DISEASE ECOLOGY AND A REFORMIST ALTERNATIVE - THE CASE OF INFANT-MORTALITY

This paper attempts to shed some light on the recent debate between th ose who advocate a reformed medical geography and those who respond th at reform is not necessary. We show that disease ecology and a reformi st alternative display certain tendencies in the ways in which they ad dress issues of health and disease. We use the example of geographic v ariations in infant mortality rates to show how two non-positivist per spectives from social theory, political economy and humanism, support a reformist viewpoint, while also acknowledging the value of a complem entary disease ecology approach. Two concepts, the social construction of health and illness and social relevance, are used to portray the p olitical economy approach; humanism is described in terms of the meani ng of individual experience and the importance of place. The paper con cludes with a discussion of the respective roles of disease ecology an d a reformist approach in models of infant mortality and a summary of the main differences between the two perspectives. Copyright (C) 1997 Elsevier Science Ltd