Local to Global and back home again

1
Local to Global(and back home again)?

• Globalization and Health

ses - employment - education - social enviro -
physical enviro - healthy child dev -personal -
health services - social support net -
biology/genetic - gender - culture
2
"Why is Jason in the hospital?Because he has a
bad infection in his leg.But why does he have an
infection?Because he has a cut on his leg and it
got infected.But why does he have a cut on his
leg?Because he was playing in the junk yard next
to his apartment building and there was some
sharp, jagged steel there that he fell on.But
why was he playing in a junk yard?Because his
neighbourhood is kind of run down. A lot of kids
play there and there is no one to supervise
them.But why does he live in that
neighbourhood?Because his parents can't afford a
nicer place to live.But why can't his parents
afford a nicer place to live?Because his Dad is
unemployed and his Mom is sick.But why is his
Dad unemployed?Because he doesn't have much
education and he can't find a job. But
why ...?"
3
Thesis of This Talk

• Health matters because everything else (love,
  money, status, politics, sex, religion, rights,
  compassion, culture, arts, music etc.) is
  insignificant unless one lives with enough
  quality of life to make it worthwhile.
  Globalization matters because everybody
  (including you!) increasingly relates to one
  another in a single system that affects each
  determinant of health.
• Globalization
• Health
• YOU!

History? Politics? Inter-societal relations!
ses - employment - education - social enviro -
physical enviro - healthy child dev -personal -
health services - social support net -
biology/genetic - gender - culture
4
Start from Where You Are

• Smiths Falls in the World A Case Study of
  Globalization in a Canadian Rural Town
• Where I live - Lanark County
• Learning and Knowledge in the 21st century
• Where I work higher education

ses - employment - education - social enviro -
physical enviro - healthy child dev - personal -
health services - social support net -
biology/genetic - gender - culture
5
But First, What on Earth is Globalization?And
whats in a word? Why globe, vs. world or planet?
ses - employment - education - social enviro -
physical enviro - healthy child dev -personal -
health services - social support net -
biology/genetic - gender - culture
6

• Trade and Financial Liberalization? Global
  Economis Crisis? Corporate McWorld?? The New
  World Order? A Brave New World? Riots at the
  G20/WTO? The End of the Sovereign State?
  Outsourcing? World Government? Global War on
  Terror? Rich vs. Poor? The Planet in Peril? Blood
  Diamonds? WaterWars? Climate Change?
  shrinkingworld.com? The Multicultural Global
  Village of United Nations Holding
  Hands?.......................
• Systemic Risk?..........Collective Destiny?

ses - employment - education - social enviro -
physical enviro - healthy child dev -personal -
health services - social support net -
biology/genetic - gender - culture
7
Trying to understand Globalization causes
feelings of pessimism, confusion, optimism,
guilt, hopelessness, pessimism, confusion,
optimism, guilt, hopelessness, being overwhelmed,
feelings of persecution and injustice, concern
overwhelmed, feelings of persecution and
injustice, concern for others, dizzying sense of
dominance and power, travel for others, dizzying
sense of dominance and power, travel lust,
hatred, anger, fear, insecurity, excitement,
hope, depersonalization, time pressure, denial,
escapism, utopian ecstasy, wanting to reverse it,
wanting to turn away from it, and wanting to save
the world. The strong feelings make it hard to
judge, hard to study, hard to sleep at night.
UGS Understanding Globalization Syndrome

• the commentary on globalization is already
  voluminous and the term risks becoming an
  ill-defined and vague cliché.
• All or nothing, tries to encompass everything,
  ends up saying nothing
• Global-de-Gook

ses - employment - education - social enviro -
physical enviro - healthy child dev -personal -
health services - social support net -
biology/genetic - gender - culture
8
My attempt to define

• there was a period in the past where people
  existed in social systems that bore minimal or
  non-existent relations to our own, and
• This has changed (over centuries) social
  relations are sufficiently related throughout the
  world as to include all regions in a single
  system. So
• Globalization is the term that describes how this
  has changed, though it is not complete (we are
  still globalizing). (Jinha, 2008)

ses - employment - education - social enviro -
physical enviro - healthy child dev -personal -
health services - social support net -
biology/genetic - gender - culture
9

• 1439 Printing Press
• 1492 Discover of NA by Europe
• 1543 Copernican revolution
• 1648 Peace of Westphalia
• 1665 First Scientific Journal
• 1773 Boston Tea Party
• 1876 Telephone invented
• 1905 Russian Revolution
• 1914 End of WWI
• 1944 Bretton Woods
• 1957 Nuclear disarmament movement
• 1989 Fall of Berlin Wall
• 1991 World Wide Web
• 1995 WTO formed
• 1997 Asian Economic Crisis
• 2000 MDGs
• 2001 9/11
• 2001 Budapest Declaration on OA
• 2009 Global Economic Crisis (GEC)

ses - employment - education - social enviro -
physical enviro - healthy child dev -personal -
health services - social support net -
biology/genetic - gender - culture
10
Globalization, just an abstract concept?

