Global Health Issues & Policies
This article discusses globalization, global stratification, and their relationship to global health issues and policies. Large numbers of people throughout the world face significant health challenges. Health is defined by the World Health Organization as being in “a state of complete physical, mental and social well-being” (WHO, 2009). Following a brief review of the basic sociological perspectives on global stratification, the relationship between a country's level of wealth and its government's ability to provide safe drinking water, good nutrition, and access to medicines and medical treatment is discussed, along with health issues such as unsafe abortion, sexually transmitted diseases, and other infectious diseases such as tuberculosis and malaria as well as HIV /AIDS.
Keywords Biotechnology; Dependency Theory; Globalization; Global Stratification; G8 Nations; HIV /AIDS; Infectious Diseases; International Division of Labor theory; Sexually Transmitted Diseases; Socialized Medicine; Universal Health Care; Unsafe Abortion; World Systems Theory
Global Health Issues
For much of the first half of the 20th century, global approaches to health focused on curing infectious diseases. Later in the century, developments in transportation technology exacerbated the transmission of infectious diseases, affecting more people on a global scale. The spread of disease was also accelerated by mass migrations caused by war, civil strife, hunger, and natural disasters. The industrialization of agrarian societies, coupled with the internationalization of trade, has led to some improvements in controlling infectious disease. Today, global health is considered political issue. It is concerned not only with infectious disease, but also chronic diseases, as well as environmental pollution, occupational health, injury prevention, war, and hunger. The entire international community is now a part of the effort to reverse poor health conditions (MacArthur, 2003).
In September 2000, world leaders from 189 countries gathered at the United Nations in New York for the Millennium Summit, which focused on facilitating economic growth and combating health challenges. As the United Nations Children’s Fund reported “as some countries look ahead to prosperity and global cooperation, many barely had a future, being mired in miserable, unending conditions of poverty, conflict and a degraded environment. Some 1.1 billion people still are forced to live on less than $1 a day, and 30 per cent of these are children. Even in the world's richest countries, one in every six children still lives below the national poverty line” (UNICEF, 2008, par. 2).”
Globalization, or the global expansion of trade, technology, transportation, communication, and culture, is beneficial to some populations, but harmful to others—namely, the disadvantaged and poor, threatening their health and well-being. Additionally, humanity faces significant challenges related to pollution, global warming, and atmospheric damage (Harris & Seid, 2004). The term global stratification refers to the division of the world’s population between those who are advantaged and those who are disadvantaged. In 2012, 6.6 million children under the age of five died of preventable causes such as pneumonia, diarrhea, and malaria, as well as from malnutrition, poor hygiene and lack of clean water. Millions of people die each year because they lack access to basic services, including vaccines, antibiotics, nutrition supplements, and insecticide-treated bednets.
In many of the world's poorest countries, the malaria parasite has become resistant to chloroquine, which has long been the standard frontline treatment (McKinnell, 2008). Over 8.5 million tuberculosis cases were diagnosed in 2012, mostly in African countries. HIV/AIDS remains a huge problem in sub-Saharan Africa and throughout the world. In 2012, an estimated 33.4 million people worldwide were living with HIV/AIDS. Approximately 97 percent of these cases are in low and middle-income countries, many of which are in Sub-Saharan Africa. An estimated 2 million people are living with HIV in Latin America, in addition to 4.7 million in Asia and 1.5 million in China.
Poor countries face serious challenges related to unequal health care. Private health insurance is essentially non-existent. The majority of health insurance companies will not reimburse for care in developing countries and health professionals often migrate from poor countries to rich countries, impacting the global health economy (Inglehart, 2006). Health care professionals and social scientists are continuing to work to understand the underlying reasons for health inequality. These include the marginalization of large groups of people throughout the world and injustices in trade and the availability of care. Moreover, health care professionals from poor countries rarely return to work in the countries they were born. In addition to the work of international national organizations, university-level programs have been developed to help medical students do more work to address the global problems in inequality and health (Garman & Hughes, 2006).
Global stratification is a top-down, hierarchical arrangement of inequality among countries, with their position determined by the amount of control these groups have over their own resources as well as the resources outside their borders.
Health is defined by the World Health Organization as a state of complete physical, mental and social well-being. This does not only mean that disease, or frailness is controlled, but goes beyond that narrow definition (Kendall, 2006). But disease is a prime global problem and there are still many uncontrolled infectious diseases such as malaria and tuberculosis, often due to unsanitary or overcrowded living conditions in low-income countries (Kendall, 2006).
The world faces three main health and policy problems. First, for some diseases, there are no good tools or cures. Next, in some cases, cures are available, but too expensive to the reach the poor who need them most. Third, even if solutions to the healthcare crisis are cheap or even free, systems and personnel are not available to get them to the right places (Chan, 2007).
Globalization of Health-Related Technologies
There are also several issues related to the globalization of health-related technologies. Development of new drugs and vaccines is often lacking for diseases that most often occur in poor countries. Drugs are often misused, or are not pathogen resistant. To counteract these negatives, vaccines and medicines must be made available at a lower cost (Inglehart, 2006). But equally as important is the fact that technology, including health-related technologies, have adverse effects on the environment, and that these technologies are often not available to those who need them most among the poor and the disadvantaged.
Several theories have been put forward to answer the question of why so much of the world is getting richer and thus, receiving better health care, while the poor cannot achieve even a basic standard of living. These theories include the Development (and within it, the Modernization Theory), the Dependency Theory, the World Systems Theory and the International Division of Labor Theory. Each of these theories reflects the sociological perspectives of the structural-functionalist and conflict schools of thought in sociology (Macionis, 2007).
A structural-functionalist theory, the Development and Modernization theory argues that a higher standard of living occurs when a nation industrializes and social mobility becomes possible. Low income countries can improve their standard of living through economic growth and the falling away of traditional cultural beliefs and values (Rostow, 1971).
According to conflict theorists, because poor countries need the money offered by high income countries, they are continually in debt and can never repay what they owe, making them continually dependent on more foreign capital in what amounts to a vicious cycle (Macionis, 2007).
World Systems Theory
The World Systems Theory argues...
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