Explaining geographies of health care: a critique

This paper considers the ways in which geographers have sought to explain the spatial organisation of health care services. It does so at three interlocking scales: the global/international, the national, and the local. It considers the substantive adequacy and explanatory problems associated with different perspectives and also discusses the normative implications of alternative interpretations of patterns of health care services. The paper notes the ways in which some conventional geographies of health care, which seemed to postulate convergence towards greater egalitarianism in service provision between and within states, have been challenged by changing economic circumstances, and by a changing political and intellectual agenda. The paper also considers some emerging geographies of community-based struggles around health services and discusses their potential and limitations. Finally there is a discussion of the potential contribution, if any, of a distinctively geographical perspective on health care.