• In Smiths Falls job crisis, where a predicating
  cause has been Hersheys decision to realign its
  global supply chain, globalization would be
  conspicuously absent if we were to try and avoid
  it. (Jinha, 2008)
• One language has two words (Scholte, 2005)
• one for global aspiration, meaning becoming
  global - the other for intrusive globalization,

ses - employment - education - social enviro -
physical enviro - healthy child dev -personal -
health services - social support net -
biology/genetic - gender - culture
11
GlobalizationTransplanetary Social Relations

• Globalization then, is a stage of human
  development where social and economic relations
  are sufficiently interconnected, more direct and
  sufficiently penetrant of the worlds regions so
  as to have real effects everywhere these effects
  are mediated through

• communications technologies,
• migration,
• a global financial system,
• a global knowledge commons
• common state governance structures in a world
  system of international relations

• the international and within-country division of
  labour
• and the global supply chain of production.

ses - employment - education - social enviro -
physical enviro - healthy child dev -personal -
health services - social support net -
biology/genetic - gender - culture
12
Finally

• This is the world today - mobile, rapidly
  changing with local conditions relating more
  directly to global conditions, where borders are
  less important as boundaries as they are
  reference points to the wider world (Jinha, 2008)
• AndThere is a responsibility for health care
  educators to create an environment that nurtures
  the development of a global perspective and
  awareness of oneself in relationship with the
  world and with others (Leuning, 2001).

13
Back Down to EarthSmiths Falls Employment/SES

• Industrial Town, meeting point of
  transcontinental trade on the CPR
• Service Centre to Rideau Regional (Montague)
• Closing of Hersheys plant, RRC and other
  shutdowns and downsizing A loss of 1500 jobs in
  a town of 10,000 with 54 employment rate
• to 100,000 in Ottawa
• almost 30 of active labour force
• already one of the poorest towns in Ontario
• Canadas Manufacturing Crisis - A staggering
  360,000 jobs lost in manufacturing since 2002
  before the 2009 GEC

ses - employment - education - social enviro -
physical enviro - healthy child dev -personal -
health services - social support net -
biology/genetic - gender - culture
14
SES - Employment

• For every 1 rise in unemployment, 4.3 more men,
  and 2.3 more women enter mental hospitals 4.1
  more people commit suicide and 5.7 more people
  are murdered (Batt, 1983).
• Unemployment is generally thought to be an
  enormous stress and strain on individuals and
  families,
• Note that research not entirely consistent
  regarding overall health effects of
  recession/depression

ses - employment - education - social enviro -
physical enviro - healthy child dev -personal -
health services - social support net -
biology/genetic - gender - culture
15
Smiths Falls Community

• Wonderful people, a history of industry and
  innovation, a town built on navigating obstacles,
  a rich history and amazing youth

16
Smiths Falls Community Profile2006 (before
closings)
Facing Hard Times

• 18 rely on Soc Assistance compared to 9 in
  Ontario
• One quarter of families earn
• Most new employment is PT/low pay/non-unionized
• 1/3 of children living in poverty come from
  families working full-time
• High proportion of people with disabilities
• Nearly 50 youth (15-24) are not in school
  Ontario35

Open Doors of Lanark County, D. Jinha/Robberstad
(2007), Stats Canada(2006)
ses - employment - education - social enviro -
physical enviro - healthy child dev -personal -
health services - social support net -
biology/genetic - gender - culture
17
Health Services, Child Development

• Highest teen pregnancy rate in region
• One-third of families with children are headed by
  single mothers.
• 41 of lone-parent families have children between
  ages 0 and 6, and 68 of these have incomes below
  the poverty line.
• There is a wait of months to years to access
  mental health services.
• There is no public transportation, and even
  getting to soup kitchens can be difficult.

ses - employment - education - social enviro -
physical enviro - healthy child dev - personal -
health services - social support net -
biology/genetic - gender - culture
18
Rural Homeless Urban Homeless

