Social determinants of health in the context of globalization and modernization

Many of modern epidemics, including AIDS, polio, and malaria may in a few years’ time even out. But, for a developing nation, new challenges in the form of cancer, road accidents and cardiovascular disease will emerge. Further, although sufficient progress has been made in checking infant mortality rates in the Third World since the 1980s, cases of easily contagious epidemics like tuberculosis have not declined. This goes on to show that the benefits of globalization have not reached all corners of the world. The ailments mentioned in the following table and the mortalities that result from them mostly pertain to developing and under-developed countries of the world.
Top 10 Leading Causes of Death (2000 estimates)

Ranking Specific Cause Percent of Total Deaths

1 Coronary heart disease 12.4
2 Cerebrovascular disease (stroke) 9.2
3 Lower respiratory infections 6.9
4 Unintentional injuries 6.1
5 HIV/AIDS 5.3
6 Chronic obstructive pulmonary 4.5
disease (e.g. emphysema, chronic
bronchitis)
7 Perinatal conditions 4.4
8 Diarrheal diseases 3.8
9 Digestive diseases 3.5
10 Tuberculosis/lntentional injuries 3.0/3.0
Source: The World Health Report 2001 (Geneva: The World Health
Organization, 2001)

Even the former chief of the World Health Organization agrees that there is a disconnection between wealth creation and wider access to public health as a result of globalization. This excerpt is from a speech by Dr. Gro Brundtland, the former Director-General of the World Health Organization, at the World Economic Forum on January 29, 2001, emphasizes this point.

“Technologies are spreading, communication is worldwide, people know what is available, and yet the dramatic gaps and lack of access become greater and greater. We must look upon the world as a shared responsibility so that we deal with the gaps and help those technologies become available for those who don’t have access. That’s the only way to keep globalization from becoming really unhealthy.” (Brundtland, 2001)

Moreover, Public health authorities across the world have concentrated more on such pediatric areas as polio, malnutrition, malaria, etc and have made impressive progress. For example, there is already evidence that people are living longer lives across the socio-economic spectrum. The downside is “exposure to numerous new health threats more commonly associated with old age, namely cancer and heart disease. In India, for example, deaths from heart attacks, cancer, and other non-communicable diseases are projected to double from 4 million a year in 1990 to 8 million a year in 2020” (Levy & Sidel, 2006). Such is the paradox of globalization that during the same period, family-planning initiatives have found wide acceptance. In the last two decades, the usage of contraceptive devices has increased exponentially in many under-developed countries. The birth rates have declined by 15% as a result. This can have negative consequences for these nations in the long term. In a decade or two they may confront the same “demographic imbalance” that the western world presently faces. This would mean that societies in the future will have disproportionately high percentage of elderly men and women who do not contribute to the growth of economy (Levy & Sidel, 2006).

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