CONCEPTS FOR TRAVERSING ECO-HEALTHSCAPES
Figure 8.2 provides a conceptual model that can be adopted and specified for humans and animals. The factors in Figure 8.2 are either influences external to the individual or population or influences internal to the individual or population. For example, all the factors and processes outlined in Lambin et al. (2010) can be considered external. However, internal factors (personal connections to specific areas, therapeutic benefits derived from specific place assemblages, etc.) play an important role in health, and in creating resources for healthy environments. We now turn to a brief review of some key internal factors and how they might inform an Eco-Healthscape approach.
FIGURE 8.2 Proposed conceptual model for integrating place and health for shared health at human-animal interface.
One of the most important and widely adopted frameworks in understanding the intersection of place and health is that of therapeutic landscapes. The concept was introduced to describe how and why certain environments can provide healing (Gesler, 1992). Therapeutic landscapes research tends to come out of the humanist tradition in geography, which emphasizes the lived experiences of individuals above identifying general mechanisms or associations. Williams (1998) described therapeutic landscapes as “those changing places, settings, situations, locales, and milieus that encompass both the physical and psychological environments associated with treatment or healing.” The concept, w'hile initially focused on extraordinary spaces such as sites of ceremonial significance, has since been expanded to consider therapeutic benefits and restorative nature of everyday spaces such as farms (Kaley et al., 2019) and forests (Morita et ah, 2007). Work considering animals in therapeutic landscapes has only recently begun, generally w'ithin the context of health-benefits derived from human interaction with animals - such as “care farms” (Kaley et ah. 2019) or companion animals (Fletcher and Platt, 2018). The therapeutic benefits derived from place are not intrinsic qualities of the spaces in and of themselves
(Gorman, 2017). Thus, the therapeutic nature of movements/mobilities has also recently been explored (Gatrell, 2013).
Health benefits (i.e. not just risks) can be relationally derived and experienced by individuals through their interactions with specific locales. These relations are defined and structured by a complex assemblage of factors. How animals perceive and experience space remains speculative, but trying to understand the intersection of animal behaviour(s) and specific environments, as opposed to habitat categories, might shed some light on this question, especially as it relates to understanding animal-human relations. Typical ecological approaches to understanding habitat requirements and quality resort to enumerating features of the environment at sites where they are present (and comparing to where they are absent). More consideration could be given to, for example, what animals are doing at a specific locale, to inform that site’s importance (functionally and ecologically) to that animal.
Sense of Place
One’s personal connection to a given setting is frequently theorized in geography through the construct of their so-called sense of place; that is, the sum of their emotional and personal feelings towards a specific locale (Tuan, 1975). Sense of place is a key resource at the intersection of geography and health. As people spend time and interact with a place, they develop attachments to these places in complex ways. Knowing, interacting, and living within natural areas has been positively linked to sense of place development and positive health benefits (Russell et al„ 2013). Sense of place is also linked to the concept of ecological identity (Thomashow, 1996), which relates to conservation values, attitudes, and behaviours. Personal values can be a critical driver of political and institutional actions (Diaz et al., 2015). There has been increased research interest on how sense of place drives conservation and biodiversity protections (Russell et al., 2013). Although rooted in humanist and phenomenological traditions, sense of place has also been frequently used and examined in quantitative settings, often proxied with a variable representing “time of residence” or in some way quantifying duration of time spent in a location which tends to be positively correlated with sense of place sentiments (Lewicka, 2011).