• In 2007, nearly 9000 people used a homeless
  shelter in Ottawa and the average stay was 38.4
  days (Alliance to End Homelessness, 2007).
• A third of Canadas homeless are youth and 40-50
  of Canadas street youth problem in urban
  centers originates with migration from small
  towns (Transitions, 2003)

ses - employment - education - social enviro -
physical enviro - healthy child dev - personal -
health services - social support net -
biology/genetic - gender - culture
19
Other Issues in Lanark County

• Depressed Agricultural Incomes
• Privatization loss of health services in
  smaller centres
• Waste/Heavy Industries Close to Homes
• Carp Dump Controversy
• Clean Air Bath Tire incineration
• Real and Perceived Urban-Rural Divide
• Property Rights
• Guns, Religion, Tradition, Homogeneity
• Rural Culture

ses - employment - education - social enviro -
physical enviro - healthy child dev -personal -
health services - social support net -
biology/genetic - gender - culture
20
Algonquin Land Claim United Algonquin/ Settler
Stand Against Uranium Mine at Sharbot Lake
21
How did we get here?
22
Smiths Falls 7 Hard Times

• Pre-20th ce

• 1. Disenfranchisement of First Nations
• Missisauga, Algonquin, Iroquois
• 2. Rideau Canal Work Camp
• Pitiful conditions
• - immigrant workers
• 3. WWI
• End of Globalization I
• - cancellation of farm contracts in Europe
• (Lockwood, 1994)

23
20th Century

• 4. Great Depression.
• 5. 1950s - 1100 Jobs leave the CPR
  mechanization Loss of Malleable Iron Works and
  Frost and Wood Centralization
• 6. 1990s 1000 job loss Closures/ Consolidation
• 7. 2009 outsourcing
• and deinstitution-
• alization

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• How? Why?

25

• Be aware when things are out of balance. When
  rich speculators prosper while farmers lose their
  land when government officials spend money on
  weapons instead of cures when the upper class is
  extravagant and irresponsible while the poor have
  nowhere to turn, all this is robbery and chaos.
• (from the Tao Te Ching, circa 500 BC)

26
Transnational Social Policy ,Trade, Growth,
Recession, Restructuring and Unemployment

• Post-WWII
• Bretton Woods, Marshall Plan and GATT
• boom in Western economic growth that financed the
  social welfare state as a transnational norm
• However, growth slowed from 3.5-4 from 1960 to
  1973, to less than 2 from 1973 to 1990. During
  this period, the social welfare system began to
  erode and unemployment rose to 7.8 in OECD
  countries

27
Unbalanced Liberalization
Robbery and Chaos

• North Fierce Competition, Consolidation,
  centralization, mechanization, outsourcing
  unemployment, instability, decline of social
  cohesion
• Outsourcing
• Jobs are more mobile than people
• Jobs move from high-wage post-industrial
  countries to industrializing nations
• Chinas massive industrial complex

poor have nowhere to turn
28
North-South
poor have nowhere to turn

• South Indebtedness and SAPs
• Exposed uncompetitive economies to global
  competition (Clothes for Zambia, GHW report)
• Public sector, health and education eviscerated,
  and farmers lose their land with agricultural
  liberalization reservoirs of low-wage labour -
  (Michel Chossudovsky Globalization of Poverty)
• Poverty-driven conflict and insecurity (govts of
  the world spend the budget for HIV/AIDS medicine
  in 3 days on military)

farmers lose their land
when government officials spend money on weapons
instead of cures
29
Financial Globalization
rich speculators prosper

• The GEC, Argentinian and Asian economic crises
• Capital market liberalization (pegged currency
  for Argentinian and Asian)
• Bad lending, crony capitalism, expectation of
  bailout
• Bank deregulation
• Speculative bubble
• Capital flight, contagion, stock market crash
• Bailouts

the upper class is extravagant and irresponsible
Robbery and Chaos
30
Why Agricultural Economies are Poor

• Canada agriculture 2 of GDP
• In South 20,30,40 of GDP
• SAPs simultaneous during the 1970s and 80s,
  agricultural commodities flooded markets
  depressing prices
• North maintained subsidies
• In 2001/02 in the Ivory Coast, three consolidated
  export firms, ADM, Cargill and Bollore controlled
  21 of the countrys cocoa exports, and the
  largest Ivorian exporter exported less than one
  percent of the crop.
• When the Ivorian government attempted to regain
  some control exporters as a group boycotted the
  country and forced them to reverse their policy

