Globalizations Influence on Public Health Discussion

Globalizations Influence on Public Health Discussion ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Globalizations Influence on Public Health Discussion Hello, I need help with my public health discussion post and discussion response. They are due Thursday night. The assignment is straight forward, read the articles that I have attached and summarize them. I have attached the article and the assignment guidelines in the pdfs. I have also attached the discussion post that you will respond too. Let me know if you have any further questions. Globalizations Influence on Public Health Discussion screen_shot_2020_12_01_at_2.39.12_pm.png screen_shot_2020_12_01_at_2.43.31_pm.png annurev_publhealth_031210_101225.pdf the_effect_of_fear_on_access_to_care_among_undocum.pdf PU32CH15-Labonte ARI ANNUAL REVIEWS 9 March 2011 20:17 Further Annu. Rev. Public Health 2011.32:263-283. Downloaded from Access provided by on 11/30/20. For personal use only. Click here for quick links to Annual Reviews content online, including: • Other articles in this volume • Top cited articles • Top downloaded articles • Our comprehensive search The Growing Impact of Globalization for Health and Public Health Practice Ronald Labonte?, Katia Mohindra, and Ted Schrecker Institute of Population Health, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada; email:,, Annu. Rev. Public Health 2011. 32:263–83 Keywords First published online as a Review in Advance on December 21, 2010 economic integration, trade, neoliberalism, global health diplomacy The Annual Review of Public Health is online at This article’s doi: 10.1146/annurev-publhealth-031210-101225 c 2011 by Annual Reviews. Copyright All rights reserved 0163-7525/11/0421-0263$20.00 Abstract In recent decades, public health policy and practice have been increasingly challenged by globalization, even as global ?nancing for health has increased dramatically. This article discusses globalization and its health challenges from a vantage of political science, emphasizing increased global ?ows (of pathogens, information, trade, ?nance, and people) as driving, and driven by, global market integration. This integration requires a shift in public health thinking from a singular focus on international health (the higher disease burden in poor countries) to a more nuanced analysis of global health (in which health risks in both poor and rich countries are seen as having inherently global causes and consequences). Several globalization-related pathways to health exist, two key ones of which are described: globalized diseases and economic vulnerabilities. The article concludes with a call for national governments, especially those of wealthier nations, to take greater account of global health and its social determinants in all their foreign policies. 263 PU32CH15-Labonte ARI 9 March 2011 20:17 INTRODUCTION: FROM INTERNATIONAL HEALTH TO GLOBAL PUBLIC HEALTH Consuela has just lost her job in a Mexican factory where she assembled 120 computer CPUs each hour for a contract manufacturer. She and her coworkers were actually employed by an agency offering “just-in-time” workers. Her job was stressful and unhealthy, but the income was important to her family. When the 2008 global ?nancial crisis spilled over into the real economy, she was dismissed Annu. Rev. Public Health 2011.32:263-283. Downloaded from Access provided by on 11/30/20. For personal use only. with a severance that was scarcely one-tenth of the legal minimum. Her husband, one of the millions of undocumented workers in the United States and Canada, is afraid of losing his weekday job in agriculture and his weekend job as a gardener, as rising unemployment rates fuel antimigrant sentiments. With no access to medical care, he is concerned that his worsening lung infection could be tuberculosis, but he is afraid to mention this even to his friends. He and Consuela still text-message each other every day, but if his remittances continue to drop they will no longer be able to afford even basic mobile telephone service. Consuela has no way to pay the out-of-pocket costs for her three children’s health care and schooling; partly because of the continuing ?scal policy constraints associated with a costly bailout of Mexican banks in the 1990s, Mexico’s efforts to extend social insurance across the nation have yet to reach her. She will also have to move soon. The building in which she has a small apartment has been sold, and the entire block will be torn down and redeveloped for tourist condominiums and townhouses for the growing numbers of (primarily American and Canadian) retirees seeking an affordable place in the sun. Consuela’s story is a stylized but evidencebased (71, 97, 117) account that weaves together many of the ways in which contemporary globalization is affecting public health (see sidebar, Global Flows). In keeping with dominant trends in the emerging ?eld of critical globalization studies (6), our emphasis in this article is on globalization as “[a] pattern of transnational economic integration animated by the ideal