Health: An Interdisciplinary Journal for the Social Study of Health,Illness and Medicine

This article explores why landscape is a crucial element in researching the relationship between environment and well-being. The main point we make is that human social agents are embedded in particular landscapes, and it is in landscapes that environmental changes are experienced, which can have implications for well-being. We draw from a variety of perspectives on landscape that understands a fundamental creative relation between humans and landscape and recent developments in neo-materialism theorising. Landscape is understood here as an assemblage of different forms of matter, animate and inanimate objects, as well as symbolic and cultural processes. A case study is also presented to indicate how landscape can be studied in relation to environment and change. Using the conceptual ideas laid out in the first section of the article, we analyse landscape, environment and well-being in Xuan Thuy National Park in North Vietnam. The area is part of a precarious coastal region where extreme weather events have impacted on the well-being of both humans and other matter. This article concludes with suggestions on the use of this landscape approach in researching environment and well-being.

This article reflects on the relations between health and natural landscapes. The study explores how the landscape context – its textual and sensory aesthetics – positively shapes experiences and perceptions of the landscape, for those people who seek out natural environments for health. While health promotion is designated along the lines of encouraging choice or improving access to natural environments, this article wants to show how physical activities are intertwined with atmospheres and affects emanating from the natural and human world. An in-depth case-study of trail running across two sites (New Zealand, United Kingdom) is used to analyse the interconnections between health landscapes. It finds that when participants say that landscape ‘matters’ for health, they are referring to: (1) aesthetics and feelings, (2) flexibility and adaptiveness and (3) exploration and adventure. Avoiding the conclusion that the landscape is merely a resource for health, the analysis confirms that it is the complex of spaces, social practices, along with their physical fleshy selves, minds and emotions, and the particular quality of the earth beneath them, that gives rise to positively perceived health, for both immediate and enduring benefit.

This article considers conceptual frameworks and models applied in research about the multiple relations between human contact with natural environments (specifically green public spaces), diverse kinds of human activities and uses of those spaces, and effects on physical and mental health. Conceptual frameworks are tools for thinking about such complex subjects. Conceptual models represent the multiple relations between key factors and variables. These models can be used to represent the mutual interactions between the core components of environmental conditions of specific green public spaces, the main kinds of human activities in those settings, and various impacts on health. A literature search showed that the authors of various conceptual models used a metaphor of pathways to represent relations between explanatory variables by linear cause–effect relations. Mutual interaction between key variables and feedback loops between different components of the model are rarely included. Hence, it is argued that these models do not represent the complexity of real world situations. The authors propose a systemic conceptual framework founded on core principles of human ecology. The proposed conceptual framework and model have been formulated during and after an EU 7th Framework project about the ‘‘Positive Health Effects of the Natural Outdoor Environment in Typical Populations in Different Regions of Europe.”

Since antiquity, attempts to conceptualise the aetiology of mental illness have included social constructionist, biomedical, and psychosocial theories. The change of these concepts over the centuries is reflected in therapeutic approaches as well as the location, layout and interior design of psychiatric institutions. This article focuses on the genealogy of one of these concepts – the proposed link between meteorological parameters, specifically air and sun, and mental illness. Based on detailed archival materials, including administrative records, medical notes and correspondence as well as oral histories, relating to the Devon County Mental Hospital near Exeter (UK), it traces this link over time within and beyond the medical community to the extent that it served as pretext for underlying social causes of the illness. In doing so, this article makes an empirical contribution to geographical perspectives on the construction of psychiatric institutions throughout history while also advancing such work in theoretical terms by drawing attention to the shifts in medical and lay conceptualisations of mental illness.

An understanding of best practice rural water, sanitation and hygiene (rWASH) and its associated indicators can ensure greater success and reduced failure of future projects. While numerous organisations have actively implemented rWASH projects since the early 1990s with donor reports, funding proposals and reviews frequently claiming best practice, there remains a paucity of information on what constitutes ‘best practice’ rWASH. A scoping review of qualitative and quantitative literature was done with six primary factors identified as key contributors to best practice rWASH: regulatory environment, community ownership, programme methodology, funding, technology and capacity. In the absence of standardisation, a benchmark of proven techniques may be used as an alternative to identify ‘best practice’ within the sector and propose minimum requirements for the development of best practice rWASH. Clearly defining best practice rural water, sanitation and hygiene is useful for governments, donor agencies and implementing organisations and those monitoring outcomes of programmes against national and global targets.

Involving and engaging the public are crucial for effective prioritisation, dissemination and implementation of research about the complex interactions between environments and health. Involvement is also important to funders and policy makers who often see it as vital for building trust and justifying the investment of public money. In public health research, ‘the public’ can seem an amorphous target for researchers to engage with, and the short-term nature of research projects can be a challenge. Technocratic and pedagogical approaches have frequently met with resistance, so public involvement needs to be seen in the context of a history which includes contested truths, power inequalities and political activism. It is therefore vital for researchers and policy makers, as well as public contributors, to share best practice and to explore the challenges encountered in public involvement and engagement. This article presents a theoretically informed case study of the contributions made by the Health and Environment Public Engagement Group to the work of the National Institute for Health Research (NIHR) Health Protection Research Unit in Environmental Change and Health (HPRU-ECH). We describe how Health and Environment Public Engagement Group has provided researchers in the HPRU-ECH with a vehicle to support access to public views on multiple aspects of the research work across three workshops, discussion of ongoing research issues at meetings and supporting dissemination to local government partners, as well as public representation on the HPRU-ECH Advisory Board. We conclude that institutional support for standing public involvement groups can provide conduits for connecting public with policy makers and academic institutions. This can enable public involvement and engagement, which would be difficult, if not impossible, to achieve in individual short-term and unconnected research projects.

Societal impact is an increasingly important imperative of academic funding. However, there is little research to date documenting how impact is accomplished in practice. Drawing on insights from Actor–Network Theory, we explore the research–policy interface within an interdisciplinary research project on the relationships between air pollution and human health. Health policy impact was important to the researchers for moral as well as pragmatic reasons but it was a goal that was seen as potentially in tension with that of doing science. In fields such as air pollution and health, networks of policymakers and researchers are inevitably entangled, and we found that processes of engagement operated to delineate science from policy. Health was initially black-boxed and under-explicated, used as a signifier in itself for societal impact. By mobilising networks of policy actors, brought together in workshops to rank the importance of policy scenarios for the research team, the connections between air pollution and health were materialised and made actionable. This was achieved by framing existing data sets, emission technologies, policy expertise, pollutant species and human health in particular ways and, in doing so, excluding others. The process of linking air pollution and health research to achieve societal impact not only influenced how these phenomena were known but, critically, enabled and constrained potential policy responses. Tracing these research arrangements made the material discursive processes of ‘impact’ visible and analysable as objects of social science scholarship, and therefore generated a productive site for critically engaging with processes of environment and health science and policy.