The changing shape of island epidemics: historical trends in Icelandic infectious disease waves, 1902–1988

Iceland's centuries-long history of epidemics with its unusually complete disease records has attracted study from several disciplines. But detailed spatial data of particular interest to historical geographers date only from 1895 and were consistently maintained for about a century thereafter. Within this period, this paper concentrates on morbidity records of reported cases of infectious diseases for an 87-year window which was open between 1902 and 1988. In this time slice, spatially detailed data for seven demographically important infectious diseases allow the geography of 131 discrete epidemic waves with a recorded total of 529,000 cases to be tracked. Changes in the behaviour of the seven diseases over the period are analyzed and related to both epidemiological theory and to the changing historical geography of the island. The paper complements earlier Icelandic work by the authors on the historical geography of single diseases (measles, influenza and poliomyelitis) by extending the range of diseases, and by considering their common spatial behaviour and their interrelationships.     

Securitizing infectious disease

Over the past decade there has been an increased awareness in the field of international relations of the potential impact of an infectious disease epidemic on national security. While states’ attempts to combat infectious disease have a long history, what is new in this area is the adoption at the international level of securitized responses regarding the containment of infectious disease. This article argues that the securitization of infectious disease by states and the World Health Organization (WHO) has led to two key developments. First, the WHO has had to assert itself as the primary actor that all states, particularly western states, can rely upon to contain the threat of infectious diseases. The WHO's apparent success in this is evidenced by the development of the Global Outbreak Alert Response Network (GOARN), which has led to arguments that the WHO has emerged as the key authority in global health governance. The second outcome that this article seeks to explore is the development of the WHO's authority in the area of infectious disease surveillance. In particular, is GOARN a representation of the WHO's consummate authority in the area of coordinating infectious disease response or is GOARN the product of the WHO's capitulation to western states’ concerns with preventing infectious disease outbreaks from reaching their borders and as a result, are arguments expressing the authority of the WHO in infectious disease response premature?     

The U.S. Public Health Service and smoking in the 1950s: the tale of two more statements

During the 1950s, the United States Public Health Service prepared two statements on the link between smoking and lung cancer that have not been recognized by other historians. This article employs extended discussions of these two statements as vehicles to explore both internal developments at the federal health agency and larger questions surrounding the disciplinary emergence of chronic disease epidemiology. The primary cast of characters includes Surgeons General Leonard A. Scheele and Leroy E. Burney, Lewis C. Robbins (a lower-ranking Public Health Service officer, who had chief responsibility for the agency's smoking-related programs from 1958 through 1962 and who left behind a daily professional diary), and Journal of the American Medical Association (JAMA) editor John H. Talbott. These men, and others, are seen grappling (at varying levels of engagement) with the appearance of what we now recognize as a profoundly different way of understanding chronic disease causation, which centers on survey-taking and statistical analysis of risk factors.     

The Philippines insurrection and the 1902–4 cholera epidemic: Part II—Diffusion patterns in war and peace

The great epidemic of cholera which swept through the Philippine Islands in the immediate aftermath of the Philippine–American War (1899–1902) spread in two temporally distinct, but spatially concordant, waves of infection. Part I of this paper studied the first wave (wave I, March 1902 to February 1903). Here, in Part II, we explore the manner in which the second wave (wave II, May 1903 to February 1904) diffused through the same geographical areas. Using the cholera reports prepared by the Chief Quarantine Officer for the Philippine Islands and published weekly in the contemporary USPublic Health Reports, the diffusion of wave II is analysed at the geographical levels of province, island and nation. Comparison with wave I confirms that spatially contagious spread dominated in both waves at all spatial scales. However, it is shown that there were important differences between the waves in their intensity, speed of spread and resulting spatial patterns. Amelioration of the disruption brought about by the Philippine–American War may account for some of the observed differences between the two waves.     

