1. Spatial Health Analysis Click to continue

2. A series of sketch maps and charts are used to present a selection of well-recognised health patterns. These examples have been chosen to illustrate some of the specific questions of interest to the health analyst. (Note: these diagrams are intended only to show generalised patterns and not to convey statistical information) (outline maps: www.geoexplorer.co.uk)

3. Healthy life expectancy at birth reflects average length of life in years, adjusted due to poor health. The differences between the developed and less developed nations are extremely large. In developed countries female life expectancy is consistently higher than male, while this effect is removed or even reversed in less developed countries. France UK USA Brazil India Uganda Zimbabwe Female Male (data source: WHO world health report 2000) Healthy life expectancy at birth, 2000

4. The pattern of global malaria is governed by the distribution of mosquitoes bearing the malaria parasite, in tropical and sub- tropical environments. However, this pattern is also influenced by socioeconomic factors such as spraying and management of marshland. Malaria was present in many European countries well into the 20 th Century. (outline map: www.geoexplorer.co.uk data source: www.who.int/) Non-malarial areas Limited risk Malarial areas

5. The global map of infant mortality displays a pattern strongly reflecting levels of development, with UNICEF estimating that malnutrition contributes to more than 50% of deaths of children under 5 in developing countries. The global HIV/AIDS epidemic also contributes significantly to these figures, reversing previously declining trends in recent years. (outline map: www.geoexplorer.co.uk data source: www.unicef.org/) Lowest rates Highest rates

6. The graph shows deaths per 100,000 due to ischaemic heart disease among males aged 20- 64 in 1991-93 by social class in the UK. (Social class I has the highest status, V the lowest.) There is much higher incidence among men of lower social class. Although this pattern applies nationally, it is much stronger in some regions than others, and has persisted for many decades. I II IIIn IIIm IV V London North East Region UK (data source: statistics.gov.uk) Ischaemic heart disease death rates, UK

7. Lung cancer rates in Britain are highest in Scotland and the north. The highest rates are seen in industrial and inner urban areas. This general pattern is apparent for many diseases. Lung cancer is strongly associated with material deprivation and especially with smoking. Lowest incidence rates (males) Highest incidence rates (males) (outline map: www.geoexplorer.co.uk data source: www.statistics.gov.uk/)

8. Insulin-dependent diabetes mellitus (IDDM) is one of the most common chronic diseases in the USA and is increasing. International variation in IDDM is among the greatest of any non- communicable disease, with some of the highest rates in the Americas. Diabetes is associated with several lifestyle factors, particularly obesity. Lowest death rates (whites) Highest death rates (whites) (outline map: www.geoexplorer.co.uk data source: www.cdc.gov/)

9. These examples include various causes of disease, which are mediated by social conditions. Differences are evident between countries and regions, social classes and genders: some are changing while others are long-established. All these patterns are amenable to change by medical interventions, individual lifestyle changes, social and international policy. (outline maps: www.geoexplorer.co.uk)

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