Global processes penetrate all structures of society and affect all its social institutions, including health and healthcare. On the one hand, these changes have a beneficial effect on the development of the health care sector: the intensity of the exchange of scientific information, access to effective foreign medical technologies, the latest telecommunications, allowing the introduction of remote forms of diagnosis, treatment, training of specialists, and others. At the same time, the economy inherent in globalization grows out of centers of economically profitable activities, does not seek total development of territories and resources, but is guided only by economic expediency, which leads to serious problems in the field of health, employment, social protection, and the quality of life, for example, the population of rural areas. For the US, as Weisbrot et al. (2020), globalization and neoliberalism bear enormous costs for health and social well-being and quality of life in general.
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The influence of globalization can be both direct and indirect and is combined with the action of factors that are fundamentally different but are also global. For example, the latter includes such a demographic factor as the aging of the population (Dieleman et al., 2017).
Globalization has had an immediate, direct impact primarily on patients’ national and ethnic composition, giving it exceptional diversity.
The freedom of cross-border movement generated by globalization has significantly expanded the migration of the population in search of work and better living conditions, escape from the devastating consequences of military conflicts and political and social instability, and other reasons. Globalization has led to the widespread development of the so-called “medical tourism,” that is, travel to other countries for medical purposes, including diagnosis, treatment, health promotion, and cosmetic interventions.According to approximate estimates of the international organization “Patients Without Borders,” the global medical tourism market reaches $ 20 to 35 billion, and its growth rate is approximately 25-35% (Sanderg, 2017). At the same time, large-scale movements of patients worldwide are multidirectional: patients travel not only from developing countries to developed countries of the world with high-quality medicine, but significant flows of them move in the opposite direction.
Mainly under the influence of globalization in a number of developing countries in recent decades, large hospitals have appeared with the latest equipment and personnel trained in the West. Often such hospitals are created with the participation of foreign companies and capital. They are able to provide comfortable conditions and high-quality medical care, but at lower prices due to the low cost of local labor (Sandberg, 2017). This attracts residents from rich countries, including the US, where the cost of medical services is much higher.
Comparing Two Populations: The US and Haiti
When speaking about population health, experts define population either in terms of nations or in terms of more specific and discrete communities that need to be addressed in policies. In the case of cholera, one discussed Haiti’s population as a case of a nation most affected by this disease. The author belongs to the US population and, more specifically, lives in a major city of SC and identifies herself as a black female.
While precise physical, geographical, and social characteristics may be relevant for a health population particularization in the US, they may be less relevant for Haiti. The reason for that is that while the US healthcare system is one of the most developed and advanced globally, it is not Haiti’s case: the healthcare there is unfairly underdeveloped and impoverished (Aurelus & Saintil, 2020). By 2017, expenditures on health per capita in Haiti had been estimated at 62 US$ and amounted to 8.04% of GDP in total, whereas in the US, total health expenditures comprised 18% of GDP and resulted in more than 10200 US$ per capita (Macrotrends, 2020; The World Bank, 2020). Needless to say that the disparity is huge. Thus, healthcare in Haiti should be addressed as a whole.
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One of the leading indicators of the country’s social well-being is the health authorities’ level and work. While these are not the only characteristics, they largely determine the differences in health care across countries. With this approach in mind, the OECD (2019) assessed the quality of health systems in 20 Latin American and Caribbean countries using 16 objective generally accepted indicators such as infant mortality rates and the number of doctors. The research result shows a huge difference between states. The gap in life expectancy reaches 17 years.
According to the study results, Haiti ranks as one of the last places in terms of the level of healthcare and the provision of medical services to the population. Haiti has the lowest life expectancy at 61.5 years, which is more than 17 years less than in the US (OECD, 2019). It also had the highest infant mortality rate at 64 deaths per 1,000 newborns per year, compared with 14 in the US.
Haiti, where healthcare is most neglected, has the worst rates in other dimensions, such as maternal mortality, the proportion of births attended by qualified doctors, measles vaccination, health care costs per capita, and drinking water supply. The large gap in the healthcare level is a consequence of global structural factors: both at the national policy level and the level of global capitalism (Sell & Williams, 2020). These structural factors result from a harmful combination of unfair policies, economic distress, and incompetent governance.
Aurelus, E., & Saintil, I. (2020). Health Disparity in Haiti Due to the Economic System of the Country. Frontiers in Medical Case Reports, 1, 1-6.
Dieleman, J. L., Squires, E., Bui, A. L., Campbell, M., Chapin, A., Hamavid, H.,… & Sadat, N. (2017). Factors associated with increases in US health care spending, 1996-2013. Jama, 318(17), 1668-1678.
Macrotrends (2020). Haiti Healthcare Spending 2000-2020. Web.
OECD (2019). Health systems characteristics: A survey of 21 Latin American and Caribbean countries [PDF]. Organization for Economic Co-operation and Development.
Sandberg, D. S. (2017). Medical tourism: An emerging global healthcare industry. International Journal of Healthcare Management, 10(4), 281-288.
Sell, S. K., & Williams, O. D. (2020). Health under capitalism: a global political economy of structural pathogenesis. Review of International Political Economy, 27(1), 1-25.
The World Bank (2020). Current health expenditure per capita, PPP (current international $). Web.
Weisbrot M., Baker D., Rosnik D.(2020). The scorecard on development: 25 years of diminished progress. In Navarro, V. (Ed.) Neoliberalism, globalization, and inequalities: Consequences for health and quality of life, 276-298. Routledge.