Note on the Measurement of Spatial Imbalance

This note presents a new measure of spatial imbalance that uses the center of gravity (or the mean center) of a distribution and the geometric center (or the centroid) of a region to define a vector indicating the relative position of the distribution in the region. The spatial imbalance of a distribution in a region is defined as the distance and directional deviation of the center of gravity of the distribution from the geometric center of the region. The convex hull of a region is introduced as the reference for maximum spatial imbalance of the distribution in the region. The spatial imbalance is measured in terms of (1) the relative distance of the center of gravity between the geometric center and the convex hull; and (2) the direction from the geometric center to the center of gravity. This new measure is tested by quantifying the westward movement of the contiguous U.S. population between 1790 and 1950. It describes the well‐known observation that the U.S. population was moving westward across the contiguous United States and toward reduced spatial imbalance.     

The Spatial Dynamics of Epidemic Diseases in War and Peace: Cuba and the Insurrection against Spain, 1895–98

This paper examines the spatial transmission and rate of propagation of three infectious diseases (enteric fever, smallpox and yellow fever) in times of war and peace in Cuba between 1895 and 1898. For the three diseases studied, the analysis will demonstrate that, compared with peacetime, the Cuban Insurrection caused increased epidemiological integration of the settlement system of Cuba, acceleration of the spatial processes of disease transmission and a marked change in the geographical drift of infectious disease activity. While the first two findings may be attributed to the heightened levels of population mixing that accompanied the insurrection, the third implies that hostilities fundamentally altered the spatial courses of diseases. These changes transcended stark biases in the predisposition to infection among Spanish soldiers (to yellow fever) and Cuban civilians (to smallpox). Finally, it is shown that the military were the prime agents causing contrasts in the epidemiological experience of Cuba between war and peace.     

‘A matter of commonsense’: the Coventry poliomyelitis epidemic 1957 and the British public

In 1956, the British Ministry of Health instituted a vaccination programme against poliomyelitis, but run into myriad supply and administrative issues. When Coventry experienced an epidemic in 1957, it came to symbolise these problems. Throughout, it was claimed that the government lacked ‘common sense’. This article explores how and why ‘common sense’ was used as a rhetorical weapon in the debates over policy at the local and national level. While those claiming ‘common sense’ were often at odds with medical and administrative authorities, the arguments were often informed by deeply held beliefs about vaccination and disease.     

Revealing circumstances of epidemiologic transition among Indigenous peoples: The case of the Keg River (Alberta) Métis

Rates of type 2 diabetes and other metabolic disorders are elevated among Indigenous peoples; however, no research has examined the origins of these diseases among the Métis. This case study documents a transition in lifestyle and health that affected the Keg River Métis of northern Alberta during the middle decades of the 20^th century. This community began to experience previously absent diseases, including obesity, heart disease, gestational and type 2 diabetes, and preeclampsia. This shift in disease burden appears tied to rapid socio‐cultural and economic change driven by a decline of traditional economic activities, access to government transfer payments and wage labour, an increasingly sedentary lifestyle, and a growing availability of non‐traditional foods. This study points to earlier emergence of diabetes among Canadian Indigenous populations than commonly credited and presents the case for a rapidly evolving epidemic tied to environmental and cultural change. Underlying this were structural changes that emerged out of colonization.     

复杂理论视角下城市健康地理学探析

城市公共健康问题是根植于所依托的地域空间背景下的复杂问题,因而,目前学界主要以还原论的模型假设来分析影响城市健康的复杂多因子关系时存在一定局限。本文在分析城市健康地理问题的"地方"复杂性基础上,提出用复杂理论认识城市的健康问题,将城市健康地理系统看作为具有开放性、组分的知识局限性、自组织性、路径依赖、涌现性、正反馈和锁定特征的复杂系统。从复杂理论视角探讨了当前城市健康地理学研究的三个主要议题,进而提出复杂理论视角下城市健康地理学研究框架及未来研究展望。     

Iran–US Public Health Cooperative Organization (PHCO): Education,Healthcare, and Health Services in the Southwest of Iran (Fars), 1950–60

Fars is among the largest provinces of Iran that received the most technical assistance from the American economic delegation in the 1950s. After settling in the province and during ten years of activity, the American delegation provided technical assistance in the fields of health engineering, health education, preventive medicine, nursing, medical services, and medical education. This paper explains how the technical assistance of US personnel contributed to the general health of the Fars province. The findings of this research show that after the formation of the Public Health Cooperative Organization (PHCO) in 1950, not only did most of the cities and villages of this province began to enjoy safe drinking water, but also public health improved. Additionally, the birth of children with disabilities and the spread of infectious diseases such as malaria and trachoma declined by means of preventive medicine centers and health education.     

