Critical appraisal
The significant questions this article raises for me are:
- How to establish that places considered ordinary, thus every day become therapeutic or health affirming?
- What are the premises that must be considered to give credence to the proposal of the authors?
These questions are important since there is a need to base one opinion or proposal over an already established or proven opinion that could support the proposal. Therefore, this essay shall present the strengths of the author’s proposal.
With the premise that therapeutic landscapes have contributed noticeably to the development of post-medical geography of health”, the authors would like to pose that health-affirming and health-denying places exist together in everyday life. They believe and tried to illustrate that it is possible for places to simultaneously hurt and heal so that the therapeutic effect of a place is largely contributory on individuals’ physical and social locations.
Landscape, in geographic terms, has been defined to refer to the appearance of an area particularly its social, cultural, and political aspects that shape the place. It is a social document that produces and sustains meaning (Gesler, 1992). Gesler (1998) went as far as suggesting that “places achieve positive or negative reputations because people perceive that they do or do not fulfill basic needs such as providing security, a feeling of identity, material wants or aesthetic pleasure,” (p 17).
The key points of the paper are:
- The development of reputation or image of a place depends on the relational aspects of place such as how a place interacts with depends on the existing social and economic structures and how places are perceived by that outside and within their boundaries
- Construction and interpretation of the image of the place happens within broad social processes that may impact some areas or social groups such as the shift from industrial to post-industrial production of cities, which may be considered an economic condition, and earn a level of places of decline;
- Negative experience, perception, and label results in a stigma so that even people in a stigmatized location also bear with them the negative perception as evidence or symbol of the stigma, thereby, stereotyped;
- Although boundaries may serve a separation and containment, other negative physical attributes of a place such as pollution or dirt where masking or the “neighborhood halo effect” may occur, although Greenberg and Schneider (1996) contends that some places viewed as unpleasant by outsiders may be perceived differently by the area residents;
- Thus, the authors propose that the re-negotiation of a local place image is central to the maintenance of well-being: that the healing process could occur in every day and less pristine places, that the interpretation of places a therapeutic is of central importance to well-being.
Investigating the health-affirming and health-denying landscapes adds up to the understanding of risk perception and stigma as well as the rationale on how or why places are constructed as therapeutic. Experience of places and the meanings attached to these experiences could be a component of the complex ways materials and social conditions interact to produce health inequality.
Critical Assessment
In consideration of the investigation undergone by the authors, they have chosen a definite place for the case study, i.e., Hamilton, Ontario, to conduct in-depth interviews with residents, city officials, newspaper and other reports, as well as experiences of the authors as lifetime residents.
They were able to establish that Hamilton was considered a “place on the margin” which meant people smoked more and houses are worthless as compared to Ontario as a whole. It has a greater proportion of low-income households, poorly educated residents, and lone-parent families with poor health. The government recognized the dominant image of Hamilton as an unhealthy industrial city and there was a concern about its image as a dirty, sick place. There had been considerable effort by the local government to improve the image with alternate identities and iconography based on nature such as the Niagara Escarpment and the Royal Botanical Gardens countering the dominant industrial metaphor.
The authors pointed out that residents of Hamilton have renegotiated the dominant image by emphasizing the health-affirming characteristics of locally significant places and by drawing imagined boundaries between the healthy and unhealthy neighborhoods.
The suggestions of the authors, and opinions found among the residents, however, did not point out what was initially proposed to be answered: whether ordinary everyday places were health-affirming. The study could have had a more solid impact if it had tried to establish a positive effect on the health of residents of the changes made to beautify Hamilton, Ontario. An investigation on the general health of a population sample could have been done before the government beautification program, and another after the area beautification since the focus of the study had been on the health affirming effects in reinventing everyday places.
References
Gesler, W.M. (1992). “Therapeutic landscapes: medical issues in light of the new cultural geography.” Social Science and Medicine 34, 735-746.
Gesler, W.M. (1998). “Bath as a healing place.” In Kearns and Gesler (eds) Putting health into Places. Syracuse University Press, 17-35.
Greenberg, M. R. and Schneider, D. (1996). Environmentally Devastated Neighborhoods. Rutgers University Press.
Wakefield, Sarah and Colin McMullan (2005). “Healing in places of decline: (re) imagining everyday landscapes in Hamilton, Ontario.” Health and Place 11, 299-312.