CSS Geography Political, Tourism and Medical Geography Syllabus

Define a 'buffer state' and give an example.

A small, usually neutral state lying between two larger, potentially rival powers, reducing the chance of direct conflict. Historical examples include Afghanistan between the British and Russian empires, and Mongolia between Russia and China.

What is the core claim of Halford Mackinder's Heartland Theory (1904)?

That the 'Pivot Area' or Heartland (interior of Eurasia) is the key to world domination. His dictum: 'Who rules East Europe commands the Heartland; who rules the Heartland commands the World-Island; who rules the World-Island commands the World.'

What is the central thesis of Nicholas Spykman's Rimland Theory?

That the 'Rimland' (the coastal fringe of Eurasia surrounding the Heartland), not the Heartland, holds the key to world power: 'Who controls the Rimland rules Eurasia; who rules Eurasia controls the destinies of the world.'

What is Alfred Thayer Mahan's central argument on geopolitics?

In 'The Influence of Sea Power upon History', Mahan argued that control of the seas (naval power, merchant fleets and overseas bases) is the decisive factor in national power and global dominance.

Define 'geopolitics'.

The study of how geography (location, resources, territory, distance) influences politics and international relations, especially the power rivalry among states over space and strategic advantage.

What is 'world systems theory' (Wallerstein), and its three structural zones?

A theory that the world economy is a single capitalist system with a global division of labour, divided into the Core (wealthy, industrialised, dominant), the Periphery (poor, dependent, exporting raw materials), and the Semi-periphery (intermediate, exploited by the core but exploiting the periphery).

What is meant by 'uneven development' in political-economic geography?

The systematic tendency of capitalism to concentrate wealth, investment and growth in certain regions (cores) while underdeveloping others (peripheries), producing persistent spatial inequalities at global and regional scales.

Define 'globalization of capital'.

The increasing worldwide mobility and integration of financial capital and investment, where money, production and finance flow across borders, often via transnational corporations and global financial markets, integrating national economies into a single global capitalist system.

What is a 'transnational corporation' (TNC) and why is it central to globalization of capital?

A firm that owns or controls production, services or assets in more than one country. TNCs are central because they organise global production networks, move capital and investment across borders, and shape patterns of uneven development.

What is the 'new international division of labour' (NIDL)?

The relocation of manufacturing and labour-intensive production from developed core countries to lower-wage peripheral/developing countries, while core countries retain higher-value functions (R&D, finance, management), facilitated by TNCs and globalization.

Define tourism (UNWTO sense).

The activities of persons travelling to and staying in places outside their usual environment for not more than one consecutive year, for leisure, business or other purposes not related to an activity remunerated from within the place visited.

Distinguish between tourism and recreation.

Recreation refers to leisure activities undertaken during free time, often locally and without overnight stay. Tourism specifically involves travel away from one's usual environment, typically including at least one overnight stay; tourism is essentially recreation that involves travel.

In the tourism system, what is the difference between 'pull' factors and 'push' factors of demand?

Push factors are internal motivations that drive a person to leave home (need for escape, rest, prestige, exploration). Pull factors are external attractions of a destination that draw the tourist (climate, scenery, culture, attractions, price).

What is 'effective demand' versus 'suppressed demand' for tourism?

Effective (actual) demand is the number of people who actually participate in tourism. Suppressed demand is those who do not travel; it is split into 'potential demand' (will travel when circumstances change, e.g. more income/time) and 'deferred demand' (held back by supply problems like lack of facilities).

List the main determinants of tourism demand.

Disposable/discretionary income, amount of leisure time (paid holidays), price of the trip, demographic factors (age, family stage), education, mobility/transport, motivation and lifestyle, and exchange rates.

What is the difference between intrinsic and extrinsic motivation in tourism demand?

Intrinsic motivation comes from within the individual (personal desire for relaxation, adventure, self-development). Extrinsic motivation arises from external influences (advertising, social pressure, fashion, recommendations).