The Female Mortality Advantage in the Seventeenth-Century Rural Low Countries

Data from famines from the nineteenth century onward suggest that women hold a mortality advantage during times of acute malnutrition, while modern laboratory research suggests that women are more resilient to most pathogens causing epidemic diseases. There is, however, a paucity of sex-disaggregated mortality data for the period prior to the Industrial Revolution to test this view across a broader span of history. We offer a newly compiled database of adult burial information for 293 rural localities and small towns in the seventeenth-century Low Countries, explicitly comparing mortality crises against ‘normal’ years. In contrast to expected results, we find no clear female mortality advantage during mortality spikes and, more to the point, women tended to die more frequently than men when only taking into account those years with very severe raised mortality. Gender-related differences in levels of protection, but also exposure to vectors and points of contagion, meant that some of these female advantages were ‘lost’ during food crises or epidemic disease outbreaks. Responses to mortality crises such as epidemics may shine new light on gender-based inequalities perhaps hidden from view in ‘normal times’ – with relevance for recent work asserting ‘female agency’ in the early modern Low Countries context.     

The Poliomyelitis Epidemic in Johannesburg in 1918: Medical and Public Responses

ABSTRACT

This article traces the appearance of poliomyelitis in Johannesburg during the first recognised epidemic in South Africa in the early months of 1918. The course of the epidemic is examined by reviewing available statistics and investigating the problems that the epidemic imposed on medical and health authorities, both locally and within higher echelons of power. The response of the Johannesburg community to the disease is explored, as are the treatments available to polio patients at a time when the disease was regarded as ‘a mystery’. The place of the 1918 epidemic in the wider history of polio in South Africa is also explored.     

Investigating the Influence of Spatial and Temporal Granularities on Agent‐Based Modeling

Epidemic agent‐based models (ABMs) simulate individuals in artificial societies that are capable of movement, interaction, and transmitting disease among themselves. ABMs have been used to study the spread of disease at various spatial and temporal scales ranging from small communities to the world, over days, months, and years. The representations of space and time often vary between different epidemic ABMs and can be influenced by factors such as the size of a modeled population, computational requirements, population environments, and disease‐related data. The influence that the representations of space and time have on epidemic ABMs is difficult to assess. Here we show that the finest representations of space and time—termed spatial and temporal granularities (STGs)—in a parsimonious ABM affect speed, intensity, and spatial spread of a synthetic disease. Specifically, we found disease spread faster and more intensely as spatial granularity is coarsened, whereas disease spread slower and less intensely as temporal granularity is coarsened in a parsimonious ABM. Our study is the first to use the same epidemic ABM to examine the influence of STGs. Our results demonstrate that STGs influence ABM dynamics including early disease burnout and that an interrelationship exists between the coarsening of STGs and the speed and intensity at which disease spreads. Our parsimonious ABM is extended based on a structured community model and we found STGs also influence ABM dynamics in a more realistic context that includes hierarchical movement. Broadly, our study serves as a basis for further inquiry toward the influence of space–time representations on more realistic models that include multiscale mobility, routine movements (e.g., commuting), and heterogeneous population distributions.     

A forgotten plague

Dysentery, or rödsot, as the disease was previously known in Sweden, continues to be a major scourge in developing countries. However, the disease has almost disappeared in the West. Very different circumstances prevailed before infectious diseases declined as some of the major causes of death during the 19th century. In that era, 10,000 people could die of dysentery in a single year in Sweden. The demographic consequences of dysentery in Sweden and the causes of the disease and its disappearance are discussed in this article. It is shown here that despite the devastating effects of dysentery epidemics, most government actions were targeted at cholera. Considerable regional and local differences are revealed as the disease is mapped over Sweden. Clusters of high mortality formed, and even in hard-hit Jönköping County some parishes were almost never affected. It becomes apparent that the outbreaks have been the result of complex interactions between different variables and have led to widespread disease of uneven and often epidemic proportions.

