Locating health and illness: a study of women's experiences in two contrasting Edinburgh neighbourhoods

Abstract

This research explores the geography of health inequalities from a qualitative perspective. It considers the links between place, health and well-being by drawing on the life histories and daily routines of women in Edinburgh. The study is based on in-depth interviews undertaken with twenty-four women aged between 45 and 59; twelve women were interviewed in each of two urban neighbourhoods. These neighbourhoods differ on some key health and socioeconomic indicators - one neighbourhood is relatively affluent; the other is relatively deprived. Two interviews were conducted with each respondent. The first interview used lifegrids, which are more usually used in quantitative research, to locate health histories within the broader context of women's biographies. The second interview focused upon respondents' current daily routines, in order to consider how understandings and experiences of health and illness might be shaped by the web of resources and relationships that constitute everyday lives within particular geographical and social spaces.

The research prioritises the contribution of lay perspectives to understandings of health inequalities. Interviews were designed to tap into lay understandings of the meaning of inequality and to explore the psycho-social dimensions of health. This has two key implications for the research findings. First, the data testify to people's resistance to separating out 'health' and 'illness' from other dimensions of life experiences. Second, positive well-being emerges as a central theme within people's conceptualisations of health.

By combining a lifecourse perspective with a focus upon current experience, the research is able to situate women's experiences of both good health and illness within a web of health-relevant (health enhancing and depleting) resources. The study investigates a number of these resources: money, employment, features of the physical and social environment, and personal relationships. The findings indicate that access to such resources is influenced by social position. Furthermore, social position is also shown to have shaped women's trajectories into the neighbourhoods in which they now live. Thus, the analysis suggests how dimensions of individual biographies interact with experiences of particular places in ways which are relevant for health.

The thesis as a whole draws on lay perspectives and experiences to elaborate current understandings of the processes which underpin geographies of health inequalities. Theoretically, it confirms the importance of psycho-social pathways linking life experiences with health. Conceptually it contributes to the debate on contextual and compositional factors accounting for geographical patterns of health and illness. Overall, it points to the priority that well-being has in people's lives and the extent to which this is mediated by experiences of social inequality.