GLOBALIZATION
AND PUBLIC HEALTH
PRESENTED BY: DR. IMROSE RASHID
GUIDE/ MENTOR: PROF. (DR.) S. M. SALIM KHAN

CONTENTS
1. Globalization, Global Health and Public Health.
2. Changing Concepts of Public Health.
3. Causes, Aspects and Types of Globalization.
4. Social Changes due to Globalization.
5. How Globalization affects Public Health.
6. Globalization of Public Health.
7. Threats to Global Health.

GLOBALIZATION
GLOBAL HEALTH
PUBLIC HEALTH

GLOBALIZATION
• Derived from the word ”globalize” refers to
“the emergence of an international network of economic systems”.
• Globalization –
“Process of rapid economic, cultural and institutional integration among
countries”.
“The spread of products, technology, information, and jobs across
national borders and cultures”.

GLOBAL HEALTH
“An area for study, research, and practice that places a priority on
improving health and achieving health equity for all people worldwide”
Replaced the older terminology of “International health.”
primarily referred to
“A focus on the control of epidemics across the boundaries between
nations”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852240/

PUBLIC HEALTH
• The term came into general use around 1840.
• It arose from the need to protect the public from the spread of
communicable diseases.
• Peter Frank conceived public health as good health laws.
• The public health act passed in 1848 in England enunciated the
principle that state is responsible for the health of its people.

“The science and art of preventing disease, prolonging life, and
promoting health and efficiency through organized community efforts
for the sanitation of the environment, the control of communicable
infections, the education of the individuals in personal hygiene, the
organization of medical and nursing services for early diagnosis and
preventive treatment of the disease, and the development of social
machinery to ensure for every individual a standard of living adequate
for the maintenance of health, so organizing these benefits as to enable
every citizen to realize his birth right of health and longevity”
- Winslow (1920)

CHANGING CONCEPTS OF PUBLIC
HEALTH

1. DISEASE CONTROL PHASE (1880-1920) -
• Public health was largely a matter of sanitary legislation.
• Aimed at control of man’s physical environment.
• Water supply and sewage disposal.
• Vastly improved the health of people through disease and death
control.

2. HEALTH PROMOTIONAL PHASE (1920-1960) -
• The process of enabling people to increase control over, and to
improve their health.
• Provision of basic health services through primary health centres
and subcentres.
• Initiated as personal health services.
• Mother and child health service, school health services, industrial
health services, mental health and rehabilitation services.

3. SOCIAL ENGINEERING PHASE (1960-1980)
• Chronic diseases began to emerge e.g. cancer, diabetes,
cardiovascular diseases, alcoholism and drug addiction.
• New concept of “risk factors” as determinants of diseases came into
existence.
• Social and behavioral aspects of disease were given a new priority.

4. HEALTH FOR ALL PHASE (1981-2000)
• World Health Assembly in 1977 set the main social goal.
• Attainment by all the people of the world by the year 2000 of a
level of health that will permit them to lead a socially and
economically productive life.
• The essential principle of “Health For All” is the concept of “equity
of health”.

CAUSES OF GLOBALIZATION

1. Trade Liberalization.
2. Technological advances.
3. Reduced cost and improvement of communications and transports.
4. Deregulation of financial markets.
5. Increased significance of Transnational Corporations.

ASPECTS OF GLOBALIZATION

In 2000, The International Monetary Fund (IMF) identified 4 basic
aspects of globalization.
1. Trade and Transactions.
2. Capital and Investment.
3. Migration of people.
4. Dissemination of knowledge

TYPES OF GLOBALIZATION

Economic Globalization
Countries that trade with many other countries and have few
trade barriers are economically globalized.
Social Globalization
Social globalization refers to the sharing of ideas and
information between different countries.
Political Globalization
Political globalization refers to the amount of political co-
operation that exists between different countries.

Ecological Globalization
Earth is a single ecosystem rather than a collection of separate
ecological systems because so many problems are global in nature
Sociological Globalization
Belief that we are all global citizens and should all be held to the same
standards and have the same rights
Technological Globalization
Connection between nations through technology such as television,
radio, telephones, internet, etc.

MEASUREMENT OF GLOBALIZATION
KOF INDEX
• Measures three important dimensions of globalization: Economic,
Social and Political
• Given by Alex Dreher.
• Latest version
published in 2018.

SOCIAL CHANGES DUE TO GLOBALIZATION

1. SPATIAL CHANGE –
• Refers to how people organize and interact across physical or
territorial space.
• Long-haul flights, trade in foreign currencies, and the Internet are
examples of social interaction across distant locations.
• The creation of virtual communities, through social media such as
Twitter, Facebook and YouTube.

2. TEMPORAL CHANGE -
• How we think about and experience time.
• New modes of transportation have enabled larger numbers of people
to travel greater distances in shorter amounts of time.
• Mechanization and scientific advances have sped manufacturing,
agricultural, and construction processes.

3. COGNITIVE CHANGE –
• How we think about ourselves and the world around us.
• The dissemination and adoption of knowledge, ideas, values, and
beliefs have become worldwide.
• The ascendance of English, as the leading language for diplomacy.

HOW GLOBALIZATION AFFECTS PUBLIC
HEALTH

POPULATION HEALTH
• Population health has been defined as "the health outcomes of a
group of individuals, including the distribution of such outcomes
within the group“.
• Determinants of population health-
 Institutional determinant.
 Economic determinant.
 Socio-cultural determinant.
 Ecological determinant.

