Health and disease.

Health and disease display uneven spatial patterns at all scales: between geo-political areas of the world, between countries, between sub-national units and within sub-national units. Health viewed as an outcome serves as a key indicator in assessments of well-being, development and policy impacts. The internationally agreed Millennium Development Goals, established to focus on eradicating poverty, give three of the eight goals to health outcomes (Sachs 2004). Geographers have sought to explore the particular influence of place in determining such patterning of health and disease at different scales (Curtis 2004; Davey-Smith et al. 2001; Mitchell et al. 2000; Gordon et al. 1999; Thomas et al. 2002). The opposite relationship of health and disease on place has been researched in relation to population responses, such as adaptations in the built environment or labour protection laws, to natural hazards and risks to health arising from different kinds of places. However, the small-scale processes by which health and particularly disease themselves act as forces in shaping and changing communities and places are far less well explored. This potentially vast topic is the main concern of this chapter. Material presented here is by no means comprehensive. Rather, the chapter will show-case research on four topics which serve to illustrate some of the processes by which health and disease may act as a force for change in the geographies of communities and places. These topics are the social and spatial consequences of the epidemic of the human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS), the effects of long-term ill-health on residence patterns, the impact of stigma on both individual life-courses and the emergence of stigmatized places and the production or reproduction of social relations and values through meanings reflected, represented and enacted in specific places that have come to be associated with health and healing