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Globalization and Health | Global Events | USA | Europe | Middle East | Asia Pacific
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Among those factors are the globalization of the economy, demographic change, and the rapidly rising costs of health care in all countries.
In a world where nations and economies are increasingly interdependent, ill health in any population affects all peoples, rich and poor. As global needs change, the responses of the international health agencies are also being critically reexamined a process that will in turn have consequences for health policies worldwide. This chapter shows that the world's nations the United States included- now have too much in common to consider health as merely a national issue. Instead, a new concept of"global health" is required to deal with health problems that transcend national boundaries, that may be influenced by circumstances or experiences in other countries, and that are best addressed by cooperative actions and solutions.
The chapter sets the scene by discussing some key problems and showing how they are bringing nations' health needs closer together. This increased movement of people and goods, occurring in a context of growing political instability, means that risks are being transferred too: for example, opportunities for the transmission of emerging and resurging infectious diseases have increased, and more people than ever before are exposed to substances from other countries that potentially affect their health, from food to tobacco and from weapons to banned drugs There are at least four routes for the international transfer or acquisition of health risks: 1 the movement of people; 2 the international exchange of both legal and illegal potentially toxic products and contaminated foodstuffs; 3 the variance in environmental and occupational health and safety standards; and 4 the indiscriminate spread of medical technologies.
Since , the number of refugees and persons displaced within their own countries by war, environmental crisis, or economic collapse has increased by over 60 percent, from approximately 30 million to 48 million Toole, A reported More people than ever before are exposed to substances from other countries that potentially affect their health, from food to tobacco and from weapons to banned drugs.
Even though the majority of people affected by infectious diseases are in the developing world, all nations, even the richest, are susceptible to the scourges of infection.
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In the past two decades dozens of new diseases or new forms of old diseases have been identified see Table for some examples. HIV, estimated to infect some 23 million people worldwide WHO, c , is by far the most important of the new infections, both globally and in the United States. Older diseases including tuberculosis, dengue, malaria, and cholera-that had been partially controlled are resurging, considerably increasing the burden of disease, and exacerbated in some cases by the spread of drug-resistant strains.
The emergence and reemergence of infectious diseases in the United States and abroad pose serious challenges to our detection and surveillance systems.
Globalization and Health
As people travel and international trade and telecommunications increase, toxic products, both legal and illegal, reach wider markets. Tobacco and alcohol use are promoted by worldwide marketing campaigns, which frequently originate in the United States.
Every minute, 6 people die from smoking-related diseases. The use of baImed drugs has also increased in recent decades. The variance between the developed and the developing worlds in environmental and occupational health arid safety standards, as well as standards for such items as foods, drugs, vaccines, and medical devices, creates serious heals risks for everyone. The variance encourages multinational corporations to site their hazardous production facilities in developing nations that lack or do not enforce strict regulations.
In this way, corporations avoid the stringent environmental and occupational regulations of the developed world. The developing countries can further be divided into subgroups such as the poorest developing countries 46 nations and the heavily indebted poor countries 15 countries.
Industrial country: one of the developed countries. Although many health technologies are highly beneficial, some create adverse health effects and require unnecessary financial expenditures IOM, b.
ipdwew0030atl2.public.registeredsite.com/420706-mobile-phone.php Yet the regulation of imported technology at the national level is usually fragmented, ineffective, and focused primarily on pharmaceutical products. There have been efforts over the years either to develop common international standards for the regulation of health technologies or to bring the various national standards into closer alignment, both in the pharmaceuticals industry and in medical devices and technologies. This is the global demographic transition, marked by declining fertility and the aging of populations.
As populations age, the relative burdens of health problems that predominate among adults such as depression, heart disease, and cancers-gradually increase, as the burdens of those that predominate among children gradually decrease. While the developed regions experienced this "health transition" earlier this century, it is now well under way in developing countries. Within the next 25 years, therefore, it is expected that the dominant health problems of the majority of the world's population will rapidly come to resemble those of the industrialized nations today.
Heart disease and depression are set to become the hNO most important causes of disease burden worldwide by The idea that noncommunicable diseases are linked to affluence is thus rapidly losing credibility: the dominant diseases of Latin America or the nations of China and India are increasingly like those ofthe United States. Adults in developing regions are already suffering a heavy burden of noncommunicable diseases, even though this has traditionally been overlooked.
In the developing regions as a whole, almost one-tenth of the total burden of disease is contributed by mental health problems such as depression, schizophrenia, epilepsy, and suicide. Alcohol-related problems are estimated to affect between 5 and 10 percent of the world's population.
Alcohol and illicit substances tend to be associated with increased violence, itself a major cause of death and disability. Developing nations are struggling to meet the challenges that these diseases pose for their health systems, even as they continue to grapple with an unfinished agenda of deadly infections, malnutrition, and poor reproductive health Frenk et al. The added burden on their already stretched health systems is likely to create further strains on their economies, with possible consequences for their growth and for international trade.
One DALY is equivalent to one lost year of healthy life. Studies have shown, for example, that the cost of an average case of malaria in Sub-Saharan Africa is equivalent to about 12 days of productive output; the total cost of malaria in for the region was estimated at 1 percent of gross domestic product WHO, b. The United States is the poorer for the poverty of the rest of the world. More than one-fifth ofthe world's population lives in extreme poverty. Almost a third of all children are undernourished, and up to 2. In addition, the gap between rich and poor is increasing.
Much of this can be blamed on poverty.
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Infant mortality rates in the developing countries, though falling, are still on average almost 10 times greater than in the industrialized countries WHO, b. And, every year, 7 million adults around the world die of conditions that could be inexpensively prevented or cured; tuberculosis alone causes 2 million ofthese deaths WHO, a. Women in the poorest countries and communities continue to suffer the health consequences of poor reproductive health and a lack of access to methods for limiting and spacing their families.
International survey data demonstrate that between and million women who would like to space or limit childbearing are not using modern contraceptives IOM, d.