PROXIMAL
DETERMINANT
DISTAL
DETERMINANT
CONTEXTUAL
DETERMINANT
PROXIMAL
DETERMINANT
DISTAL
DETERMINANT
CONTEXTUAL
DETERMINANT

FEATURES OF GLOBALIZATION
1. New Global Governance Structure.
2. Global Markets.
3. Global Communication and Diffusion of Information.
4. Global Mobility.
5. Cross Cultural Interaction.
6. Global Environmental Changes.

PROXIMAL
DETERMINANT
DISTAL
DETERMINANT
PROXIMAL
DETERMINANT
DISTAL
DETERMINANT
CONTEXTUAL
DETERMINANT
CONTEXTUAL
DETERMINANT

POPULATION HEALTH

1. HEALTH RELATED POLICIES –
• World Health Organization
• World Bank
• International Monetary Fund.
• World Trade Organization.
2. ECONOMIC DEVELOPMENT AND TRADE –
• Global Market facilitates economic growth.
• Goods and services are increasingly being traded.
• Illegal drugs and human trafficking is also globalizing.

3. SOCIAL INTERACTION AND KNOWLEDGE –
• Population migration.
• Conflicts.
• Globalization of education.
4. HEALTH SERVICES –
• Universal access.
• Inequitable access.
• Illegal trading of drugs.
• Movement of healthcare professionals.

5. SOCIAL ENVIRONMENT AND LIFE STYLE –
• Social networks and social integration.
• Social protection.
• Social exclusion and inequality.
6. PHYSICAL ENVIRONMENT –
• Outbreaks of infectious diseases.
• Improved surveillance and monitoring.
• Increased speed of response.

GLOBALIZATION OF PUBLIC HEALTH

INTERNATIONAL HEALTH ORGANIZATIONS
WORLD HEALTH ORGANIZATION
• Specialized agency of the United Nations that is concerned with
international public health.
• It was established on 7 April 1948.
• Headquartered in Geneva, Switzerland.
• Played a leading role in the eradication of smallpox.
• Current issues include communicable diseases, non communicable
diseases, occupational health and substance abuse.

CENTERS FOR DISEASE CONTROL AND PREVENTION
 Leading National public health institute of the United States.
 Headquarter in Atlanta, Georgia.
 Main goal is to protect public health and safety through the control
and prevention of disease, injury, and disability.
 Focuses on infectious disease, food borne pathogens, environmental
health, occupational safety and health, health promotion, injury
prevention.

WORLD BANK
 Created in 1944, based in Washington DC.
 Leading institution for investments in health and development.
 World Bank strives to alleviate poverty.
 Providing loans, credits, and grants to poor counties.
 To implement various development projects in areas such as
education, healthcare, agriculture, environmental and natural
resource management, infrastructure, and other relevant projects.

UNITED NATIONS INTERNATIONAL CHILDRENS EMERGENCY FUND
 Created by the United Nations General Assembly on 11 December
1946.
 To provide emergency food and healthcare to children and mothers
in countries that had been devastated by World War II.
 Spends majority of its budget on promoting health initiatives, and
prioritizes the needs of the world's most vulnerable children.
 Strives to address major health concerns such as HIV and AIDS,
maternal and child nutrition, excessive maternal mortality, increasing
vaccination rates and child survival and development.

THREATS TO GLOBAL HEALTH

AIR POLLUTION AND CLIMATE CHANGE
 Air pollution is considered as the greatest environmental risk to
health.
 Nine out of ten people breathe polluted air every day.
 Killing 7 million people prematurely every year.
NON-COMMUNICABLE DISEASES
 NCDs such as diabetes, cancer and heart disease, are collectively
responsible for over 70% of all deaths worldwide, or 41 million
people.
 Five major risk factors: tobacco use, physical inactivity, harmful use
of alcohol, unhealthy diets and air pollution.
https://www.who.int/emergencies/ten-threats-to-global-
health-in-2019

GLOBAL INFLUENZA PANDEMIC
 WHO is constantly monitoring the circulating influenza viruses.
 Every year, WHO recommends which strains should be included in
the flu vaccine.
 Influenza pandemic is unpredictable and inevitable.
FRAGILE AND VULNERABLE SETTINGS
 More than 1.6 billion people (22%) live in places where protracted
crises and weak health services leave them without access to basic
care.
 Vulnerable settings - Drought, famine, conflict, and population
displacement.

ANTIMICROBIAL RESISTANCES
 Drug resistance is driven by the overuse of antimicrobials in people,
or in animals as well as in the environment.
 Resistance to Anti-TB drugs is a formidable obstacle to fighting a
disease that affects 10 million people and kills 1.6 million every year.
EBOLA AND OTHER HIGH THREAT POTENTIALS
Ebola, Zika, Nipah, Middle East respiratory syndrome coronavirus,
SARS and disease X.
 Ebola outbreaks in the Democratic Republic of the Congo put more
than 1 million people at risk.
 Democratic republic of Congo is a conflict zone.

WEAK PRIMARY HEALTH CARE
 Primary health care is the first point of contact people have with
their health care system.
 Many countries do not have adequate primary health care facilities.
 All countries have committed to renew the commitment to primary
health care made in the Alma-Ata declaration in 1978.
DENGUE
 An estimated 40% of the world is at risk of dengue fever.
 Around 390 million infections a year.
 WHO’s Dengue control strategy aims to reduce deaths by 50% by
2020.

VACCINE HESITANCY
 Vaccination is one of the most cost-effective ways of avoiding
disease
 It currently prevents 2-3 million deaths a year.
 Vaccine hesitancy is the reluctance or refusal to vaccinate despite
the availability of vaccines.
HIV
 The epidemic continues to rage with nearly a million people every
year dying of HIV/AIDS.

CONCLUSION

THANK YOU