of creating self-regulating global 264 Labonte? · Mohindra · Schrecker markets for goods, services, capital, technology, and skills” (45). This de?nition does not assume away such phenomena as the increased speed with which information about new treatments, technologies, and strategies for public health can be diffused or the opportunities for political participation and social inclusion that are potentially offered by new forms of electronic communication. However, in contrast to simply descriptive accounts, we consider the economics of globalization to be its driving force.Globalizations Influence on Public Health Discussion The globalization of culture, for example, is inseparable from the emergence of a network of transnational mass media corporations that dominate distribution and content provision through the allied sports, cultural, and consumer product industries. Relatedly, global promotion of brands such as Coca-Cola and McDonald’s is both a cultural phenomenon and an economic one, driven by the opportunity to expand pro?ts and markets even as it contributes to the “global production of diet” (25), increasing obesity and its health consequences in much of the developing world. The Framework Convention on Tobacco Control, as a contrasting example, saw state and nonstate actors negotiate the ?rst international public health law, albeit one without enforcement measures, which aims to reduce the harms associated with a toxic product whose production and marketing are global in scale and scope (80). Economic interests in the global tobacco trade chipped away at its provisions, and the proliferation of bilateral investment treaties (which allow companies, including tobacco multinationals, to sue governments for infringements of the “intellectual property rights” of their logos through cigarette plain-packaging or warning-label requirements) could put a chill in governments’ compliance with its protocols (8, 99). The approach taken to situate public health policy and practice1 in their worldwide 1 It is useful to distinguish between public health practice (typically, the activities of public sector practitioners in the ?eld) and policy (the legislation, regulations and direction Annu. Rev. Public Health 2011.32:263-283. Downloaded from Access provided by on 11/30/20. For personal use only. PU32CH15-Labonte ARI 9 March 2011 20:17 context has historically shifted between two conceptual positions: international and global (14). The ?rst was driven by the concern of wealthier nations with disease risks in poorer countries. Its origins extend back to medieval efforts to halt the spread of infection that accompanied the movement of goods and people. In the context of an earlier wave of globalization in the mid- to late-nineteenth century, many colonial governments and corporate philanthropies began to fund basic public health measures in developing countries as a way to counteract the spread of infectious disease (13). Motivations were complex, embracing political and economic interests, reducing cross-border contagion or risks to colonizer-country nationals working abroad, and faith-based ideals of charity or missionary-led conversion. Similar interests underpin, at least in part, the contemporary rise of health in foreign policy discourse, but with a shift in nomenclature to “global health.” Koplan and colleagues (72) trace global health’s “fashionable” status to a fusion of international health’s disciplinary base in tropical medicine with public health’s roots in population-wide intervention and social reform. However, contemporary concern with global health also has strong connections with social movements concerned primarily with the effects of market-driven (neoliberal) global economic policies, notably those associated with extended intellectual property rights (and their negative impact on access to essential medicines), increased commercialization/cost-recovery in health care systems (promoted by the World Bank and the International Monetary Fund in the wake of structural adjustment programs of the late 1980s and early 1990s), and increased pressures for trade openness (which can reduce the policy from superiors that de?ne the universe of actions available to practitioners). Public health policy in the context of this chapter also, however, includes a variety of activities outside the health sector, for instance including choices related to trade, investment, and migration. space and capacity for public health reforms, affecting low-income countries in particular). Regardless of origins, two axioms distinguish global health as a conceptual basis for research, policy, and practice from its international predecessor: recognition of global Global flows: Globalization is associated with a number of ?ows that have direct and indirect effects on health. Increased pathogen flows: Whether it is the risk of drug-resistant tuberculosis or pandemic in?uenza, the movement of people means the transport of pathogens. SARS was a wake-up call to a somnambulant public health community and the spark for new International Health Regulations and multilateral