Disease ecology in health and medical geography: History, progress, and innovations†

This paper describes the development of the disease ecology tradition of health and medical geography including some key themes and innovations. It first grounds disease ecology in the history of ecology from the natural sciences and the human ecology traditions within the social sciences. These ecological studies of disease developed in response to limitations in the biomedical approach to studying health and disease that developed after germ theory. While the biomedical approach, which mostly focused on human biology, led to groundbreaking advances in medicine for many decades, it had its limits. Disease ecology applications have modern roots in the decades before and after World War II through colonial and tropical medicine as well as work conducted in an array of other sites, including Nazi Germany, the Soviet Union, and the United States when there were large efforts to create infectious diseases maps and conduct ecological analyses of diseases. Hundreds of disease ecology studies have been implemented on diverse disease systems since World War II. The field progressively broadened in scope, especially during the 1990s and beyond, with several innovations including the application of political ecology approaches to the study of health and disease. Two other recent innovations are summarized through case studies: disease ecology approaches in health intervention research and applications of theory and methods from landscape genetics. The first case study highlights the ecological and geographic heterogeneity associated with the health impacts of drinking‐water tubewell interventions in rural Bangladesh. The paper also considers ‘landscape genetics’ approaches via a case study about influenza that uses modern genetic and spatial tools along with an ecological approach; it describes how the evolution of the virus is related to human‐environment‐animal interactions. The paper concludes by outlining promising future directions for disease ecology, emphasizing the field's ongoing incorporation of new theories and methods.