RGS-IBG Annual International Conference 2018

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277 Health geographies
Chair(s) Matthew Sparke (University of California, Santa Cruz, USA)
Timetable Friday 31 August 2018, Session 1 (09:00 - 10:40)
Room Glamorgan Building - Seminar Room -1.59
Contact the conference organisers to request a change to session or paper details: ac2018@rgs.org
Regional concentration and correlates of diabetes mellitus in Nigeria: The Need for a Regional Policy Response
Tolulope Osayomi (University of Ibadan, Nigeria)
Diabetes mellitus (DM) is a major chronic degenerative disease in the world including Nigeria where it is an emerging concern.Despite the huge public health impact, little on the geographic analysis of DM in the country is understood. Therefore, the study set out to examine the geographical variations in DM prevalence in Nigeria with the aid of Global Moran’s I, Local Moran’s I and spatial regression. Evidence shows the existence of a DM pocket in the southeastern Nigeria comprising Abia, Anambra, Enugu and Imo states. The OLS and spatial regression models explained 31.9 and 33 percent of the variation in the spatial pattern of DM respectively. Possible factors for the emergent pattern include the socio-cultural practices and traditional dietary patterns, symbolic significance of obesity, low level of education and high level of urbanisation. From the policy perspective, the study proposes a regional policy intervention among other recommendations
Necessary, yet haunting. On the implications of the Dayton peace treaty for Bosnia & Herzegowina’s transplantation system
Frank Meyer (Leibniz Institute for Regional Geography, Germany)
In 1995, the Dayton Agreement effectively ended the Bosnian War – a military conflict between different Bosnian factions, Serbia, Croatia and the NATO. As a result, three separate political entities were formed – Bosnia & Herzegowina, the Republika Srpska and the Brčko District. All form the country of Bosnia & Herzegowina (in short: Bosnia), yet remain politically and institutionally distinct. While this result was meant as a necessary move towards dividing the conflicting war parties in order to end military actions, it was never adapted to function as a long-term political system and effectively limits Bosnia’s ability to develop state institutions and efficient regulations. Exemplified by its transplantation system, it is apparent that the limited cooperation between the three entities has become a key obstacle to the development of a viable system of organ donation and knowledge transfer. Instead, each entity has developed outwards cooperation with other countries, yet also has to cope with attempts of its citizens to subvert the existing waiting lists due to long waiting times following organ scarcity.
The European petrochemical industry: Regional inequalities and polluting practices
Calvin Jephcote (University of Surrey / University of Warwick, UK)
Environmental concerns are not constrained by political borders, with informed solutions often requiring cross-country cooperation in the provision of transparent, accessible and compatible of data.

The following analysis seeks to collate publicly available Pan-European data, initially to examine the regional relations between the petrochemical industry and a “triple jeopardy” of social, environmental and health inequalities. Secondly, the analysis seeks to link private company records with public data, to understand how site-specific characteristics and practices may determine the magnitude of pollutants released. Finally, emphasis is placed upon data limitations and future requirements.

Bayesian multilevel models were constructed to account for variability caused by spatial hierarchical structures, uncertainty, and to incorporate group-level influences. There is evidence to suggest that the environmental contributions of the petrochemical industry are associated with regional health and social inequalities, although this is shown to be location dependent. The quantity of benzene releases at each facility is found to be significantly influenced by: economic activity, company ownership, geographic location, facility density, and the polluting practices of neighbouring petrochemical facilities (P <0.05). These findings enhance the European petrochemical debate, evaluating the impact of industrial practice, and identifying persistent pockets of environmental injustices even within a heavily regulated market.
Humanitarianism between care, calculation, control and contestation
Matthew Sparke (University of California, Santa Cruz, USA)
Katharyne Mitchell (University of California Santa Cruz, USA)
In this paper we report on research into contemporary humanitarianism relating to global refugee reception and global health. We argue that humanitarianism is often too simply theorized as a form of biopolitical care turned control. Instead we argue for more searching human geographies that can do justice to complex assemblages of care, calculation and contestation that continue to complicate the control imperatives of liberal and neoliberal state-making. Drawing on examples from the sanctuary movement, refugee accommodation squats, and global health partnerships, we suggest these evolving assemblages illustrate an articulatory politics at the heart of humanitarianism.
Decks, drums and the diagnosis of risk: the design of clinical space in a post-antibiotic age.
Daryl Martin (University of York, UK)
Nik Brown (University of York, UK)
Sarah Nettleton (University of York, UK)
Chrissy Buse (University of York, UK)
Alan Lewis (The University of Manchester, UK)
This paper opens up questions of infection control, architectural atmospherics, embodied practices and their intersections in the contemporary accomplishment of clinical space. Specifically, we focus on the example of the recently opened Skane University Hospital Infectious Disease Center, located in Malmö and designed by CF Moller + Link Arkitektur. We do so in order to illustrate how recent strains of infectious disease are reflected in its architectural design, which uses open-air decking to enclose a central drum of patient space and an internal administrative core. We also explore how this design, in turn, shapes new experiences of illness, risk and care. This is a building in which design becomes an articulation of infection control, its architects responding to shifting understandings of what clinical space might look like when our antibiotics fail. Locating this building within a wider history of hospital architecture, we use archival sources to trace the changing arrangements, organisational imperatives and affective atmospheres of ward design. Through this, we explore how such mutable spatial organizations enacted changing ideas of disease management - from the control of space to the control of contact between people through space. Locating our contemporary case study alongside historical examples, and within geographical writings on architecture and its affective atmospheres, allows us to develop a greater understanding of the role of materialities, mobilities and design in the social construction of risk in a post-antibiotic age.
Who has the final say? women power, and landscapes of risk for under five mortality in Nigeria.
Mildred Oiza Ajebon (Durham University, UK)
There is ample evidence in academic literature on women disempowerment as a risk factor for a range of poor child health outcomes in the global south. Common measures of empowerment such as education, income and general wealth levels of households as social determinants of under-five mortality have been well researched and mainly from public health perspectives. However, other household power domains such as control over food, freedom of movement and power of health care decision making within the household have been understudied. There is an urgent need for a broader understanding of the wider geographical and socioeconomic context within which women disempowerment and under-five mortality may occur. This paper employs both statistical techniques and GIS-based hotspots mapping of the 2003-2013 Nigeria Demographic and Health Survey (NDHS) cluster level data to examine the spatial variation in women empowerment in relation to under five mortality rate in Nigeria. A north south divide in both women empowerment levels and under-five mortality rate is observed. The results clearly demonstrate the value of geographical approaches for identifying landscapes of vulnerability for targeting intervention strategies aimed at reducing under-five mortality rate in developing countries.