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272 hard tourism
attract customers, negotiate the traditionality of
handicrafts as they blend and juxtapose product
features for a tourism market.
Further reading
Cohen, E. �1992) `Tourist arts', in C.P. Cooper and
A. Lockwood �eds), Progress in Tourism, Recreation
and Hospitality Management, London: Belhaven
Press, vol. 4: 3±32. �A review of literature of
handicraft objects produced for the tourism
market.)
ÐÐ �ed.) �1993) special issue of Annals of Tourism
Research 20�1). �Eleven articles are devoted
exclusively to tourist arts.)
Graburn, N. �ed.) �1976) Ethnic and Tourist Arts:
Cultural Expressions from The Fourth World, Berkeley,
CA: University of California Press. �Contains an
early scholarly work on ethnic art and linkages to
commoditisation and tourism.)
Littrell, M. A. �1990) `Symbolic significance of
textile crafts for tourists', Annals of Tourism
Research 17: 228±45. �Discusses a content analysis
of international tourists' perceptions of inherent
symbolism in textile craft objects purchased for
self-consumption.)
Swain, M.B. �1993) `Women producers of ethnic
art', Annals of Tourism Research 20: 32±51.
�Explores gender issues and the production of
ethnic arts in global capitalism environment.)
hard tourism
JOSEPHINE M. MORENO, USA
MARY A. LITTRELL, USA
Hard tourism refers to development primarily
focused on quick economic returns. It is characterised
by large numbers of tourists seeking
replication of their own culture in institutionalised
settings, with little authentic cultural or environmental
interaction with the host. The term is often
used as a synonym for mass tourism, and an
antonym to soft tourism.
ROSS K. DOWLING, AUSTRALIA
health
In 1976 the World Health Organisation defined
health as `a complete state of physical, mental and
social well-being, not just the absence of disease
or infirmity.' In spite of this long-standing definition,
health in relation to tourism has been
researched largely from the perspective of `tourist
illness'. This fails to recognise the full extent of
tourism and health issues by limiting attention to
both a negative �illness) orientation and visitororiented
focus. Some research has explored the
concept involving destinations with perceived
health benefits, such as spas, and forms of special
interest tourism in which the tourist is actively
seeking improved health. Limited work has also
focused on the positive concept of the value of
tourism per se, to enhance good health and quality
of life for both host and guest.
Health and tourism require a more rigorous
connection to contemporary approaches to an
expanding new ecological public health. Adoption
of this paradigm broadens the framework for
discussion of ecologically sustainable tourism.
It augments the emphasis on economic
considerations to a much broader range of
variables, such as quality of life of the host
community, the well-being of tourists, and
interactions of human health and the natural
environment. The sustainable tourism debate
has recognised the importance of natural and social
environments as underpinning economic viability
of the industry, but the debate has largely neglected
health as integral component.
Most research listed under tourism and health
where the latter is equated with illness originates in
either of two disciplinary backgrounds. The first
group, medical investigators interested in the
epidemiology of tourism-related disease, rarely
differentiate between tourists and others. There
has developed a specialised field of travel medicine,
emporiatrics, with its own enterprises, professional
associations, journals and regular conferences. A
second and broader group of social scientists have
demonstrated their interests in the relationship of
tourism-related illness to motivation and experience.
These researchers generally have little
background in public or community health. Each
group places their primary focus on illness and its