Manuscript Topics

The influence of geographic context on variation in health outcomes and health care access is confirmed by many studies. Environmental influences on health are now recognized, exemplified by gene-environment interactions, impacts of physical environment (air quality, for example) on mortality, and impacts on obesity and diabetes of inequitable access to healthy food outlets and to exercise. The impact of area deprivation, poverty and segregation on disease (beyond the influence of individual risk factors) is now acknowledged in measures of geographic health need and disease burden. In terms of quantitative models for disease, assessing the role of spatial factors and cross-level interaction in multilevel models, and representing spatial clustering and spatial heterogeneity in disease have been a major focus. Spatial access to healthcare considers geographic influences on health care use (e.g. GIS measures of spatial accessibility), and spatial equity in healthcare provision, over both primary and secondary sectors.

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