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Health and sustainable agricultural development: Perspectives on growth and constraints
Book reviews
into account and recognised as valid, although there was a lack of substantive material to illustrate these points. In the discipline of geography these sorts of methodologies are only just beginning to be disseminated in this way, and geographical health studies in particular tend to lack imaginative methodologies and traditionally have given credence to the subjective. The authors highlight the significance of the literal and symbolic ‘placing’ of people with learning difficulties (or similar health service users), and maintain that ‘settings spatially represent people’s place within society, they are powerful mediums of personal identity and value’ (p. 5.5). Here the authors pri‘community’ as a valued, vilege acceptable forum for personal and social development. The move from the hospital and institution in community care services is largely bound up with a reconceptualising of the appropriate place for people with social and health differences. Overall the book is wide ranging in its considerations of services and service measurement and outcomes, without really considering casestudies in depth. For geographers interested in health and place it may be a useful ‘over-view’ text as it forces the consideration of the contextual, and does not allow a singular interpretation of either people with learning difficulties or support services: it recognises (if it doesn’t fully investigate empirically) that service policy outcomes are multiple and complex and differ spatially and temporally.
University
H. Parr of Wales, Lampeter
Health and Sustainable Agricultural Development: Perspectives on Growth and Constraints Vernon W. Ruttan (ed) Westview Press, Boulder, CO (1994) 17Opp $35.00 paperback Health and Sustainable Agricultural Development is the third tome in a series edited by Vernon W. Ruttan. The series (or ‘consultations’ as the
editor describes it) grew out of ‘conversations’ (p. ix) held at the Hubert H. Humphrey Institute of Public Affairs at the University of Minnesota. This book, like the previous two publications emanating from the spring 1988 consultations, is billed as ‘informal dialogues’ with ‘a number of leading agricultural, environmental, health and social scientists who were asked to identify the implications of global change for agricultural research priorities into the twenty-first century’ (p. ix). The volume under review here represents conversations from the ‘Health Constraints in Agricultural Development’ dialogue. Because no formal papers were presented nor requested, the original conversations were taped. The transcripts first appeared as staff papers at the Department of Agricultural and Applied Economics at Minnesota. Over a two-day period in the summer of 1990, 17 scholars met to discuss a theme that is ‘a bit more speculative’ than the previous two conferences. Specifically, the charge of the consultation was to ponder the following. ‘When one starts asking what would be the impact if a number of health concerns--such as malaria and tuberculosis resurgence; failure to make progress on parasitic disease (with a few exceptions); the failure to use the knowledge we have about infectious disease; the emergence of new viral diseases such as AIDS; and the health effects of environmental change-should come together at the same time it is not too difficult to visualize large numbers of sick people in many villages around world. The numbers could be large enough to seriously impinge on food production capacity’ (p. 4). To be sure, no one would argue that this scenario is unworthy of Organized thoughtful reflection. around five topics (health policy and health systems, disease in the tropics, nutrition and environmental health, the implications of health for agricultural development, and a summary and conclusion), the book attempts to direct these macrohypothetic0 situations into a succinct conversation with the reader. Simply stated, though, it does not work. As
any academic knows, just bringing great minds together for breezy exchanges (‘Thanks, David’ p. 12; ‘Let me draw on another personal illustration’ p. 2.5; ‘I was interested in your comment about . . .’ p. 32; ‘Mark, I have sung this song myself for many years’ p. 76; ‘If I understood you right, Mark, you said . . .’ p. 123; ‘I have several points that don’t hang together well’ p. 140) is not a verbatim recipe for a book publication. Moreover, this reviewer believes that there is no place in a scholarly work to include jokes about airline food (p. 60) in a discussion about the relationship between food and health supply. The text suffers from the kind of polite banter that peppers the conversations of scholars and friends. This means the reader must search out key points. However, there is not even an index to aid the reader. To the book’s credit, there is at least a bibliography, although there are fewer references here than one might find in a refereed journal article. When most of the presenters make a factual statement, they do not list references for the reader to pursue that information (although Thomas Whitmore’s contribution does include a footnote and he and Zbigniew Bochniarz, John Sanders, and Bruce F. Johnston include detailed tables or figures with specific references). Also, the editor (Chapter 17, ‘lmphcations and priorities’) and the editor and David E. Bell (Chapter 18, ‘Agricultural and health research: bridging the island empires’) use author-year citations in the text. These are the exceptions to the norm in this book. Interesting moments and stimulating points can be found in this book if the reader can move beyond the format. James Chin debunks the ‘magic bullet’ syndrome that many expect with the development of an AIDS vaccine. His comments surface in his own ‘chapter’ as well as his remarks elsewhere. John Saunders’ discsussion of how the Sundanian region was historically quite a healthful place makes for fascinating reading, and he glimpses at a political economic interpretation of ill health and disease. This is, though,
251
Book
reviews
