Co-Written by Sudhamshi Beeram, Parul Malik & Arathi P Rao

Image by Eric Westbrook

The term “globalization” used in a variety of contexts over the years is mostly debated to be an evolution across the fields of economy and industry and as the bridging of geographical gaps.  It is essentially a functional integration of the global population (Lee & Collin, 2001) and according to Baylis, Owens & Smith (2008), “It is the process of increasing interconnectedness between societies such that events in one part of the world have effects on people and societies far away.” Being one of the widely accepted definitions of globalization, this serves the purpose of explaining its correlation with the aspect of health.

More than ever before, the world is interconnected through globalization, and health is an integrated result of socio-cultural, biological, economic, environmental and institutional dimensions (Koh, Piotrowski, Kumanyika & Fielding, 2011). To properly elicit the effect of globalization on health, we ought to understand its impact on the local population. It is essential to gain knowledge about the factors which make few people healthy and others unhealthy. These factors are known as determinants of health which influence the individual and community in a wider aspect.

Health outcomes, whether good or bad are influenced by a person’s interaction with the society they live in. The cultural practices; dietary habits they follow; social norms they face; their genetic make-up; their access to health services; housing facilities and the policies functional in their localities are to be considered to assess one’s health status (Koh et al., 2011). Hence, a precise understanding of these determinants plays a crucial role in prevention and containment of the health risks they might be susceptible to. Globalization paved a way for an increase in the incidence of infectious as well as non-communicable diseases. The association of globalization and health can be explicitly explained using the examples of the Ebola virus outbreak and the increasing incidence of type II diabetes mellitus.

In these COVID- 19 times, going back to the Ebola outbreak can provide us some valuable insights. Ebola is one of the many diseases that crossed the boundaries and spread at a rapid pace (Arwady et al., 2015). Some of the major reasons for the outbreak of Ebola were increased migration of people, evolutionary mechanism of the causative virus and unknown zoonotic reservoirs. (Kaner & Schaack, 2016). Another interesting factor in Ebola crisis was a reduced population of apes prior to infection suggesting wild life death could have been a silenced cause of Ebola relative to globalization (Olival & Hayman, 2014).

Similarly, Type II Diabetes mellitus may be considered as an outcome of extensive changes in lifestyle and adaptation of the unhealthy behavioural habits. Westernization has accelerated the transition in the nutrition through advertising and marketing of unhealthy products (Nilsson & Bennet, 2017). Other contributing factors include a sedentary lifestyle; increased screen time due to use of television and smart phones (Hu, 2011). Smoking and alcohol consumption are two independent factors occurring due to rapid socio-economic development. These habits when coupled with stress are perceived to trigger the abnormalities of the glucose mechanism in the body leading to Type II diabetes mellitus (Joseph & Golden, 2017).

It is, therefore, more evident that globalization has wide ranging negative impacts. But the public health domain cannot ignore the positive side of this coin of globalization. How it will finally impact, would be subjective to various factors at various levels- be it at the Individual, population or governmental.

Therefore, utilizing the upside effect of globalization to combat the health risks is efficacious. Firstly, improving the surveillance and monitoring systems globally can help in preventing spread of newly emerging diseases such as Ebola (Lee & Collin, 2001). Secondly, to prepare and respond to similar future epidemics, development of health care infrastructure and in-depth research must be prioritized. Safe, potent and cost-effective health care services must be provided to local population for individual security and to safeguard the society (Lee & Collin, 2001). The potential widespread of diseases through migration can be handled by the global screening systems and timely quarantine measures at the travel points (Dénes & Gumel, 2019).

Subsequently, the modification of diet and cultural adaptation of lifestyle intervention is a key to prevent Non- communicable diseases (NCDs) like diabetes mellitus to a large extent. The imports and exports of cheaper vegetables and fruits through global trade liberalization across the countries can be helpful in encouraging healthy eating. Policy formulation and public health strategies must focus on creating environment favourable to prevention of NCDs and promotion of a healthy lifestyle (Nilsson & Bennet, 2017). Therefore, a balance of the upsides and downsides of globalization with a behavioural change approach, strong public health infrastructure and conscientious access is required to structure the healthcare systems across the world.

References

Arwady, M.A., Bawo, L., Hunter, J.C., Massaquoi, M., Matanock, A., Dahn, B., & Monroe,
B. (2015). Evolution of Ebola virus disease from exotic infection to global health priority,
Liberia, mid-2014. Emerging infectious diseases21(4), 578.

Baylis, J., Owens, P., & Smith, S. (Eds.). (2017). The globalization of world politics: An
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Dénes, A., & Gumel, A. B. (2019). Modeling the impact of quarantine during an outbreak of
Ebola virus disease. Infectious Disease Modelling4, 12-27.

Hu, F.B. (2011). Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes
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34(6), 1249-1257.

Joseph, J. J., & Golden, S. H. (2017). Cortisol dysregulation: the bidirectional link between
stress, depression, and type 2 diabetes mellitus. Annals of the New York Academy of
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Kaner, J., & Schaack, S. (2016). Understanding Ebola: the 2014 epidemic. Globalization and
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Koh, H.K., Piotrowski, J.J., Kumanyika, S., & Fielding, J.E. (2011). Healthy people: a 2020
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Lee, K., & Collin, J. (2001). Review of existing empirical research on globalization and
health. World Health Organization, Geneva.

Nilsson, P. M., & Bennet, L. (2017). Diabetes: the cost of globalization. Heart and
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Olival, K.J., & Hayman, D.T. (2014). Filoviruses in bats: current knowledge and future
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Dr. Sudhamshi Beeram has a bachelor’s degree in Naturopathy and Yogic Sciences and is currently a postgraduate student, pursuing Master of Public Health (Global Health) at Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India

Dr. Parul Malik is a medical doctor with a Master of Public Health (Global Health) degree from Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India.

Dr. Arathi P Rao is the Coordinator of the MPH Programme and the Head of Manipal Health Literacy Unit at the Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India.


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