Child Health in an Era of Globalization: A Case Study of Saskatoon, Saskatchewan.

摘要

Research Objectives: Globalization is increasingly considered an important influence on the determinants of health. Globalization, for the purposes of this study, was defined as "a process of greater integration within the world economy through movements of goods and services, capital, technology and (to a lesser extent) labour, which lead increasingly to economic decisions being influenced by global conditions."(1) Although there have been many conceptual and theoretical explorations of the globalization and health relationship, only a limited number of empirical studies have sought to link the processes of globalization to health effects in a specific context and/or for a particular population such as children. The objectives of this thesis were two-fold: to investigate primarily the economic pathways and related political pathways by which globalization influences the determinants of health and health outcomes in low-income children ages zero to five in a mid-sized Canadian city (Saskatoon, Saskatchewan); to identify and analyze the policy responses at various levels (national, provincial, and municipal) that address the effects of globalization on determinants of health such as household income and distribution, employment and education for parents, housing, and social programs.;Study Design and Methodology: This study was a case study that used mixed methods. The case in this research was Saskatoon, a mid-size city located in the Canadian province of Saskatchewan. The analytical framework used to guide this study was developed by Labonte and Torgerson.(2) Methods included: a demographic profile for the City of Saskatoon; an environmental scan of federal, provincial, and municipal policy that has direct relevance for child health; process tracing; semi-structured interviews with low-income parents of young children (n=26); and trend analysis of child health outcomes among children ages zero to five.;Findings: The current phase of globalization in Canada and Saskatchewan is inextricably linked with the implementation of neoliberal policies such as tax restructuring, trade liberalization, privatization, deregulation, and greater integration in the global economy. This phase of globalization contributed to changes in the determinants of health that affect children and their families in Saskatoon. For instance, globalization has involved retrenchment of the welfare state in Canada and Saskatchewan. As the welfare state diminished in size and responsibility, poverty tended to deepen among those that were already poor. The retrenchment of the welfare state also led to diminished program access. In addition, globalization has emphasized the restructuring of the labour market to be more competitive and flexible. A restructured labour market and reduced access to services and programs contributed to greater inequalities in income in Canada, Saskatchewan, and Saskatoon. Finally, globalization contributed to declining housing affordability in Canada's cities such as Saskatoon.;Trend analysis at the neighbourhood-level to determine the linkages between changes in the determinants of child health and changes in child health outcomes was inconclusive. Further research is required to determine if the disparities in the determinants of child health that have been exacerbated by the economic and political processes of globalization have contributed to increasing disparities in child health outcomes.;Conclusion: This study indicated that the economic and political processes of globalization influenced the determinants of health among young low-income children and their families in Saskatoon through a number of pathways, but this is not to suggest that globalization was the only phenomenon at work. Although it was very difficult to draw any conclusions regarding the globalization and health relationship with certainty, this study offered a logical and a multi-prong approach to examining the effects of globalization on children's health and health determining conditions. Studies of this nature are important for contributing to our understanding of the complex structures that influence health and for building up the linkages between globalization and health on a case-by-case basis.