In this paper, we reflect on the positioning of health geography within the wider academic landscapes of geography and health-related research. Drawing on examples from a number of countries, we consider the extent to which a ‘new geography of health’ has emerged in recent years. We structure our discussion around the themes of place, theoretical engagement and critical relevancy. Changes within the subdiscipline are placed in the context of a central question: what is new about the new geography of health?

An engagement with public health concerns and aspects of social theory such as the structure/agency debate is crucial to medical geography. The imperatives underlying this engagement center on place, a geographical concept which is prominent in both social theory and recent health philosophy. Without detracting from its distinguished heritage, this reformed medical geography will analyze issues such as the consequences of illness and health service provision for both personal well‐being and the collective experience of place by communities.

Background: Shifting to active modes of transport in the trip to work can achieve substantial co-benefits for health, social equity, and climate change mitigation. Previous integrated modeling of transport scenarios has assumed active transport mode share and has been unable to incorporate acknowledged system feedbacks.Objectives: We compared the effects of policies to increase bicycle commuting in a car-dominated city and explored the role of participatory modeling to support transport planning in the face of complexity.Methods: We used system dynamics modeling (SDM) to compare realistic policies, incorporating feedback effects, nonlinear relationships, and time delays between variables. We developed a system dynamics model of commuter bicycling through interviews and workshops with policy, community, and academic stakeholders. We incorporated best available evidence to simulate five policy scenarios over the next 40 years in Auckland, New Zealand. Injury, physical activity, fuel costs, air pollution, and carbon emissions outcomes were simulated.Results: Using the simulation model, we demonstrated the kinds of policies that would likely be needed to change a historical pattern of decline in cycling into a pattern of growth that would meet policy goals. Our model projections suggest that transforming urban roads over the next 40 years, using best practice physical separation on main roads and bicycle-friendly speed reduction on local streets, would yield benefits 10–25 times greater than costs.Conclusions: To our knowledge, this is the first integrated simulation model of future specific bicycling policies. Our projections provide practical evidence that may be used by health and transport policy makers to optimize the benefits of transport bicycling while minimizing negative consequences in a cost-effective manner. The modeling process enhanced understanding by a range of stakeholders of cycling as a complex system. Participatory SDM can be a helpful method for integrating health and environmental outcomes in transport and urban planning.Citation: Macmillan A, Connor J, Witten K, Kearns R, Rees D, Woodward A. 2014. The societal costs and benefits of commuter bicycling: simulating the effects of specific policies using system dynamics modeling. Environ Health Perspect 122:335–344; http://dx.doi.org/10.1289/ehp.1307250

There is increasing recognition that the neighborhood-built environment influences health outcomes, such as physical activity behaviors, and technological advancements now provide opportunities to examine the neighborhood streetscape remotely. Accordingly, the aims of this methodological study are to: (1) compare the efficiencies of physically and virtually conducting a streetscape audit within the neighborhood context, and (2) assess the level of agreement between the physical (criterion) and virtual (test) audits. Built environment attributes associated with walking and cycling were audited using the New Zealand Systematic Pedestrian and Cycling Environment Scan (NZ-SPACES) in 48 street segments drawn from four neighborhoods in Auckland, New Zealand. Audits were conducted physically (on-site) and remotely (using Google Street View) in January and February 2010. Time taken to complete the audits, travel mileage, and Internet bandwidth used were also measured. It was quicker to conduct the virtual audits when compared with the physical audits (χ=115.3 min (virtual), χ=148.5 min (physical)). In the majority of cases, the physical and virtual audits were within the acceptable levels of agreement (ICC≥0.70) for the variables being assessed. The methodological implication of this study is that Google Street View is a potentially valuable data source for measuring the contextual features of neighborhood streets that likely impact on health outcomes. Overall, Google Street View provided a resource-efficient and reliable alternative to physically auditing the attributes of neighborhood streetscapes associated with walking and cycling. Supplementary data derived from other sources (e.g., Geographical Information Systems) could be used to assess the less reliable streetscape variables.

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Narrative analysis produces strategies to inform the conduct, interpretation and presentation of interview talk, and encourages and enables researchers to take account of research participants’ own evaluations. We suggest this to be a useful method for geographers because it focuses on how people talk about and evaluate places, experiences and situations, as well as what they say. With an example from health geography, we show how it allows for interactive texts, thus providing a tool for geographers doing qualitative research to connect intimate details of experience to broader social and spatial relations.

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