City and health: an exploratory overview of research issues

The bottom line of welfare on our planet and its people is not only dependent on traditional economic measures, but also on knowledge and education and – last but not least – on human health. Human health is a critical factor for the welfare and prosperity of society. Many parameters appear to play a role in a health equation, even though the empirical measurement of health is fraught with many conceptual and empirical problems. As a consequence, we observe many disparities in empirical health conditions in a heterogeneous society; an appropriate definition and measurement of 'good health' are far from easy. Next to health disparities caused by a heterogeneity among the population, there is also an important geographical component in the spread of health patterns of the population as a result of differences in environmental quality-of-life, spatial density, quality of and access to health care facilities, and social stress conditions. From this perspective, geography matters in the field of human health. Although geographic differences in health conditions are not the only reason for people to reside or stay in a certain place, they are certainly an important decision parameter, often in combination with wellness conditions and environmental quality conditions. The aim of the present paper is to provide an overview of the literature on the geography of health and wellness, while the study is concluded with some lessons for research and policy. _Purpose:_ The aim of the present paper is to provide an overview of the literature on the geography of health and wellness. Methodology/Approach: Literature review. We will outline the geography of human health, through a concise literature survey of the geographical patterns in human health outcomes to address the general research findings on spatial differences in health in relation to urban-rural patterns of life. _Findings:_ The measurement of human health is fraught with many difficulties, as it is often not clear whether a correction is made for supply factors (such as health care facilities) or for individual characteristics of the people concerned (such as age or gender). In the social-medical research literature this has led to an increasing popularity of meta-analytic methods. _Research Limitation/implication:_ Meta-analysis may be seen as a collection of quantitative research techniques that aim at providing a synthesis of previously undertaken impact studies in a given field. Clearly, and ideally, both the response and the moderator variables would have to be identical, but in reality this is not the case. Besides, the quality of the research may be difficult (often reflected in the quality of the journal in which the results are published), while also the contextual conditions may be completely different (such as physical-geographical conditions or socio-economic or poverty conditions). This makes the results of meta-analytic studies somewhat ambiguous, but nevertheless it is a valuable method that may shed more light on the determinants of health outcomes. There is clearly a case for more detailed spatial data on individual health situations. There may be a self-selection (or sorting) mechanism in the locational decisions of households so that there is a need for a more systematic data collection and analysis in this area. _Originality/Value of paper:_ The paper aims to unravel the various forces that determine human health, in particular from the spatial perspective of places of residence. _Category:_ Research pape