health collaborations. Global trade, another ancient vector of disease, poses other health risks, from the spread of pests to that of pestilence: It was a freighter’s dumping of infected bilge waters that caused the Latin American cholera pandemic of the 1990s (73).Globalizations Influence on Public Health Discussion Increased information flows: Advances in computing and telecommunications have shaped modern globalization, increasing the spread of health knowledge and technological innovation, the reach of multinational ?rms, and the rise of contesting social movements. But despite the global spread of interconnectivity, access to the information superhighway remains highly skewed. Most people in high-income countries are connected, but scarcely 1 in 100 Africans are (119), where the costs of broadband access (adjusted for per-capita income) can be 170 times greater than in the United States (128). Increased trade flows: The accelerated ?ow of traded goods and services enabled by economic integration has created new sources of wealth and health for some. But patterns of production and exchange, along with labor market changes, have left many vulnerable to employment insecurity, insuf?cient health and safety protections, and environmental degradation. In addition, the energy requirements of global production chains, and the fossil fuels used in transportation, are now among the fastest-growing sectoral contributors to climate change emissions (84). • Globalization and Public Health 265 PU32CH15-Labonte ARI 9 March 2011 20:17 Increased financial flows: Foreign direct investment (FDI) and the more recent rise of outsourced contract production have reorganized production across national borders, in the process creating a genuinely global labor market that increases economic inequality and the insecurity of many workers. FDI ?ows have now been dwarfed by shortterm ?nancial ?ows, with far-reaching consequences not only for health but for the power to implement policies that protect and enhance health. Annu. Rev. Public Health 2011.32:263-283. Downloaded from Access provided by on 11/30/20. For personal use only. Increased people flows: Migration, long a de?ning feature of globalization and the pursuit of greater opportunity, is driven increasingly by economic and environmental necessity (121). Rich-country borders remain open to the best and the brightest but are revolving doors for workers with limited credentials, especially in the wake of the 2008 global recession. economic interconnectedness as both cause and consequence of the distribution of international disease burdens, and a parallel recognition that many of the pressing health issues facing nations are now inherently transnational if not global, not only because of cross-border disease threats, but also because conditions of life and work that increase vulnerability to disease and affect access to preventive and treatment services are inseparable from global distributions of power, wealth, and resources (78). A further dimension is added by the expansion of research on social determinants of health (SDH), much of which was consolidated in 2008 by a World Health Organization commission on the topic (30; see also the article by Marmot & Friel in this volume (50)]. The insight that people’s health is affected by their conditions of life and work is hardly new; public health activism around these conditions has a long if episodic history dating back at least to the Industrial Revolution. However, expansion of the evidence base means that public health policy and practice must now respond to the multiple channels of in?uence that connect global forces and processes to health by way of the SDH (15, 76). We return to this point later in the article. 266 Labonte? · Mohindra · Schrecker GLOBALIZATION’S NEW CHALLENGES TO PUBLIC HEALTH Although many SDH exist, in the global context “the most devastating problems that plague the daily lives of billions of people . . . emerge from a single, fundamental source: the consequences of poverty and inequality” (96, p. 12). Over the long term and with considerable variation at any given income level, richer societies are healthier (35, 126), whereas poverty, however de?ned, remains one of the most important contributing conditions to ill health. Globalizations Influence on Public Health Discussion Thus, if globalization could be shown to be reliable and effective in increasing growth rates and reducing poverty, setting aside for the moment the health-negative environmental impacts of such growth, then measures to promote globalization, such as trade liberalization, should be embraced for their health bene?ts (47). The evidence that globalization contributes either to economic growth or to poverty reduction, however, is at best equivocal, depending inter alia on how one assesses the extent to which national economies have been integrated into the global marketplace, how poverty is de?ned, and how many uncertainties about data quality one is willing to live with or overlook (68). Even globalization’s enthusiasts concede that there may be substantial numbers