University of Toronto, Scarborough
GEOGRAPHIES OF DISEASE
GGRB28H3
S319 Thr. 11-1.
Professor Mark Hunter
Room: B527
E-mail: mhunter@utsc.utoronto.ca
Office hours: Thursdays. 1:30-3.30 or by appointment.
TAs: Michelle Majeed [michellemajeed@hotmail.com]; Sarah Sanford [sesanford@yahoo.ca]
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This course examines the geographical distribution of diseases and the spatial processes in
which diseases are embedded.
The course is divided into four parts. In the first part we will ask whether greater connections
between people and places, a shift sometimes called ‘globalization’, is initiating a new era of
infectious diseases. We also explore how geographical ideas (such as stereotypes about the
‘Third World’) shape health issues. In the second part we take an historical and theoretical
step back. We explore how colonialism produced health inequalities as well as interrogate
theoretical debates surrounding geography and health. In the third part we explore Aids,
including in the continent of Africa, and through the politics of pharmaceuticals and
antiretroviral drugs. In the fourth part we explore Bird Flu and TB and their geographical
and social contexts.
Questions we will address will include the following:
-- How do images of the ‘Third World’ affect the way that we view global health?
-- How did colonialism create certain disease patterns?
-- What has been the effect of the turn to the market in the last two decades on health?
-- What are the theoretical tools we need to understand global health inequalities and
geographical divisions in health?
-- What is the connection between the rise of slums and disease, including bird flu?
COURSE OBJECTIVES
By the end of the course you should have an understanding of the following:
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Theoretical debates surrounding geography and health
The importance of ideas or stereotypes about people and places to health issues
The ways in which global inequalities shape health
The historical antecedents of global health inequalities
The key social factors driving Aids, TB, and flu
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CLASS SOURCES
There is one required book and a Reader for this course. Both are available at the university
bookstore. The required book is:
Farmer, Paul. 1999. Infections and Inequalities: the Modern Plagues. Berkeley: University of
California Press.
The required reader contains 17 additional articles.
It is a requirement of the course that you read all of the prescribed readings and attend all of
the lectures. Readings have been kept to a minimum to allow you to read them in detail.
Powerpoint presentations will be posted on the intranet after each lecture but the full lecture
notes will not be circulated.
You might also find it useful to explore the following web sites:
www.who.org; www.unicef.org; www.unaids.org; www.eldis.org; www.aegis.org;
www.thebody.com. You’ll find information HIV/Aids in Canada at: http://www.phacaspc.gc.ca/publicat/aids-sida/haic-vsac1205/pdf/haic-vsac1205.pdf
ASSIGNMENTS AND EVALUATION
Mid-Term Exam (in class, 26th October): 30%
You must attend the mid-term exam. The only exception is if you are ill and in that case I will
require a note from your doctor. There will be no exceptions to this rule. If you are ill, there
will be only one further time set for a future make-up exam. However, the make-up exam will
include readings from all of the classes up to the time of this exam (i.e. there will be more
revision involved in the make-up exam). More details about the mid-term exam will be posted
on the intranet and given verbally in class.
Course Paper (due in class on 23rd November): 35%
Detailed information about the format of the paper will be given to you one month in advance
of the deadline for the paper (i.e. before 23rd October). The paper should be handed in during
class on the 23rd November class or, if you cannot attend class, in the allocated slot in the
Social Science Department (B520). A late assignment will lose 10% per day and will we be
graded zero if submitted three days after the assignment was due (although you will receive
the paper back with the grade that it would have received). Papers can be collected from my
office approximately two weeks after they were handed in (the exact time will be posted on
the intranet). We will endeavor to have the exams marked before the final exam.
Final Exam (date to be decided): 35%
EXPECTATIONS
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I will try as hard as possible to make the lectures interesting. I encourage your participation
through questions and comments. But please to not read, sleep, or talk to anyone during the
lecture. ALSO, YOU MUST TURN OFF YOUR CELL-PHONES AND I-PODS BEFORE
THE LECTURE STARTS. We will have a ten minute break at around 12:00. Please respect
this break--if you come back late then it will be ended. If you have questions, I encourage you
to come to office hours--in groups if you prefer.
Any form of plagiarism will be severely dealt with according to the rules set out in the
Calendar <www.utsc.utoronto.ca/courses/calendar05/>
Finally, I encourage you to use the resources available to you to assist in your writing skills.
For more details see <www.utoronto.ca/writing>
CLASS BY CLASS BREAKDOWN
Class 1 (14th September): Introduction
PART 1: ‘GLOBALIZATION’ AND GEOGRAPHICAL IMAGINATIONS
Class 2 (21st September): Globalization and Health: Are we Entering a New Era of
Disease?
