Consuela has no way to pay the out-of-pocket costs for her three children's health care and schooling partly because of the continuing fiscal policy constraints associated with a costly bailout of Mexican banks in the 1990s, Mexico's efforts to extend social insurance across the nation have yet to reach her. He and Consuela still text-message each other every day, but if his remittances continue to drop they will no longer be able to afford even basic mobile telephone service. With no access to medical care, he is concerned that his worsening lung infection could be tuberculosis, but he is afraid to mention this even to his friends. Her husband, one of the millions of undocumented workers in the United States and Canada, is afraid of losing his weekday job in agriculture and his weekend job as a gardener, as rising unemployment rates fuel antimigrant sentiments. When the 2008 global financial crisis spilled over into the real economy, she was dismissed with a severance that was scarcely one-tenth of the legal minimum. Her job was stressful and unhealthy, but the income was important to her family. She and her coworkers were actually employed by an agency offering “just-in-time” workers. INTRODUCTION: FROM INTERNATIONAL HEALTH TO GLOBAL PUBLIC HEALTHĬonsuela has just lost her job in a Mexican factory where she assembled 120 computer CPUs each hour for a contract manufacturer. The article concludes with a call for national governments, especially those of wealthier nations, to take greater account of global health and its social determinants in all their foreign policies. Several globalization-related pathways to health exist, two key ones of which are described: globalized diseases and economic vulnerabilities.

This integration requires a shift in public health thinking from a singular focus on international health (the higher disease burden in poor countries) to a more nuanced analysis of global health (in which health risks in both poor and rich countries are seen as having inherently global causes and consequences). This article discusses globalization and its health challenges from a vantage of political science, emphasizing increased global flows (of pathogens, information, trade, finance, and people) as driving, and driven by, global market integration. In recent decades, public health policy and practice have been increasingly challenged by globalization, even as global financing for health has increased dramatically.

Health impacts of globalization