Understanding and representing 'place' in health research: A relational approach

Epidemiology, sociology, and geography have been successful in re-establishing interest in the role of place in shaping health and health inequalities. However, some of the relevant empirical research has relied on rather conventional conceptions of space and place and focused on isolating the "independent" contribution of place-level and individual-level factors. This approach may have resulted in an underestimate of the contribution of 'place' to disease risk. In this paper we argue the case for extensive (quantitative) as well as intensive (qualitative) empirical, as well as theoretical, research on health variation that incorporates 'relational', views of space and place. Specifically, we argue that research in place and health should avoid the false dualism of context and composition by recognising that there is a mutually reinforcing and reciprocal relationship between people and place. We explore in the discussion how these theoretical perspectives are beginning to influence empirical research. We argue that these approaches to understanding how place relates to health are important in order to deliver effective, 'contextually sensitive' policy interventions. (C) 2007 Elsevier Ltd. All rights reserved.