For the statistical analyses the digitized source material of the Demographic Data Base (DDB) at Umeå University has been used, containing statistical demographic data gathered from parishes from all over Sweden. Other sources drawn upon include published statistical data, reports from district medical officers, newspapers, parish registers, and maps.     

Models of masculinity: sex education,the United States Public Health Service,and the YMCA, 1919-1924

In 1918, the U.S. Public Health Service (PHS) told American parents that "it is no longer possible for you to choose whether your child will learn about sex or not." According to the PHS, most American boys learned about sex from "improper sources" by the age of nine. The "unfortunate effect of these early impressions" had, PHS warned, not only resulted in a gross misunderstanding of sex, but also been a major factor in the spread of venereal disease (The Parents' Part [the U.S. Public Health Service, 1918], p. 5). To counter and correct this miseducation, PHS joined with the Young Men's Christian Association (YMCA) to create a sex education program aimed at adolescent boys. Officially launched in the spring of 1919, the "Keeping Fit" campaign provides a unique insight into the federal government's attempt to medicalize and regulate American sexuality through the forum of public health.     

Epidemic temporalities: A concise literature review

How do individuals and institutions make sense of epidemics in time, before, during and after outbreaks? This concise review follows a linear chronology of outbreak ‘events’ to explore debates in medical anthropology on epidemic temporalities. It excavates key notions relating to the technologies, imaginary and governance of epidemic anticipation, epidemic emergency and epidemic aftermaths. Building upon ethnographic works which depict how epidemic temporalities are constructed, and how they travel and affect social life, it argues that they are an integral component of the evental construction of epidemics.     

PLAGUE AND POWER RELATIONS

Public policy and economic practice, quintessential expressions of institutional cognition, create an opportunity structure constituting a tunable, highly patterned,‘non‐white noise’ in a generalized epidemiological stochastic resonance that can efficiently amplify unhealthy living and working conditions, particularly within highly concentrated, marginalized urban populations, to evoke infectious disease outbreaks. This is especially true for the infections carried by socially generated ‘risk behaviours’ which are usually adaptations to histories of resource deprivation or marginalization. A number of local epidemics originating in such ecological keystone communities may subsequently undergo a policy and structure‐driven phase transition to become a coherent pandemic, a spreading plague which can entrain more affluent populations into the disease ecology of marginalization. We use this approach to contrast the ecological resilience of apartheid and egalitarian social systems, and apply these perspectives to the forthcoming social and geographical diffusion of multiple drug resistant (MDR) HIV from present AIDS epicentres to the rest of the United States.     

Impact of Cliff and Ord (1969, 1981) on Spatial Epidemiology

The influence in spatial epidemiology of the seminar work on autocorrelation by Cliff and Ord is discussed. Quantifying the evidence of spatial clustering was an important step in the development of modern statistical methods for analyzing spatial variations of diseases. Autocorrelation is nowadays mostly accounted for at a latent level within a hierarchical framework to small area disease mapping. The importance of accounting for autocorrelation in geographical correlation studies is also reviewed.     

Vers une histoire de la mémoire sportive en France ? Cadres théoriques et éléments d’analyse

The main objectives of this article are to highlight memory as a phenomenon in the field of sport, to determine its content and to understand the dynamics that governed it during the twentieth century. Memory and its socio-historical study are two growing dimensions of the postmodern era, while sport, structured by industrial societies, has shaped modes of representation, notably since the second half of the century. Through the link between sport and society, the spatial and temporal considerations as well as the reconfiguration of social frameworks, we will therefore reveal the existence and emergence of memory as a vital element of the contemporary sporting sphere. From this analysis, we will also put forward a first assessment of existing uses of sporting memory: between historical legitimacy and patrimonialisation.