socially constructed, but it is a reminder to

think also about the capacity of hazards to

shape and define our human condition, and

to raise questions about the limits of knowing,

writing about and ordering the volatile worlds

that we inhabit. nhc

Suggested reading

Blaikie, Cannon, Davis and Wisner (1994); Emel

and Peet (1989); Mustafa (2005); Pelling

(2001).

health and health care ‘The concept of

‘‘health’’ is open to differing interpretations’

(Curtis, 2004, p. 2). It can mean ‘the presence

or absence of diagnosed diseases’, but also

many different dimensions potentially contrib-

uting to the corporeal, emotional and social

well-being of people in their everyday lives.

Gesler and Kearns (2002, pp. 30–2) discuss

‘cultures of health’, identifying the explana-

tory models deployed by different people

(e.g. expertscontralay people) and drawing

inspiration from ‘ethnomedicine’ as the study

of how such models (and their deeper

cultural, religious, cosmological moorings)

vary from place to place. Additionally,

assumptions about health clearly vary within

places according toclass,ethnicity,gender

and other markers of social difference (Lewis,

Dyck and McLafferty, 2001).

Acknowledging such variability in health

beliefs suggests an approach to ageography

ofhealth that squares with recent shifts in the

sub-discipline of medical geography. In-

deed, some argue that medical geography

should be widened to include not just health

defined through the lenses of Western bio-

medicine, casting health in the negative sense

ofnotbeing physically or mentally ‘ill’, but

rather in the broader sense indicated above,

of health as well-being. This orientation de-

mands a holistic focus on the great variability

of the human condition, commonly at the

scaleof populations within territories, but in

principle also at that of individual people

interacting with quite specific sites. One up-

shot is then the enlarging of what is meant by

risk, with geographers addressing the many

risks to health that people face from infectious

illnessesbutalso from the likes ofenviron-

mental hazards, interpersonalviolenceand

occupational stress, all of which constitute

multiple ‘spaces of risk’ figuring in domains

of humandecision-makingfrom thestate

to thehousehold(Curtis, 2004, pp. 5–9).

A link exists here to a long-standing geo-

graphical concern for human well-being,

sometimes configured asquality of life,in

which a political commitment to uncovering

spatialinjustice is never far below the surface.

This concern awakened in the 1970s with the

contribution ofwelfare geography, and has

continued into more recent work on the socio-

spatial constitution of ‘health inequalities’.

A key development has been Gesler’s (1992)

notion of ‘therapeuticlandscapes’, highlight-

ing how places in all of their complexity can

foster people’s senses of healthfulwell-being,

and Curtis (2004, ch. 2) mobilizes this notion

when fashioning new perspectives on the

meeting-grounds of ‘healthandinequality’.

Another link exists to the various currents

now coalescing under the heading ofemo-

tional geographies, wherein varying human

mind–bodyassemblages(see also Butler and

Parr, 1999) are examined for how they are

constituted, enacted, experienced, re-presented

and perhaps politicized in relation to diverse

spaces,places, environments and landscapes.

Work in this vein asks about what might com-

prise places conducive to, or alternatively

destructive of, ‘emotional health’.

These new trajectories complicate what is

meant by healthcare,since such care can

no longerbe envisaged solely as providing

medical facilities of varying kinds (hospitals,

clinics, GP surgeries or even conventional

medical outreach and educational services).

Geographers have long studied these medical

facilities (seemedical geography), but they

have now begun to consider less overtly med-

icalized versions of care (Parr, 2003) – elder,

hospice and terminal care (Brown, 2003);

complementary and alternative medicines

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HEALTH AND HEALTH CARE