What are the four main components of the 'supply' side of tourism (the 4 A's)?

Attractions, Accessibility (transport), Amenities (accommodation, food, facilities), and Ancillary services (marketing, booking, support). These are sometimes extended to include Activities and Available packages.

Distinguish between primary (natural) and secondary (built) tourism resources.

Primary resources exist independently of tourism, mainly natural attractions (climate, scenery, beaches, wildlife) and some cultural heritage. Secondary resources are purpose-built or developed for tourists (hotels, resorts, theme parks, transport infrastructure).

What is 'carrying capacity' in tourism?

The maximum number of visitors a destination can accommodate before unacceptable deterioration occurs in the physical environment, the quality of the visitor experience, or the host community's well-being. It includes physical, ecological, social and psychological dimensions.

Describe the stages of Butler's Tourism Area Life Cycle (TALC) model.

Exploration, Involvement, Development, Consolidation, Stagnation, and then either Decline or Rejuvenation. The model traces visitor numbers over time as a destination evolves and approaches its carrying capacity.

What is the 'multiplier effect' in tourism economics?

The process by which initial tourist spending circulates through the local economy, generating additional rounds of income, output and employment as money is re-spent. The tourism multiplier measures the total economic impact relative to the original spend.

What is 'leakage' in tourism economics?

The portion of tourist expenditure that does not remain in the destination economy but flows out, e.g. to pay for imported goods, foreign-owned hotel profits, and expatriate wages. High leakage reduces the net economic benefit, especially in developing countries.

List the main positive and negative economic impacts of tourism.

Positive: foreign-exchange earnings, employment, income, multiplier effects, infrastructure development, and regional development. Negative: economic leakage, seasonality of jobs, over-dependence on one sector, inflation of local prices, and opportunity costs of investment.

Give two positive and two negative socio-cultural impacts of tourism.

Positive: revival/preservation of local culture and crafts, and greater cross-cultural understanding. Negative: commodification of culture and loss of authenticity, and social problems such as crime, the 'demonstration effect', and erosion of traditions.

What is the 'demonstration effect' in tourism?

The tendency of local residents, especially the young, to imitate the consumption patterns, behaviour and values of visiting tourists, which can erode traditional culture and create discontent.

List key negative environmental impacts of tourism.

Pollution (air, water, noise, litter), depletion of natural resources (water, energy), habitat and ecosystem destruction, soil erosion and trampling, loss of biodiversity, and visual/aesthetic degradation of landscapes from overdevelopment.

Define 'sustainable tourism'.

Tourism that meets the needs of present tourists and host regions while protecting and enhancing opportunities for the future; it manages resources so that economic, social and aesthetic needs are met while maintaining cultural integrity, ecological processes and biodiversity.

Define 'medical geography' (geography of health).

The branch of human geography that applies geographic concepts and techniques to study health, disease and health care, examining the spatial patterns of diseases and their environmental, social and economic causes, plus the distribution of health services.

What is the difference between 'disease ecology' and 'health-care geography', the two main branches of medical geography?

Disease ecology (geography of disease) studies the spatial distribution and environmental causes of disease and how humans interact with their environment to produce illness. Health-care geography studies the spatial distribution, planning, accessibility and delivery of health-care services.

Distinguish between an endemic, an epidemic, and a pandemic disease.

Endemic: a disease constantly present in a population or region at a relatively stable rate (e.g. malaria in parts of Africa). Epidemic: a sharp rise in cases above normal in a community or region. Pandemic: an epidemic that spreads across countries or continents affecting very large populations (e.g. COVID-19).

Distinguish between morbidity and mortality.

Morbidity is the incidence or prevalence of disease/ill-health in a population (how many are sick). Mortality is the incidence of death in a population (how many die), usually expressed as death rates.

What is the 'epidemiological transition' model?

Omran's model describing the shift, as countries develop, from a society dominated by infectious/communicable diseases and high mortality (Age of Pestilence and Famine) to one dominated by chronic, degenerative and lifestyle diseases with low mortality (Age of Degenerative and Man-Made Diseases).

