THE INTERSECTION OF HEALTH SCIENCES AND GEOGRAPHY

A While many diseases that affect humans have been eradicated due to improvements in vaccinations and the availability of healthcare, there are still areas around the world where certain health issues are more prevalent. In a world that is far more globalised than ever before, people come into contact with one another through travel and living closer and closer to each other. As a result, super-viruses and other infections resistant to antibiotics are becoming more and more common.

B Geography can often play a very large role in the health concerns of certain populations. For instance, depending on where you live, you will not have the same health concerns as someone who lives in a different geographical region. Perhaps one of the most obvious examples of this idea is malaria-prone areas, which are usually tropical regions that foster a warm and damp environment in which the mosquitos that can give people this disease can grow. Malaria is much less of a problem in high-altitude deserts, for instance.

C In some countries, geographical factors influence the health and well-being of the population in very obvious ways. In many large cities, the wind is not strong enough to clear the air of the massive amounts of smog and pollution that cause asthma, lung problems, eyesight issues and more in the people who live there. Part of the problem is, of course, the massive number of cars being driven, in addition to factories that run on coal power. The rapid industrialisation of some countries in recent years has also led to the cutting down of forests to allow for the expansion of big cities, which makes it even harder to fight the pollution with the fresh air that is produced by plants.

D It is in situations like these that the field of health geography comes into its own. It is an increasingly important area of study in a world where diseases like polio are re-emerging, respiratory diseases continue to spread, and malaria-prone areas are still fighting to find a better cure. Health geography is the combination of, on the one hand, knowledge regarding geography and methods used to analyse and interpret geographical information, and on the other, the study of health, diseases and healthcare practices around the world. The aim of this hybrid science is to create solutions for common geography-based health problems. While people will always be prone to illness, the study of how geography affects our health could lead to the eradication of certain illnesses, and the prevention of others in the future. By understanding why and how we get sick, we can change the way we treat illness and disease specific to certain geographical locations.

E The geography of disease and ill health analyses the frequency with which certain diseases appear in different parts of the world, and overlays the data with the geography of the region, to see if there could be a correlation between the two. Health geographers also study factors that could make certain individuals or a population more likely to be taken ill with a specific health concern or disease, as compared with the population of another area. Health geographers in this field are usually trained as healthcare workers, and have an understanding of basic epidemiology as it relates to the spread of diseases among the population.

F Researchers study the interactions between humans and their environment that could lead to illness (such as asthma in places with high levels of pollution) and work to create a clear way of categorizing illnesses, diseases and epidemics into local and global scales. Health geographers can map the spread of illnesses and attempt to identify the reasons behind an increase or decrease in illnesses, as they work to find a way to halt the further spread or re-emergence of diseases in vulnerable populations.

G The second subcategory of health geography is the geography of healthcare provision. This group studies the availability (or lack thereof) of healthcare resources to individuals and populations around the world. In both developed and developing nations there is often a very large discrepancy between the options available to people in different social classes, income brackets, and levels of education. Individuals working in the area of the geography of healthcare provision attempt to assess the levels of healthcare in the area (for instance, it may be very difficult for people to get medical attention because there is a mountain between their village and the nearest hospital). These researchers are on the frontline of making recommendations regarding policy to international organisations, local government bodies and others.

H The field of health geography is often overlooked, but it constitutes a huge area of need in the fields of geography and healthcare. If we can understand how geography affects our health no matter where in the world we are located, we can better treat disease, prevent illness, and keep people safe and well.

MUSIC AND THE EMOTIONS

Neuroscientist Jonah Lehrer considers the emotional power of music

Why does music make us feel? One the one hand, music is a purely abstract art form, devoid of language or explicit ideas. And yet, even though music says little, it still manages to touch us deeply. When listening to our favourite songs, our body betrays all the symptoms of emotional arousal. The pupils in our eyes dilate, our pulse and blood pressure rise, the electrical conductance of our skin is lowered, and the cerebellum, a brain region associated with bodily movement, becomes strangely active. Blood is even re-directed to the muscles in our legs. In other words, sound stirs us at our biological roots.