Farmer, Chapter 2
Cohen, M.L. 2000, "Changing patterns of infectious disease", Nature, vol. 406, no. 6797, pp.
762-767.
McMichael, A.J. 2004, "Environmental and social influences on emerging infectious diseases:
past, present and future", Philosophical transactions of the Royal Society of London.
Series B: Biological sciences, vol. 359, no. 1447, pp. 1049-1058.
Class 3 (28th September): Geographies of Blame: Geographical Imaginations and
Disease
Farmer, chapter 4.
Treichler, P. 1991, "AIDS, Africa, and Cultural Theory", Transition, vol. 51, pp. 86-103.
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PART 2: A STEP BACK: HISTORY AND THEORY
Class 4 (5th October): Global Health: from Colonialism to Market Triumphalism
Farmer, chapter 1
Packard, R. 2000, "Post-Colonial Medicine", Medicine in the Twentieth Century, eds. R.
Cooter & J. Pickstone, Harwood Academic Publishers, Harwood, pp. 97-112.
Schoepf, Brooke et. al. 2000, "Theoretical Therapies, Remote Remedies: SAPs and the
Political Ecology of Poverty and Health in Africa. " in Dying for Growth. Global
Inequality and the Health of the Poor. Common Courage Press, Monroe, Maine, pp.
91-126.
Optional
Worboys, M. 2000, "Colonial Medicine" in Medicine in the Twentieth Century, eds. R. Cooter
& J. Pickstone, Harwood Academic Publishers, Harwood, pp. 67-80.
Class 5 (12th October) New Geographies of Health: Emerging Theoretical Debates
Eyles, J. & Litva, A. 1993, "‘Coming out: exposing theory in medical geography’", Health
and Place, vol. 1, pp. 5–14.
Kearns, R. & Moon, G. 2002, "From medical to health geography: novelty, place and theory
after a decade of change", Progress in Human Geography, vol. 26, no. 5, pp. 605-625.
Massey, D. 2004, "Geographies of responsibility", Geografiska Annaler: Series B, Human
Geography, vol. 86, no. 1, pp. 5-18.
PART 3: HIV/AIDS
Class 6 (19 October): Aids in Africa. Spaces of Poverty
Schoepf, Brooke et. al. 2000, "Theoretical Therapies, Remote Remedies: SAPs and the
Political Ecology of Poverty and Health in Africa. " in Dying for Growth. Global
Inequality and the Health of the Poor. Common Courage Press, Monroe, Maine, pp.
91-126.
Stillwaggon, E. 2006, AIDS and the ecology of poverty, Oxford University Press, Oxford;
New York. Introduction.
Class 7 (26th October) Mid-Term Exam
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Class 8 (2nd November): Diverse Geographies of Aids
Farmer, Chapter 5
Gil, V.E., Wang, M.S., Anderson, A.F., Lin, G.M. & Wu, Z.O. 1996, "Prostitutes, prostitution
and STD/HIV transmission in mainland China", Social science & medicine (1982),
vol. 42, no. 1, pp. 141-152.
UNAIDS. 2006, “Chapter 2: Overview of the Global Aids pandemic”. Download from
http://www.unaids.org/en/HIV_data/2006GlobalReport/default.asp. (Note. You might
also like to look at other chapters of this 2006 UNAIDS report).
Class 9 (9th November): Aids and ARVs. Pharmaceuticals, social movements and global
health
Biehl, J.G. 2004, "The Activist State: Global Pharmaceuticals, AIDS, and Citizenship in
Brazil", Social Text, vol. 22, no. 3, pp. 105-132.
Mbali, M. 2004, "AIDS discourses and the South African state: government denialism and
post-apartheid AIDS policy-making", Transformation, 54, pp. 104-122.
PART 4: A NEW SOCIAL ECOLOGY OF DISEASE?
Class 10 (16th November): Geography of Bird Flu
Bartlett, J.G. & Hayden, F.G. 2005, "Influenza A (H5N1): will it be the next pandemic
influenza? Are we ready?", Annals of Internal Medicine, vol. 143, no. 6, pp. 460-462.
Davis, M. 2005, The monster at our door: the global threat of avian flu, New Press; Signature
Books Services distributor, New York; York. Conclusion.
Davis, M. 2004, "Planet of Slums: Urban Involution and the Informal Proletariat", New Left
Review, vol. 26, pp. 5-34.
Class 11 (23th November): The resurgence of TB in marginalized spaces
Farmer, chapters 8 & 9.
Clark, M., Riben, P. & Nowgesic, E. 2002, "The association of housing density, isolation and
tuberculosis in Canadian First Nations communities", International journal of
epidemiology, vol. 31, no. 5, pp. 940-945.
Class 12 (30th November): Review for exam
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