344 Book Reviews

systems. There are some minor deficiencies in presentation. For example, there is some repetition between contributions which is not always con- sistent, as in the figures quoted on pages 39 and 107 for the number of fatalities and properties damaged in the 1974 Brisbane flood. The standard of the in-house publication is generally satis- factory, although several maps (notably Fig. 11) are over-reduced and there is no index. However, these are trivial matters when set alongside the merits of this highly practical collection of papers which deserves to enjoy a wide circulation amongst all those with interests in this important method of flood damage reduction.

K. Smith Department of Environmental Science, University of Sliding

Pacione, M. (ed.) Medicalgeography:progress and prospecf. London: Croom Helm, 1986. 337 pp. f27.95 hardback.

The great expansion in the scope and applications of medical geography during the past decade or so has made an assessment of progress timely. Medicalgeography:progress andprospect, another in the Croom Helm ‘Progress in Geography’ series under editor Michael Pacione, is an effort to satisfy this need.

An introduction by Pacione precedes nine essays by some of the most respected workers in the field. Although deemed ‘original’, several of the nine essays rely heavily on the authors’ previously published work and Howe’s disease maps, the disease diffusion models of Cliff and Haggett and the planning applications of Clarke and Wilson should be readily familiar to most readers.

Clearly, there are problems in integrating the increasingly diffuse subject of medical geography as Barrett’s lead-off essay shows. His attempt to define and interrelate the many branches of the subject leads to a set of rather categorical definitions which do not fit this highly eclectic subject comfortably.

A familiar chapter on the history and current use of disease mapping by Howe follows. There is rather too much history here with only a sparse coverage of contemporary cartographic software and no mention at all of probability mapping. Mayer’s essay on ecological association is lucid and comprehensive and this is followed by a well- illustrated chapter by Cliff and Haggett on disease diffusion, based largely on their classic work on measles epidemics in Iceland, but with the more complex mathematics filleted out.

The four following essays are in better sequence. Starting with Rosenberg’s broad survey of national health systems (mainly those of USA and UK), Whitelegg’s analysis of the spatial patterning of

health facilities and Phillips’s consideration of demand and utilization factors, the sequence ends with Clarke and Wilson’s operational planning models which apply many of the features referred to by the three preceding authors to the rationaliza- tion of Britain’s health services.

The final essay covers medical geography and the third world, a somewhat daunting task to which Hellen applies himself with dedication, redressing the substantial Anglo-American bias of some of the earlier essays with a hearty endorsement of the less- accessible German literature on the subject. Hellen covers both disease contribution and health care studies, providing (like Phillips earlier) an extensive list of references. While this chapter is a major effort, one wonders whether it would not have been more informative if it had also addressed the more radical approaches emerging in the medical geo- graphic work in the tropics, which afford a better opportunity for integrating disease, nutrition and health-care provision (e.g. Stock 1986).

Medical geography: progress and prospect certainly illuminates the changes which the subject has undergone since the 1960s (e.g. McGlashan 1972) and 1970s (e.g. Pyle 1979) and provides a good cross-section of contemporary work in the subject. However, in the end, the whole is not much more than the sum of the parts and the ‘prospect’ part of the title is a misnomer, relegated to a few words in the final paragraphs of some of the essays, although a final chapter of the ‘review and prospect’ nature might have saved the day. Further, the book, its text photo-reduced from word-processed output, is not an elegant object and has not been well edited or proof-read. Spelling errors and typos abound-there are five in Pacione’s own introduction-and a horrific 105.word sentence appears in Hellen’s contribution (pp. 29667). For f28 a better standard of product should have been forthcoming.

In conclusion, while the volume contains much valuable and well-written material, and will probably find heavy reference in the departmental libraries, it is poorly integrated and gives little guidance to the probable future development paths of medical geography.

McGlashan, N. D. (ed.) (1972) Medicalgeography, techniques and field studies. London: Methuen.

Pyle, G. F. (1979) Applied medical geography. Washington: Winston/Wiley.

Stock, R. F. (1986) ‘Disease and development’ or ‘the underdevelopment of health’: a critical review of geographic perspectives on African health problems. Social Science and Medicine 23(7), 689-700.

Alan Ferguson Ministry of Health, GTZ Support/Division of Family Health, Nairobi, Kenya