A recent paper in Nature Neuroscience by a research team in Montreal, Canada, marks an important step in revealing the precise underpinnings of the potent pleasurable stimulus’ that is music. Although the study involves plenty of fancy technology, including functional magnetic resonance imaging (fMRI) and ligand-based positron emission tomography (PET) scanning, the experiment itself was rather straightforward. After screening 217 individuals who responded to advertisements requesting people who experience ‘chills’ to instrumental music, the scientists narrowed down the subject pool to ten. They then asked the subjects to bring in their playlist of favourite songs – virtually every genre was represented, from techno to tango – and played them the music while their brain activity was monitored. Because the scientists were combining methodologies (PET and fMRI), they were able to obtain an impressively exact and detailed portrait of music in the brain. The first thing they discovered is that music triggers the production of dopamine – a chemical with a key role in setting people’s moods – by the neurons (nerve cells) in both the dorsal and ventral regions of the brain. As these two regions have long been linked with the experience of pleasure, this finding isn’t particularly surprising.

What is rather more significant is the finding that the dopamine neurons in the caudate – a region of the brain involved in learning stimulus-response associations, and in anticipating food and other ‘reward’ stimuli – were at their most active around 15 seconds before the participants’ favourite moments in the music. The researchers call this the ‘anticipatory phase’ and argue that the purpose of this activity is to help us predict the arrival of our favourite part. The question, of course, is what all these dopamine neurons are up to. Why are they so active in the period preceding the acoustic climax? After all, we typically associate surges of dopamine with pleasure, with the processing of actual rewards. And yet, this cluster of cells is most active when the ‘chills’ have yet to arrive, when the melodic pattern is still unresolved.

One way to answer the question is to look at the music and not the neurons. While music can often seem (at least to the outsider) like a labyrinth of intricate patterns, it turns out that the most important part of every song or symphony is when the patterns break down, when the sound becomes unpredictable. If the music is too obvious, it is annoyingly boring, like an alarm clock. Numerous studies, after all, have demonstrated that dopamine neurons quickly adapt to predictable rewards. If we know what’s going to happen next, then we don’t get excited. This is why composers often introduce a key note in the beginning of a song, spend most of the rest of the piece in the studious avoidance of the pattern, and then finally repeat it only at the end. The longer we are denied the pattern we expect, the greater the emotional release when the pattern returns, safe and sound.

To demonstrate this psychological principle, the musicologist Leonard Meyer, in his classic book Emotion and Meaning in Music (1956), analysed the 5th movement of Beethoven’s String Quartet in C-sharp minor, Op. 131. Meyer wanted to show how music is defined by its flirtation with – but not submission to – our expectations of order. Meyer dissected 50 measures (bars) of the masterpiece, showing how Beethoven begins with the clear statement of a rhythmic and harmonic pattern and then, in an ingenious tonal dance, carefully holds off repeating it. What Beethoven does instead is suggest variations of the pattern. He wants to preserve an element of uncertainty in his music, making our brains beg for the one chord he refuses to give us. Beethoven saves that chord for the end.

According to Meyer, it is the suspenseful tension of music, arising out of our unfulfilled expectations, that is the source of the music’s feeling. While earlier theories of music focused on the way a sound can refer to the real world of images and experiences – its ‘connotative’ meaning – Meyer argued that the emotions we find in music come from the unfolding events of the music itself. This ‘embodied meaning’ arises from the patterns the symphony invokes and then ignores. It is this uncertainty that triggers the surge of dopamine in the caudate, as we struggle to figure out what will happen next. We can predict some of the notes, but we can’t predict them all, and that is what keeps us listening, waiting expectantly for our reward, for the pattern to be completed.