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Kelley Lee

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date: 20 June 2019

Globalization, defined as the closer integration or interconnectedness of human societies across national borders through spatial, temporal, and cognitive changes, is creating wide ranging impacts on public health. This interconnectedness is characterized by crossborder flows of people, other life forms, goods and services, capital, and knowledge to an unprecedented degree in terms of intensity and extensity (geographical reach). The emergence of a global economy, for example, has led to the restructuring of many health-related industries such as pharmaceuticals, food, and tobacco. Other global changes taking place, such as the increased movement of populations, environmental change, and financial transactions, have had indirect yet profound impacts on health determinants and outcomes.

To date, the public health community has played a limited role in influencing the nature of the changes taking place, which have been largely driven by powerful economic and political interests. Contemporary globalization, as a result, has been characterized by an inequitable distribution of costs and benefits within and across countries. For the public health community, there is a need to better understand the linkages between globalization and health, and the possible interventions available to protect and promote public health. A review of key activities in public health practice suggests the need for a ‘global public health’ approach which seeks to minimize the costs, and maximize the benefits, to public health arising from globalization. Recent developments in infectious disease outbreak control, environmental health, health promotion, and monitoring of health status provide examples of the challenges faced. These include opposition by powerful vested interests to stronger regulation, the need for effective collective action across all societies to tackle crossborder public health issues, and the current weaknesses of global health governance. Nonetheless, there are opportunities for the public health community to influence globalization by demonstrating the shared benefits to be gained. Greater attention to the public health impacts of globalization, through redistributive policies, greater attention to health equity, and appropriate social and environmental pro tections will, in turn, contribute to more sustainable forms of globalization.

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