an epistemological digression in what can be labelled as a conventional agricultural economic interpretation between investment, tradeoffs, agricultural output, and health status. When interesting points are made, they read as anecdotes to very complex issues. The conclusions seem axiomatic: multi-disciplinary efforts must prevail if health and agricultural production are to co-exist harmoniously (p. 151), and that the family and community play key roles in determining the status of the two (p. 152). The ‘health research’ conclusions argue that: (i) health technologies must be implemented in sensitive ways that recognize the local cultural setting; (ii) families, especially mothers, serve important functions in this regard; and (iii) most research on health is concentrated in industrial nations. Accordingly, healthcare delivery systems (called ‘national health research systems’ in the text) must be tailored to local conditions (pp 157-160). These findings strike this reviewer as fairly conventional, though no doubt salient points. At a time when edited books are increasingly criticized because the written word is not closely integrated among the various authors, one can only try to imagine how the editor thought that it would be any easier to ‘conversations’. At the integrate usual high price established by Westview, this book will best serve researchers if it is made available at a library. It does not seem to be a publication one might gather for her/ his own library. Health researchers will have to look elsewhere for a systematic and theoretically driven examination of the relationship between health and agricultural development. Joseph L. Scarpaci Virginia Polytechnic Institute and State University Mental Health and the Built Environment: More than Bricks and Mortar? David Halpern Taylor and Francis London (199.5) 240~~ ISBN 0 7484 0236 5 paperback
252
David Halpern gives us the story behind this book in an autobiographical section of the preface. As an architect, he found that the prevailing ethos of his profession emphasised aesthetics to the extent that students ‘. . . learned little or nothing of the potential social or behavioural consequences of design’ (p. vii). This disenchantment with a perceived failure of architects and planners to take seriously the link between the built environment and human health led Halpern to appraise the evidence and undertake his own research. The result is a book that is refreshing for both its clarity and comprehensive scope. The book is divided into eight chapters, the first of which establishes a thorough background for the survey. The author hypothesises at the outset that potential influences of the built environment on mental health are likely to be fourfold: ‘as a source of stress; as an influence over social networks and support; through symbolic effects and social labelling; and through the action of the planning process itself’ (p. 2). This hypothetical framework provides a structure for the remainder of the book. Commendably, Halpern does not take for granted the construct ‘mental health’. As with a host of terms used throughout the study, careful definitions of mental health are provided, with ample referencing which might serve as a resource for the reader wishing further backgrounds. Halpern demonstrates a sophisticated understanding of psychology and psychiatry as well as the design professions. His discussion of rating scales is particularly helpful, reminding the novice that ‘being unhappy is a central, though not necessarily sufficient, aspect of psychological distress’ (p. 6). Such subtleties take on considerable importance as the book proceeds to appraise critically studies on the experience of housing environments. En route to that point in the book, Halpern surveys material familiar to readers of this journal: ‘psychiatric geographies’ and urban versus rural differences in mental illness. A particularly useful closing sec-
tion of the introduction reflects on the methodological quagmire of causation that besets the researcher in this field. As Halpern points out, there are many studies demonstrating association between built environments and mental health. their interpretation is However, obscured by issues of social selection and subjects’ response bias. He elucidates these problems crisply and presents methodological alternatives that are sufficiently refreshing to merit using the book as a research design resource as well as its more obvious function as a thematic survey. Subsequent chapters survey topics ranging from ‘classic’ environmental stressors such as noise (Chapter 2) to ‘social environmental stressors’ including crowding and fear of crime (Chapter 3). These surveys are thorough and highly readable. Social support and its relationship to both mental illness and the planned environment (through the generation of neighbouring) is surveyed in Chapter 4, with cited examples including both planned communities and doomed public housing projects such as Pruitt Igoe in St Louis. Chapter 5 focuses on more humanistic concerns: the power of meaning in the built environment as influencing mental health through the labelling and stigmatisation of areas and housing types. The potential for the planning process to affect mental health is surveyed in Chapter 6. Two influences are identified: an indirect effect (e.g. through the generation of traffic or population density), and a direct effect (e.g. through slum clearance and relocation of residents). Halpern focuses on the latter, adding analytical weight to Herbert Gans’ classic comment that a physical slum does not imply a social slum. It is at this stage of the book that the author includes largely unpublished data on the mental health effects of planning interventions, for ‘in order to demonstrate conclusively the relevance of the planning process per se to mental health, it must be shown that a planning decision can have an impact on residents’ mental health even in the absence of actual physical
into account and recognised as valid, although there was a lack of substantive material to illustrate these points. In the discipline of geography these sorts of methodologies are only just beginning to be disseminated in this way, and geographical health studies in particular tend to lack imaginative methodologies and traditionally have given credence to the subjective. The authors highlight the significance of the literal and symbolic ‘placing’ of people with learning difficulties (or similar health service users), and maintain that ‘settings spatially represent people’s place within society, they are powerful mediums of personal identity and value’ (p. 5.5). Here the authors pri‘community’ as a valued, vilege acceptable forum for personal and social development. The move from the hospital and institution in community care services is largely bound up with a reconceptualising of the appropriate place for people with social and health differences. Overall the book is wide ranging in its considerations of services and service measurement and outcomes, without really considering casestudies in depth. For geographers interested in health and place it may be a useful ‘over-view’ text as it forces the consideration of the contextual, and does not allow a singular interpretation of either people with learning difficulties or support services: it recognises (if it doesn’t fully investigate empirically) that service policy outcomes are multiple and complex and differ spatially and temporally.