Neuroscience has also examined dimensions of place and sense of place in humans and animals. This research has identified “place-cells” that encode spatial information and are instrumental in navigation and spatial memory (Moser et al., 2008). O’Keefe and Conway (1978) identified the hippocampus as a sort of cognitive map responsible for spatial cognition and memory functions. Experimental evidence in rats (Save et al.. 1998), monkeys (Rolls, 1999), and humans (Ekstrom et al., 2003) has confirmed the importance of hippocampal pyramidal cells in spatial cognition and memory functions. Multiple types of environmental sensory input (visual, auditory, tactile) influence firing of place-cells (Best and Thompson, 1989). It is, therefore, plausible that changes or characteristics of environment may impact spatial memory. Jeansok et al. (2007) showed that stressful environments impaired the stability of firing rates of place-cells in rats. Neuroscience research has concluded that there is convincing evidence that place constitutes a distinct dimension in neural processing. It is. therefore, plausible that the connections found to be vital between humans and their environments for health may also be at play in some animals.
The spatial dimensions of place are equally challenging as the psychological and neurological dimensions but are fundamental in defining an Eco-Healthscape across species boundaries. In classic health/medical geography studies, the home address was often used as the unit of analysis, usually summarized at the block or neighbourhood levels. Health outcomes (usually expressed as rates) over these so-called “small areas” could then be investigated in relation to other site-specific spatial variables for statistical associations. Statistically significant associations were deemed indicative of causal relations. The implicit connection was that the home address was a useful proxy for the exposures experienced by residents, and that if these exposures had a causal link with the health condition under study, these would exhibit a consistent pattern across the larger study area. A surge in research in the 2000s investigating space/place/health sought to identify “contextual” effects at the neighbourhood level through multi-level modelling. For example, some variables such as income inequality or social capital might only relate to health at an aggregate scale. These effects could then be embedded within a spatial hierarchy of factors that relate individual, neighbourhood, and contextual factors to the health outcome of interest. However, in recent years, several problems have been identified with using home addresses and residential neighbourhoods as proxies for spatial exposure.
Firstly, people move around at different rates to different locations, thereby creating different exposure profiles for people living in the same areas. This is exacerbated by shifts in commuting patterns and working arrangements to more variable and complex flows than suburb-central core commuting characteristic of the post-war era. The notion of spatial polygamy has been used to describe the “simultaneous belonging or exposure to multiple nested and non-nested; social and geographic; real, virtual, and fictional; and past and present contexts” (Matthews, 2011). These spaces vary individually but also along income, racial, and gendered lines (Matthews and Yang, 2013). They also interact differentially with health. Vallee et al. (2011), for example, found that people in deprived neighbourhoods that had more localized activity spaces were linked to negative mental health outcomes, whereas localized activity space footprints in advantaged neighbourhoods actually had a protective effect (Vallee et al., 2011).
A second concern is that people may interact with features of their environment at vastly different rates. This becomes a concern for approaches that equate presence of some environmental resource with a constant rate of use of that resource. For example, many studies have investigated neighbourhood-level green space and indicators of stress, cardiovascular disease, and overall self-reported well-being. These studies often fail to account for the differential use of greens- pace among residents in the same community, which may, for example, vary systematically with age or income. Living near a park can mean you are more likely to be physically active, or more people that are predisposed to active lifestyles choose to buy homes near parks (Cummins and Fagg, 2012); these two processes cannot be untangled from observational spatial associations (Robertson and Feick, 2018). Tools for understanding animal use of space (i.e. their geographic context) are well developed for home range mapping via a sophisticated array of tracking technologies and analytical methods to identify locations of significance for individuals and populations (see Long and Nelson, 2013). Some of these are incorporating aspects of spatial memory into their conception of home ranges.
The uncertainty in one’s true geographic context is termed the uncertain geographic context problem: it is not totally clear what spatial contexts apply to what individuals (Kwan, 2012). Ignoring this problem risks incorrect inferences about associations between health outcomes and environmental factors. These sorts of problems are compounded for more complex health issues such as vector-borne diseases, where the number of mobile actors in a transmission chain can be two, three, or more. Added to that, we typically have far less information about animals’ use of space and their interactions and differential experiences; these issues can limit the value of spatial associations in these systems (Robertson et al., 2017). Understanding how individuals’ activity space (physically and perceptively/psychologically) intersects with those both within and across species divides may shed light on positive and negative effects on shared health outcomes.