FIGURE 6.1 A three-dimensional geographical visualization of the residential mobility of 1,000 cases of amyotrophic lateral sclerosis (ALS) in southeastern Finland, distinguishing movers (blue) from nonmovers (red). The vertical lines represent periods of stability and the blue lines link the origins and destinations of the moves. Sabel et al. (2003) identified a birthplace cluster of the disease in southeast Finland—the first example of a significant ALS cluster being identified worldwide. This part of Finland has suffered from significant industrial pollution, and heavy metals are present in the environment. To determine whether these heavy metals may be implicated in the etiology of ALS, Sabel et al. (2009) used the detailed migration histories of the cases and controls to explore differences between movers and nonmovers. The results demonstrated that moving away from the area seems to be protective, meaning that the environment has a role to play in the disease etiology. SOURCE: Unpublished figure courtesy of Paul Boyle.

FIGURE 6.1 A three-dimensional geographical visualization of the residential mobility of 1,000 cases of amyotrophic lateral sclerosis (ALS) in southeastern Finland, distinguishing movers (blue) from nonmovers (red). The vertical lines represent periods of stability and the blue lines link the origins and destinations of the moves. Sabel et al. (2003) identified a birthplace cluster of the disease in southeast Finland—the first example of a significant ALS cluster being identified worldwide. This part of Finland has suffered from significant industrial pollution, and heavy metals are present in the environment. To determine whether these heavy metals may be implicated in the etiology of ALS, Sabel et al. (2009) used the detailed migration histories of the cases and controls to explore differences between movers and nonmovers. The results demonstrated that moving away from the area seems to be protective, meaning that the environment has a role to play in the disease etiology. SOURCE: Unpublished figure courtesy of Paul Boyle.

estimated 700,000 to 2.7 million people each year (Patz and Olson, 2006). The increasing movement of people and products is raising the specter of the spread of one of the most potent malaria vectors, Anopheles gambiae, from Africa to South America and Southeast Asia. Such an event occurred in the 1930s when A. gambiae was accidentally introduced to Brazil. A vigorous campaign to identify breeding areas and eradicate larvae was required during the 1930s and 1940s to avert a near disaster (Parmakelis et al., 2008). More sophisticated analyses of locational influences on malaria are vital to several current international initiatives aimed at halting the spread of malaria, including the Multilateral Initiative on Malaria, which is part of the United Nations Children’s Fund, United Nations Development Programme, World Bank, and World Health Organization Special Programme for Research and Training in Tropical Diseases.1

ROLE OF THE GEOGRAPHICAL SCIENCES

Traditionally, epidemiologists allocate risk for specific diseases such as cancer to specific causes, including willingness to participate in high-risk behaviors (e.g., smoking), nutritional status, age, genetic predisposition, and gene–environment interactions. Studies are usually based on experiments (e.g., case-control studies, cohort studies) aimed at evaluating whether a specific factor is associated with an increased risk of disease. Although useful, this approach often fails to take into account the range of locational influences that affect diseases or the temporal and spatial complexities that arise from disease latency and individual mobility through the life course. The geographical sciences have a role to play in addressing such matters. Building from an early focus on disease patterns, the geographical sciences are devoting attention to the development of models and visualizations that provide insight into space-time influences on health and disease (Jacquez et al., 2005a,b; Meliker et al., 2005). These models and visualizations

1

See www.mimalaria.org (accessed January 20, 2010).



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