Distinguish between communicable and non-communicable diseases, with examples.

Communicable (infectious) diseases are caused by pathogens and can spread from person to person or via vectors (e.g. tuberculosis, malaria, COVID-19). Non-communicable (chronic) diseases are not transmissible and develop over time (e.g. heart disease, cancer, diabetes).

What global pattern characterises the burden of communicable versus non-communicable diseases between developing and developed countries?

Developing/low-income countries bear a higher burden of infectious and communicable diseases (malaria, TB, diarrhoeal disease) plus maternal/child mortality, whereas developed/high-income countries are dominated by chronic non-communicable diseases (cardiovascular disease, cancer, diabetes) linked to lifestyle and ageing.

What was John Snow's contribution to medical geography?

In the 1854 London cholera outbreak, John Snow mapped cholera deaths and traced them to the Broad Street water pump, demonstrating that cholera spread through contaminated water. His use of spatial mapping is a foundational example of medical geography and disease cartography.

What is the 'disease triangle' (epidemiological triangle) model in medical geography?

A model explaining disease causation through the interaction of three components: the Agent (pathogen/cause), the Host (the susceptible person), and the Environment (external conditions favouring transmission). Disease results when these three interact, often with Time as a fourth factor.

What is a 'disease diffusion' model, and name its two basic types?

A model describing how disease spreads across space and time. The two basic types are Expansion diffusion (the disease spreads outward from a source while the source remains affected) and Relocation diffusion (the disease moves with migrating people, leaving the origin).

Distinguish between contagious diffusion and hierarchical diffusion of disease.

Contagious (expansion) diffusion spreads through direct contact among nearby people, strongly distance-dependent (e.g. an outbreak spreading to neighbours). Hierarchical diffusion spreads through an ordered sequence of places, typically from large cities to smaller ones (or through influential people), skipping intervening areas.

What is the gravity model as applied to medical/health-care geography?

A model predicting interaction (e.g. patient flows to a hospital) as directly proportional to the size/attractiveness of the facility and population, and inversely proportional to the distance (or distance squared) between them, reflecting 'distance decay' in health-care utilisation.

What is 'distance decay' in the context of access to health care?

The principle that the use of a health-care facility declines as the distance between the patient and the facility increases; people who live farther from services tend to use them less, contributing to spatial inequalities in health-care access.

What does the WHO mean by 'health', and how does this broaden medical geography?

The WHO defines health as 'a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.' This broadens medical geography beyond disease mapping to include social determinants, well-being, and the geography of health-care provision.

What are the 'social determinants of health'?

The non-medical conditions in which people are born, grow, live, work and age that shape health outcomes, including income and social status, education, employment, housing, sanitation, access to services, and the wider social and physical environment.

What is the concept of 'GIS in medical geography' and one key application?

Geographic Information Systems (GIS) are computer-based tools to capture, store, map and analyse spatial health data. A key application is disease surveillance and mapping, identifying disease clusters/hotspots, modelling spread, and planning the optimal location of health facilities.

Name one recent issue/development in medical geography related to global pandemics.

The COVID-19 pandemic (2019-onwards), which revived medical geography's use of real-time spatial mapping, GIS dashboards, disease-diffusion modelling, and analysis of spatial inequalities in infection, vaccine access and health outcomes.

What is meant by the 'globalization of disease' as a recent issue in medical geography?

The accelerated worldwide spread of diseases due to increased international travel, trade, migration and urbanisation, which allows pathogens to diffuse rapidly across continents (as seen with COVID-19, SARS, and HIV/AIDS), making local outbreaks potential global threats.

What is 'ecotourism' and how does it differ from mass tourism?

Ecotourism is responsible travel to natural areas that conserves the environment, sustains the well-being of local people, and involves education. It differs from mass tourism by being small-scale, low-impact, nature-based, and centred on conservation and community benefit rather than high-volume commercial development.