31
Coffee Crisis 90s

• Global Grapes of Wrath?
• The World Bank estimates that 540,000 Central
  American laborers have lost their jobs due to the
  current coffee crisis. Villages have turned into
  ghost towns as their inhabitants, no longer able
  to make ends meet, crowd into the dangerous and
  ever-expanding shantytowns that ring major cities
  in the developing world. Mexico City, one of the
  world's largest urban sprawls with 21 million
  inhabitants, is filled with such refugees.
  (Jarmen, 2002)

32
Business Globalization

• Extraction industries
• Mercantilism Classical Liberal Capitalism
  Uranium Mining at Frontenac
• Severence of property and mineral rights
• Nuclear and the geopolitics of energy driving
  up the value of uranium
• Manufactured Goods
• Phase I - Theodore Levitt 1983 article The
  Globalization of Markets
• urged business leaders to focus on global
  standardization of their industrial processes
  over tailoring to local cultures
• Phase II
• Led by Toyota then electronics etc.
• component standardization plus tailorization and
• global supply chain management

33
Inter and Intra National Division of Labour in
the Global Supply Chain of Production

• Rationalization of supply-chain and labour
• Determined/determining the relative poverty or
  wealth of nations.
• South raw - agriculture/extraction/fisheries
• East processing - manufacturing/heavy industry
• North enriching/value-added
• higher-value segment higher wages
• skilled worker is less replaceable public
  health care rationalized
• Publicly-supported basic research provides the
  knowledge base for commercial innovation
• Publicly-supported Edu from free primary to
  subsidized tertiary Edu expands the labour market
  for knowledge workers
• Immigration/Brain Drain to add
• Largest consumptive markets that are the largest,
  so service workers are required

34
Global RestructuringEg. Hersheys Supply Chain

• Raw product
• at low commodity prices
• from West African farmers through
• conglomerate traders to
• low-wage manufacturing in Mexico,
• outsourcing of lower-value segments, and
• RD, marketingadministration
• centralised in the United States.
• Products are distributed to retailers
• in North America
• and at the end of the supply chain
• The low-wage service worker meets
• You and I at the point of purchase.

35
Global supply chain transformation (Hersheys,
2007).

• 500 in SF 900 are to lose their jobs in Hershey,
  Pennsylvania
• 575 laid off from the Oakdale, California plant
  (Dow Jones Newswires, 2007).
• Hershey had already closed a plant at La Piedras,
  Puerto Rico and has since closed a plant in
  Dartmouth, Nova Scotia adding another 500
  lay-offs.(West, 2006) (MacDonald, 2007).

36
Hersheys Great Fall from Grace

• Milton Hersheys Great-Building campaign during
  the Great Depression, to..
• Blood Cocoa and the Ivory Coast
• child labour, slavery and trafficking,
  particularly of young girls
• Companies missed a 2005 deadline to certify
  labour conditions in Ghana
• ADM, Cargill and Nestle have been named in a
  child slavery lawsuit in the Ivory Coast
• Hersheys will not reveal its sources
• Global Witness a highly credible NGO1 have
  accused the chocolate industry of funding the
  civil conflict in Ivory Coast

1 Global Witness has been selected as the
recipient of the 2007 Commitment to Development
Ideas in Action Award, sponsored jointly by
Washington, DC based Center for Global
Development and Foreign Policy magazine
37
Rideau Regional and Transnational Social Policy

• Mammoth institution for people with developmental
  disabilities
• 1954, served 2400 residents and employing 1500
  people significant for local agricultural
  economy with SF as a service centre, increased
  health professional population in region
• By 2005 down to 800 staff and less than 500
  residents

38
Deinstitutionalization

• Community Living movement Govt. Cost
  rationalization led to
• De-institutionalization
• Laudable social policy to shift to community
  living throughout Western world
• BUT, Level of Community supports recommended was
  never met
• AND, good intentions and local realities dont
  always converge, esp for lifelong residents for
  whom moving meant suffering

• "Most of our residents are over fifty," he said.
  "They have severe developmental disabilities
  along with many physical handicaps. Many of our
  residents are medically fragile and many suffer
  from serious mental health issues. These are
  people who need around the clock care. Community
  integration is a great buzz phrase, but in the
  case of these people it is nothing short of
  cruel." Dave Lundy, president of OPSEU/NUPGE
  union local RRC (2005)

