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Visual epidemiology: Photographs as tools for probing street-level etiologies

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  • Cannuscio, Carolyn C.
  • Weiss, Eve E.
  • Fruchtman, Hannah
  • Schroeder, Jeannette
  • Weiner, Janet
  • Asch, David A.

Abstract

Epidemiologists and social scientists agree that place shapes health. But the model of "risk factor" epidemiology faces limits in explaining how neighborhoods, as complex systems, produce health or disease. This paper describes how visual methods can advance epidemiological inquiry. Drawing from the work of The Health of Philadelphia Photo-documentation Project (HOPPP), this paper asks the following question: how can visual methods inform the work of epidemiologists? The project was conducted in three contiguous neighborhoods that represent a steep socioeconomic gradient. Photographs served as a stimulus for probing the sources of health variation across neighborhoods. The project incorporated three visual data sources: 1) "outsider perspective" images gathered systematically by staff photographers on randomly sampled blocks; 2) "insider perspective" images taken by adult residents during their daily routines; and 3) collaborative images taken by staff photographers in partnership with local participants. During in-depth interviews, these photographs served as prompts to elicit residents' health concerns and beliefs regarding urban environmental causes of good and poor health ("street-level etiologies"). We found that visual methods generated etiologic insights regarding the production of urban health and illness. Photographs enabled systematic observation of urban neighborhoods by the research team; engaged urban residents as active agents in the search for the underlying causes of urban health disparities; and created a social bridge between researchers and urban residents.

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  • Cannuscio, Carolyn C. & Weiss, Eve E. & Fruchtman, Hannah & Schroeder, Jeannette & Weiner, Janet & Asch, David A., 2009. "Visual epidemiology: Photographs as tools for probing street-level etiologies," Social Science & Medicine, Elsevier, vol. 69(4), pages 553-564, August.
    • Handle: RePEc:eee:socmed:v:69:y:2009:i:4:p:553-564
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    2. Na’Taki Osborne Jelks & Timothy L. Hawthorne & Dajun Dai & Christina H. Fuller & Christine Stauber, 2018. "Mapping the Hidden Hazards: Community-Led Spatial Data Collection of Street-Level Environmental Stressors in a Degraded, Urban Watershed," IJERPH, MDPI, vol. 15(4), pages 1-15, April.
    3. Fusco, Caroline & Moola, Fiona & Faulkner, Guy & Buliung, Ron & Richichi, Vanessa, 2012. "Toward an understanding of children’s perceptions of their transport geographies: (non)active school travel and visual representations of the built environment," Journal of Transport Geography, Elsevier, vol. 20(1), pages 62-70.
    4. Switzer, S. & Guta, A. & de Prinse, K. & Chan Carusone, S. & Strike, C., 2015. "Visualizing harm reduction: Methodological and ethical considerations," Social Science & Medicine, Elsevier, vol. 133(C), pages 77-84.
    5. Cannuscio, Carolyn C. & Hillier, Amy & Karpyn, Allison & Glanz, Karen, 2014. "The social dynamics of healthy food shopping and store choice in an urban environment," Social Science & Medicine, Elsevier, vol. 122(C), pages 13-20.

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