The relationships between the human health and space in the Aegean Region (the Goiter case)

Human is a creature that is in a constant interaction with his surroundings that he influences his surroundings and is also influenced by it. There is a connection between space and life quality. In spite of it has been known that there is a relation between its surrounding since Hippocrates, there have been different health problems. It is significant that to know the environment, that provides healthier and livable life.It?s try to explanation in goiter case how is the space effects the human health from physical environment and disease distribution. Although the goiter is one of the preventable diseases, 30 % of Aegean Region suffers from it. It means that goiter exist and one of serious disease in the region. Its try to answer that ?Are the natural environment conditions of Aegean Region can be an indicator factor for distribution of goiter?? There hasn?t any study in Turkey, about a distribution of any disease in a geographical region, it hasn?t monitories in a period, and it hasn?t considered the geographical factors so this study is not different the others but also important. The study is about the goiter because it has thought which can be affected by the features of the natural environment (geology, altitude, precipitation, soil etc.). The Aegean Region was set as the research area, as it is an area that people settle densely plus it contains various geographical surroundings and for being accessible easily. Goiter is called of thyroid enlargement. Goiter is not only a problem about neck esthetic but also it cause of serious health problems like hypo-thyroid, cretinism, thyroid cancer. Iodine deficiency is the most important cause of goiter. Also goiter can be preventing with some precautions.The registered goiter cases from 1997 to 2006 and environment features were examined in 97 districts with in Aegean Region Form 18A and the registers of Mid-Year Population Detection Form registers between the years 1997-2006 which were declared to the city health directorates were used. The number, prevalence and geographical allocation according to the standardized speed of the goiter cases registered between the years 1997-2006 in the districts with the borders of Aegean Region. The geographical distribution and natural factors of them are tried to determine. Descriptive method has been used as the data collection technique. However, the sample districts which were chosen for the drinking water analysis within the region were chosen with the intentional sampling method. The iodine proportion of the drinking water samples from the 14 districts in the region where the goiter prevalence is the most and the least, were sent to be analyzed. To display the natural environment features of the region 1/ 100 000 topographical, 1/ 500 000 geological and 1/ 800 000 soil maps were used. To display the climate characteristics data of the Turkish State Meteorological Service and some studies that had been made in the field were used. By using the health data obtained from the forms delivered to the province health directorates on the district basis, ?The distribution of goiter in the region? was mapped one of the Geographical Information Systems programs was used. Having composed a database related to the distribution of the disease with the program and prepared a data base for distribution of disease. Also the analysis has made on SPSS program for determine the geographical factors and goiter prevalence.When the goiter case number and prevalence distribution in the region is examined according to age and gender, the most registered goiters are seen in the 15-64 age groups and especially in the female population. When the goiter distribution in the Aegean Region is examined with respect to time, is not noticed that the number of goiter case increased considerably between the years 1997-2006. While goiter had been seen in İzmir, Kütahya, Manisa, Denizli, Muğla, Afyonkarahisar ve Uşak the most, in 2006 this order changed as İzmir, Denizli, Manisa, Muğla, Kütahya, Afyonkarahisar and Uşak. When the prevalence of goiter cases registered between 1997-2006 in the region are checked, it has been seen that while in1997 it was at a pretty low rate between 0,08- 0,01 and under %1 in all provinces, in 2006 especially the female cases increased. When the standardized speed related to age in the provinces of the region is checked, the spread of 1997 as 0,01-0,14 reached to 0,17- 1,64 in 2006 has been seen. The most increased prevalence has been in Denizli and the least in Muğla. The causes of the increase can be raising population, improvement health, industrialization and pollution etc.Goiter cases are more common especially in volcanic areas as Kula, Foça, Şaphane and Hocalar, when the Aegean Region is concerned with respect to the relation between natural environment conditions and goiter data. The goiter has been seen on different altitude. There is a not direct relationship between altitude and goiter but the altitude can effects other factors like precipitation. The salts in the soil remove with precipitation. For example Kemalpaşa has located on Nıf Mountain?s brae so the precipitation is higher than other districts. So the altitude and erosion can be affected on goiter indirect.There has not any clearly relationship between vegetation and goiter. When the Aegean Region is concerned with respect to the relation between soil and goiter distribution, it seen that the goiter common on volcanic and brown soils. Also the iodine amount had been analysis in the drink water in the region but there is not any relationship.At the end of the study, it is significant that to present the diseases distribution and to investigate the geographical factors? effects on for live healthier. It is claimed that it is essential to take precautions in keeping the registration related with health more detailed and based on address, providing standardization of all registers kept, preventing duplicates, providing easier access to the data. Besides, it will be mentioned that geographers need to make studies on Medical Geography area and healthier results will be obtained with an interdisciplinary method. Goiter is a disease that can be preventable. It is thought to be important to provide the usage of iodized salt more common and aware as goiter can be prevented. It is useful to examine to iodine amount in the water while analyzing drinking water and use iodized salt especially in volcanic fields and in the locations where goiter is common. Also it is thought that the relations in the natural environment can be displayed more clearly in case this kind of study is done in a narrower field and with a larger measure. Although there have been many studies made in the field, there has been not enough study in the field of Medical Geography make letting this one. It is wished to be a guide to the ones who will make studies in this field.Key Words: Medical Geography, Goiter, Iodine, Aegean Region, GIS