Medical-Geographical Analysis of the Spatial Distribution of Diagnosed Morbidity in North Macedonia

Abstract

Medical geography provides an analytical framework for examining how spatial structures condition population health outcomes by situating disease patterns within their territorial contexts. Within this perspective, morbidity is understood as a spatially mediated phenomenon shaped by demographic composition, environmental exposure, infrastructural accessibility, and institutional capacity rather than as an exclusively biomedical expression. This paper advances an explicit theoretical proposition that spatial disparities in diagnosed morbidity are governed less by biological variability and more by regional differences in healthcare accessibility, demographic aging, and settlement structure. The study combines a medical-geographical conceptual framework with original spatial aggregation of official health statistics by planning regions in North Macedonia. The empirical component relies on regionally aggregated morbidity indicators, demographic structure data, and healthcare infrastructure distribution, analyzed through descriptive spatial comparison and correlation logic. Findings reveal pronounced regional differentiation in disease prevalence patterns, particularly between urbanized and peripheral regions, indicating that diagnosed morbidity reflects spatial visibility and institutional reach rather than epidemiological randomness. The paper contributes theoretically by conceptualizing disease distribution as an institutionally and spatially conditioned phenomenon, and empirically by providing territorially grounded evidence from a small healthcare system characterized by uneven infrastructural concentration.

Keywords: medical geography, spatial distribution of disease, morbidity, regional analysis, health geography, North Macedonia