University
H. Parr of Wales, Lampeter
Health and Sustainable Agricultural Development: Perspectives on Growth and Constraints Vernon W. Ruttan (ed) Westview Press, Boulder, CO (1994) 17Opp $35.00 paperback Health and Sustainable Agricultural Development is the third tome in a series edited by Vernon W. Ruttan. The series (or ‘consultations’ as the
editor describes it) grew out of ‘conversations’ (p. ix) held at the Hubert H. Humphrey Institute of Public Affairs at the University of Minnesota. This book, like the previous two publications emanating from the spring 1988 consultations, is billed as ‘informal dialogues’ with ‘a number of leading agricultural, environmental, health and social scientists who were asked to identify the implications of global change for agricultural research priorities into the twenty-first century’ (p. ix). The volume under review here represents conversations from the ‘Health Constraints in Agricultural Development’ dialogue. Because no formal papers were presented nor requested, the original conversations were taped. The transcripts first appeared as staff papers at the Department of Agricultural and Applied Economics at Minnesota. Over a two-day period in the summer of 1990, 17 scholars met to discuss a theme that is ‘a bit more speculative’ than the previous two conferences. Specifically, the charge of the consultation was to ponder the following. ‘When one starts asking what would be the impact if a number of health concerns--such as malaria and tuberculosis resurgence; failure to make progress on parasitic disease (with a few exceptions); the failure to use the knowledge we have about infectious disease; the emergence of new viral diseases such as AIDS; and the health effects of environmental change-should come together at the same time it is not too difficult to visualize large numbers of sick people in many villages around world. The numbers could be large enough to seriously impinge on food production capacity’ (p. 4). To be sure, no one would argue that this scenario is unworthy of Organized thoughtful reflection. around five topics (health policy and health systems, disease in the tropics, nutrition and environmental health, the implications of health for agricultural development, and a summary and conclusion), the book attempts to direct these macrohypothetic0 situations into a succinct conversation with the reader. Simply stated, though, it does not work. As
any academic knows, just bringing great minds together for breezy exchanges (‘Thanks, David’ p. 12; ‘Let me draw on another personal illustration’ p. 2.5; ‘I was interested in your comment about . . .’ p. 32; ‘Mark, I have sung this song myself for many years’ p. 76; ‘If I understood you right, Mark, you said . . .’ p. 123; ‘I have several points that don’t hang together well’ p. 140) is not a verbatim recipe for a book publication. Moreover, this reviewer believes that there is no place in a scholarly work to include jokes about airline food (p. 60) in a discussion about the relationship between food and health supply. The text suffers from the kind of polite banter that peppers the conversations of scholars and friends. This means the reader must search out key points. However, there is not even an index to aid the reader. To the book’s credit, there is at least a bibliography, although there are fewer references here than one might find in a refereed journal article. When most of the presenters make a factual statement, they do not list references for the reader to pursue that information (although Thomas Whitmore’s contribution does include a footnote and he and Zbigniew Bochniarz, John Sanders, and Bruce F. Johnston include detailed tables or figures with specific references). Also, the editor (Chapter 17, ‘lmphcations and priorities’) and the editor and David E. Bell (Chapter 18, ‘Agricultural and health research: bridging the island empires’) use author-year citations in the text. These are the exceptions to the norm in this book. Interesting moments and stimulating points can be found in this book if the reader can move beyond the format. James Chin debunks the ‘magic bullet’ syndrome that many expect with the development of an AIDS vaccine. His comments surface in his own ‘chapter’ as well as his remarks elsewhere. John Saunders’ discsussion of how the Sundanian region was historically quite a healthful place makes for fascinating reading, and he glimpses at a political economic interpretation of ill health and disease. This is, though,
251
Book
reviews
