PUBLIC HEALTH GEOSOCIOLOGY: A SOCIO-SPATIAL FRAMEWORK FOR UNDERSTANDING STRUCTURAL HEALTH INEQUALITIES

Abstract

Both social and spatial processes shape health inequalities, yet sociology and geography have traditionally 
examined these dimensions separately. This paper advances Public Health Geosociology as an integrative 
framework that combines the spatial insights of health geography, the structural analysis of medical sociology, 
and the evaluative tools of public health science. The framework is grounded in three propositions: space is 
socially produced, society is spatially structured, and health inequality is socio-spatially constructed. It shifts 
attention from merely identifying where disparities occur to explaining why they persist and how they are 
reproduced. Central to the framework is the concept of the Geography of Neglect, which explains how the uneven 
distribution of healthcare infrastructure and public investment systematically disadvantages peripheral 
populations. Drawing on evidence from Nigeria, sub-Saharan Africa, and comparable contexts, the paper 
demonstrates how distance, poverty, gender norms, social exclusion, and institutional weakness interact to 
transform geographic isolation into health exclusion. Methodologically, Public Health Geosociology advocates 
a triangulated approach that integrates spatial analytics, qualitative social inquiry, and epidemiological 
evaluation to capture the complex dynamics of health inequality. The framework introduces two key concepts: 
the Scale–Sociality Nexus, which highlights the limits of local social cohesion under conditions of institutional 
absence, and the Vaporization of Access, which describes the rapid decline in healthcare accessibility beyond 
critical distance thresholds. The paper argues that health outcomes in low- and middle-income countries are 
socio-spatial products of power, policy, and territorial organisation. Achieving Universal Health Coverage 
requires moving beyond space-blind approaches toward integrated strategies that address spatial, social, and 
institutional inequalities simultaneously.