of losers within national economies, notably as a consequence of changes in labor markets. In the past quarter-century of rapid economic integration, although the size of the global work force doubled as India, China, and the transition economies opened their borders to trade and investment, progress toward poverty reduction in low- and middle-income countries was modest. According to World Bank analyses, between 1981 and 2005 the number of people living in extreme poverty declined by 505 million (24). This decline is accounted for entirely by economic growth in China, where half of the poverty reduction occurred before that country embraced domestic or global market reforms (23). Excluding China, extreme poverty increased by 123 mil- Annu. Rev. Public Health 2011.32:263-283. Downloaded from Access provided by on 11/30/20. For personal use only. PU32CH15-Labonte ARI 9 March 2011 20:17 lion between 1981 and 2005, with decreases in poverty in some countries offset by greater increases in others. Nor did economic growth necessarily lift people very far: The number of people living on incomes below a less extreme de?nition of poverty rose by 402 million— 745 million excluding China—over the same period to 3.2 billion, or roughly half the world’s population (see Figures 1 and 2). As one senior World Bank development economist concluded, “it is hard to maintain the view that expanding external trade is . . . a powerful force for poverty reduction in developing countries” (101). It is also worth noting that povertyreducing growth in China—and in some other countries such as Vietnam—coincided with the rapid marketization of health care provision, leading to dramatic declines in access and affordability (41, 107, 115, 123), and much of the progress in development and poverty reduction that occurred over the period in question may have been undone by the recession that began in 2008 as a direct consequence of the interconnectedness of global ?nancial markets. Economic growth and poverty reduction are not the whole global health story. The global diffusion of new health knowledge and technologies may have done more to improve health status in developing countries in the last half of the past century than did economic growth per se (37). Many of these innovations originated in wealthy countries, and “in this sense, the ?rst world has been responsible for producing the global public goods of medical and health-related research and development from which everyone has bene?ted, in poor and nowrich countries alike” (36, p. 99). This transfer of knowledge is now compromised by the extension of intellectual property rights held mostly by ?rms based in high-income countries. Newly available employment opportunities for women in export-oriented industries provide opportunities for them to earn income outside patriarchal social structures and are another claimed, if indirect, health bene?t of globalization. But employment conditions in such industries are often so directly destructive of health, partly because of retailers’ relentless pressure to cut costs and deliver new products quickly (2, 3, 5), that—in the case of Bangladeshi garment factories, for instance—“it would not be possible to undertake such work for an extended period of time” (67). An innovative econometric exercise carried out as background research for the Commission on Social Determinants of Health, using data from 136 countries, helps in assessing the overall impact of globalization. Cornia and colleagues (32) described ?ve main in?uences on mortality: material deprivation, psychological stress, unhealthy lifestyles, inequality and lack of social cohesion, and technical (i.e., medical) progress. They then identi?ed a range of variables that affect these in?uences, classifying the variables as (a) related to policy choices made in the context of globalization (e.g., income inequality, immunization rates); (b) endogenous, and therefore unrelated to globalization for purposes of the analysis (medical progress); or (c) describable as “shocks” (e.g., wars and natural disasters, HIV/AIDS). The ?nal stage of analysis was a simulation that compared trends in life expectancy at birth (LEB) over the period 1980–2000 with those that would be predicted based on a counterfactual in which trends in all the relevant variables remained at the 1980 value or continued the trend they followed over the pre-1980 period. Thus, investigators assumed in the counterfactual (for instance) not only that income distribution within countries, one of the globalization-related variables, did not change over the period 1980–2000, but also that no progress occurred in medical technology and that HIV incidence remained at its 1980 level. The results of this simulation indicated that, on a worldwide basis, over the period 1980–2000 globalization canceled out most of the progress toward better health (as measured by LEB) that occurred as a consequence of diffusion of medical progress, and the effects of shocks (wars, natu … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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