an epistemological digression in what can be labelled as a conventional agricultural economic interpretation between investment, tradeoffs, agricultural output, and health status. When interesting points are made, they read as anecdotes to very complex issues. The conclusions seem axiomatic: multi-disciplinary efforts must prevail if health and agricultural production are to co-exist harmoniously (p. 151), and that the family and community play key roles in determining the status of the two (p. 152). The ‘health research’ conclusions argue that: (i) health technologies must be implemented in sensitive ways that recognize the local cultural setting; (ii) families, especially mothers, serve important functions in this regard; and (iii) most research on health is concentrated in industrial nations. Accordingly, healthcare delivery systems (called ‘national health research systems’ in the text) must be tailored to local conditions (pp 157-160). These findings strike this reviewer as fairly conventional, though no doubt salient points. At a time when edited books are increasingly criticized because the written word is not closely integrated among the various authors, one can only try to imagine how the editor thought that it would be any easier to ‘conversations’. At the integrate usual high price established by Westview, this book will best serve researchers if it is made available at a library. It does not seem to be a publication one might gather for her/ his own library. Health researchers will have to look elsewhere for a systematic and theoretically driven examination of the relationship between health and agricultural development. Joseph L. Scarpaci Virginia Polytechnic Institute and State University Mental Health and the Built Environment: More than Bricks and Mortar? David Halpern Taylor and Francis London (199.5) 240~~ ISBN 0 7484 0236 5 paperback
252
David Halpern gives us the story behind this book in an autobiographical section of the preface. As an architect, he found that the prevailing ethos of his profession emphasised aesthetics to the extent that students ‘. . . learned little or nothing of the potential social or behavioural consequences of design’ (p. vii). This disenchantment with a perceived failure of architects and planners to take seriously the link between the built environment and human health led Halpern to appraise the evidence and undertake his own research. The result is a book that is refreshing for both its clarity and comprehensive scope. The book is divided into eight chapters, the first of which establishes a thorough background for the survey. The author hypothesises at the outset that potential influences of the built environment on mental health are likely to be fourfold: ‘as a source of stress; as an influence over social networks and support; through symbolic effects and social labelling; and through the action of the planning process itself’ (p. 2). This hypothetical framework provides a structure for the remainder of the book. Commendably, Halpern does not take for granted the construct ‘mental health’. As with a host of terms used throughout the study, careful definitions of mental health are provided, with ample referencing which might serve as a resource for the reader wishing further backgrounds. Halpern demonstrates a sophisticated understanding of psychology and psychiatry as well as the design professions. His discussion of rating scales is particularly helpful, reminding the novice that ‘being unhappy is a central, though not necessarily sufficient, aspect of psychological distress’ (p. 6). Such subtleties take on considerable importance as the book proceeds to appraise critically studies on the experience of housing environments. En route to that point in the book, Halpern surveys material familiar to readers of this journal: ‘psychiatric geographies’ and urban versus rural differences in mental illness. A particularly useful closing sec-
tion of the introduction reflects on the methodological quagmire of causation that besets the researcher in this field. As Halpern points out, there are many studies demonstrating association between built environments and mental health. their interpretation is However, obscured by issues of social selection and subjects’ response bias. He elucidates these problems crisply and presents methodological alternatives that are sufficiently refreshing to merit using the book as a research design resource as well as its more obvious function as a thematic survey. Subsequent chapters survey topics ranging from ‘classic’ environmental stressors such as noise (Chapter 2) to ‘social environmental stressors’ including crowding and fear of crime (Chapter 3). These surveys are thorough and highly readable. Social support and its relationship to both mental illness and the planned environment (through the generation of neighbouring) is surveyed in Chapter 4, with cited examples including both planned communities and doomed public housing projects such as Pruitt Igoe in St Louis. Chapter 5 focuses on more humanistic concerns: the power of meaning in the built environment as influencing mental health through the labelling and stigmatisation of areas and housing types. The potential for the planning process to affect mental health is surveyed in Chapter 6. Two influences are identified: an indirect effect (e.g. through the generation of traffic or population density), and a direct effect (e.g. through slum clearance and relocation of residents). Halpern focuses on the latter, adding analytical weight to Herbert Gans’ classic comment that a physical slum does not imply a social slum. It is at this stage of the book that the author includes largely unpublished data on the mental health effects of planning interventions, for ‘in order to demonstrate conclusively the relevance of the planning process per se to mental health, it must be shown that a planning decision can have an impact on residents’ mental health even in the absence of actual physical