Globalization as a Driver or Bottleneck for Sustainable Development: Some Empirical, Cross-National Reflections on Basic Issues of International Health Policy and Management

摘要

Background: This article looks at the long-term, structural determinants of environmental and publicudhealth performance in the world system.udMethods: In multiple standard ordinary least squares (OLS) regression models, we tested the effects ofud26 standard predictor variables, including the ‘four freedoms’ of goods, capital, labour and services, onudthe following indicators of sustainable development and public health: avoiding net trade of ecologicaludfootprint global hectare (gha) per person; avoiding high carbon emissions per million US dollars GDP;udavoiding high CO2ud per capita (gha/cap); avoiding high ecological footprint per capita; avoiding becomingudvictim of natural disasters; a good performance on the Environmental Performance Index (EPI); a goodudperformance on the Happy Life Years (HLYs) scale; and a good performance on the Happy Planet Indexud(HPI).udResults: Our research showed that the apprehensions of quantitative research, critical of neo-liberaludglobalization, are fully vindicated by the significant negative environmental and public health effects ofudthe foreign savings rate. High foreign savings are indeed a driver of global footprint, and are a blockadeudagainst a satisfactory HPI performance. The new international division of labour is one of the primeuddrivers of high CO2ud per capita emissions. Multinational Corporation (MNC) penetration, the masterudvariable of most quantitative dependency theories, blocks EPI and several other socially importantudprocesses. Worker remittances have a significant positive effect on the HPI, and HLYs.udConclusion: We re-analysed the solid macro-political and macro-sociological evidence on a global scale,udpublished in the world’s leading peer-reviewed social science, ecological and public health journals, whichudseem to indicate that there are contradictions between unfettered globalization and unconstrained worldudeconomic openness and sustainable development and public health development. We suggest that thereudseems to be a strong interaction between ‘transnational capitalist penetration’ and ‘environmental andudpublic health degradation’. Global policy-making finally should dare to take the globalization-criticaludorganizations of ‘civil society’ seriously. This conclusion not only holds for the countries of the developedud“West”, but also, increasingly, for the growing democracy and civil society movements around the globe,udin countries as diverse as Brazil, Russia, China, or ever larger parts of the Muslim world.