1.2 Agencies of health analysis

This object aims to demonstrate the wide range of agencies involved in the analysis of health information. The concept of an agency here relates to organizations with a specific responsibility, and as such is not intended to include specific academic disciplines. Although medicine, epidemiology and public health have corresponding academic disciplines, many of the social sciences, including geography, cut across the specialisms of the agencies identified here.

Health and disease are experienced at the individual level and may never be reported to any official monitoring system. The severity of ill health required to cause presentation to a medical practitioner varies enormously throughout the world, but also within a single country, according to individual education, beliefs and experience. The populations of many remote locations will not bother to seek medical assistance for conditions that would involve medication or even hospital admission if experienced in a major city elsewhere in the world. Consultation with a medical practitioner creates the potential for a wide range of health analyses based on derived datasets, as well as specific studies that may seek out the individual in order to survey or measure their health status directly for research purposes. The experience of a single individual thus provides us with a starting point for an exploration of the types of agency involved in health analysis. It is the aggregation of many such individual episodes that provides the information base for the identification of patterns of disease and assessment of population health status.

There is potentially a distinct geographical element to the health analysis undertaken by each of these agencies, and there is increasing use of GIS in fields such as epidemiology, public health, health care planning and environmental management. This application of a common technology is in part due to the distinctive spatial patterns that are evident in observed health and in part due to the power of GIS for data integration. Even where the major factors determining incidence of a particular disease are strongly related to a normal biological process such as ageing, the differential spatial distribution of elderly people may lead to very distinct geographical patterning in disease rates. A geographical perspective particularly draws attention to inequalities in health, and hence to questions as to whether we should seek policy solutions across the whole of a society in the hope that these will address the needs of the most disadvantaged groups, or whether policies should instead be geographically focused on those localities with the greatest needs.

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