39
Are we better off?

• The real-earnings of the average worker have
  stood still against inflation since from the
  1970s
• In the agricultural sector, farm incomes have
  fallen below levels of the Great Depression,
  adjusting for inflation
• Unemployment insurance rates have been reduced,
  while the qualifying period has been extended.
  Indexation to wages and to cost of living has
  been adjusted to lower relative benefits
• 1995 - Welfare rates were cut by a record 21.6
  and since then have not been indexed to
  inflation. (2 increase in Fridays
  budget)Eligibility was also tightened, and since
  2000 there is no earning flexibility every
  dollar earned is a dollar deducted
• Similar freeze on indexation of cost-of-living
  for disability pensions, leaving those reliant on
  assistance 30 poorer than when the cuts and the
  freeze took effect (2 increase in Fridays
  budget)

40
Systemic RiskShared Responsibility or Collective
Collapse

• Family Farmers collectively face tight margins
  (inputs-outputs), dumping, large agribusinesses
• We understand the pressure of mining interests on
  communities, many of whom have less power than
  the Algonquin/settler coalition in Frontenac
• We get the unsettling relations between
  conspicuous consumption of our toys (candy,
  electronics, etc.) and low-wage labour, poverty
  and even slavery

41
Solidarity?

• We understand that we in the North consume energy
  and natural resources, and emit carbon at
  double-digit multiplier rates compared to the
  global majority
• We get that disparity through rationalization
  moves good-paying safe blue-collar jobs from the
  North to less-safe, less-regulated, low-wage
  labour in the South, and even sweatshops

42
Solidarity

• We understand that with our low birth rate, we
  require skilled immigrants to drive the knowledge
  economy of the North
• These are brains we drain, and sometimes waste
• We understand that the disparity driving the
  global divides and the pressure of consumption on
  resources and energy drives war, global
  insecurity and justifications for terror

43
Solidarity

• Solidarity - Not some left-wing idealistic drivel
  it is actually the core message of Gilles
  Breton your VP Academic International - in
  terms of universities in globalization and
  development
• Back home to where we are, the university

44
The University

• Not reducible to culture, state, business or
  power (Delanty)
• A place where information is not merely imbibed,
  but transformed imaginatively towards knowledge
• Your role is not to think and do as your
  professors
• Not to learn facts and information but to learn
  HOW TO LEARN
• And to build upon the good, and tear down the bad
  of the generation that came before you

45
The University and Globalization

• There is concern over the role of TRIPS in GATT,
  the corporatization of unis etc.
• BUT, my focus is on the convergence of ICTs and
  Open Access to Knowledge
• Knowledge is power, with so much at stake, with
  so much complexity, and with the lions share of
  burden of problems on the global South.
• We in the North are not sufficiently endowed with
  perspective, we need the Souths capacity

46
Imagine

• Imagine that with all the burden of crises and
  problems that Rays generation and those before
  his have placed upon your shoulders
• HOPE - You have colleagues all across the world
  endowed with the same basic resources for power
  AND
• CHANGE Imagine that our knowledge of the South
  is created, moulded, and developed in and by the
  South and the balance of knowledge is power is
  shared
• Imagine we really knew each other, not just by
  unjust social relations

47
Imagine

• If we could step back from the duplicitous role
  of creator and mender of other peoples problems
• The solutions to environmental degradation,
  HIV/AIDS, economic institutions and
  peace-building more and more come from any corner
  of the Earth, from any grass-root to tree-top
• Where would the next Einstein or Edison emerge?
  What would be the context of their thinking? What
  problems would they be solving?

48
Start from where you are

• Think of your global colleagues
• the Hillman Medical Education Fund
• My choice for collaborative research
• Towards a Vision of University Networked
  Partnerships, North-South South-South
• Equity in the global information system for
  knowledge communication
• Many choices you can make with a global
  perspective, an exciting and challenging time to
  be in university

49
Start from Where You Are

• First Nations are last 76th on the HDI
• Homelessness tells us more about the failures of
  mainstream society and government than about the
  failures of those on the street
• Uranium Mine - What the cost of nuclear energy is
  in your backyard, when we could conserve and
  invest in reneweables

50
Research Question for you!

• If we can think of the world now as an integrated
  social system, how are we doing?
• How would the globe rate on indexes of health and
  development compared to countries? Compare to
  Kenya, Canada, World, for instance
• On life expectancy
• On the HDI
• On the Gini Coefficient
• On Density of Health Workers

51
Are we just at the beginning

• Of human development?