This study looks at the different factors (environmental, physical and social) influencing the health of the population resident in the Lisbon Metropolitan Area (LMA). It theorizes the multiple dimensions of the local sociomaterial context, focusing above all on aspects that differentiate between places, and seeks to model and explain their influence on individual health by means of multivariate statistical analysis. The results obtained prove the hypothesis that in the LMA, there is a strong relationship between health and the spaces, or places, of daily life. That relationship, which is found for different contextual characteristics, remains true when individual characteristics, considered to be major health determinants, are controlled. Good access to public transport, the availability of preventive health services, high levels of social capital and low levels of material deprivation contribute significantly to a better self-assessed health status. However, the relationship is not linear; the effect of place on health is not universal but specific, clearly affecting different population groups. This work, which reveals a topography of risk and protection in the LMA, recognises the capacity of place to manage/generate health and disease, thereby constituting a new approach to an old problem of public health. With its suggestion that By suggesting that it might be possible to break the chain of risk factors that leads to health impoverishment, acting upon places becomes a way of acting socially upon individuals, integrated into their communities.
Helena Nogueira é professora Auxiliar de Geografia da Faculdade de Letras da Universidade de Coimbra, nasceu em Luanda em 1966. Licenciada em Coimbra, aí conclui o mestrado em Geografia Humana em 2001 e o doutoramento em Geografia em 2007. A par da sua atividade docente, tem desenvolvido investigação na área da Geografia da Saúde, sobretudo em questões relacionadas com variações, desigualdades e iniquidades em saúde, determinantes ambientais da saúde e planeamento urbano saudável.
She is Auxiliary Professor of Geography at the Faculty of Letters of the University of Coimbra. She was born in Luanda in 1966 and obtained her degree at the University of Coimbra and completed her Master’s Degree in Human Geography there in 2001 and her Doctorate in Geography in 2007. As well as maintaining her career in teaching, she has conducted research in the area of geography of health, mostly in matters related to the variations, inequalities and inequities in health, environmental determinants of health and healthy urban planning.