American Medical Geographer Studies

'The Why of Where'

美国医学地理学家研究病患在某地发生的原因

Mention the profession "geographer" and most people think of traditional roles of mapmakers…or of explorers studying exotic cultures. But the scope of geography has expanded, forming hybrids with some very different fields.

When Lee De Cola teaches a class, he often brings of a projector filled with the images of dozens of colorful maps, showing how Lyme Disease, West Nile Virus, or some other malady has spread across the United States. Mr. De Cola is one of just a few hundred medical geographers in America, so it is not surprising that he draws puzzled looks from those who ask about his work.

Lee De Cola: When I meet people on an airplane, they say, 'Medical geography, that sounds interesting…what's that all about?' All I have to do is tell them, 'Have you seen a map about AIDS recently?' They say, 'Sure.' That's medical geography: the Why of Where. Everything happens somewhere, so when we map it, it becomes much more illuminating to see a map of something, instead of talking about it in the abstract.

Although medical geography became an official specialty area just a few decades ago, its roots may actually be traced to ancient times. Mr. De Cola says it all started with the Greek doctor Hippocrates, known for his Hippocratic Oath, which emphasizes "above all, do no harm."

Lee De Cola: Many of the phenomena we now call geography influenced people's health. The quality of the water, the atmosphere, what lifestyles people had, what they ate, what health they had was determined by geographic phenomena. Here was a scholar writing 2,000 years ago about the very same issues we're talking about today.

In the mid-19th century, British doctor John Snow used principles medical geography to locate the source of a cholera epidemic in London, as Mr. De Cola explains.

Lee De Cola: He showed a map of cases of cholera clustered around a pump that led him to suspect that it was the pump itself that was the source of polluted water that was giving people cases of cholera. That was medical geography. He actually created what we now would call a 'geographic information system.'

In the 1930s, a group of dental geographers in Colorado found the connection between children drinking naturally fluoridated water and having fewer dental cavities. Mr. De Cola says the crossover has spurred more cooperation between geographers and such health organizations as the Centers for Disease Control.

Lee De Cola: The collaboration is really growing and it's in its very early stages. I was down at CDC last year and realized that not only could we take information about diseases and make maps of it, but we can turn that process around and start asking spatial questions and even using spatial information to help organize the information itself.

Thus, Lee De Cola and other medical geographers are combining a variety of social, economic and environmental data with the source and spread of disease.

Lee De Cola: You're collecting information on certain kinds of reports to doctors, pharmaceutical purchases, certain kinds of environmental measurements that are unusual. Putting all these things together, we [ask], 'Is there something unusual going on here? Is it an outbreak of a mosquito-borne disease? A bio-terrorism event? An oil spill here? ' Or something like that.

In the future, Mr. De Cola says medical geography will continue as an important part of medical research -- which, itself, will experience fast growth.

Lee De Cola: Bio-medicine is an exploding field. The American economy devoted over a trillion dollars to personal and public health expenditures. That number is increasing much more rapidly than the economy as a whole.

注释：

mapmaker [5mAp9meikEr] n. 地图制作者，制图师

Lyme [laim] 莱姆关节炎

West Nile Virus 西尼罗河病毒

illuminating [i5lju:mi7neitiN] adj. 启蒙的

abstract [5AbstrAkt] n. 摘要，抽象

Hippocratic Oath 希波克拉底誓言，即新开业医生所立之誓约

phenomena [fi5nCminE] n. 现象

atmosphere [5AtmEsfiE] n. 大气，空气

cholera epidemic 霍乱流行

fluoridate [5flu:Erideit] v. 在饮水中加少量氟

dental cavity 蛀牙

collaboration [kE7lAbE5reiFEn] n. 协作，通敌

pharmaceutical [7fB:mE5sju:tikEl] n. 药物

Bio-medicine 生物医学

trillion [5triljEn] num. 万亿