PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY. Presented by Barbara L. Nichols, DHL, MS, RN, FAAN

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1 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY Presented by Barbara L. Nichols, DHL, MS, RN, FAAN

2

3

4 Overview of Globalization

5 A Global Perspective Four Policy Issues Globalization Migration Demographics Policy Changes

6 A Global Perspective Globalization Migration

7 A Global Perspective GLOBALIZATION A borderless world Globalization: the international movement of technology, ideas, labor, products, and professional education and standards

8 A Global Perspective GLOBALIZATION MEANS MOBILITY OF: Capital Organizations Ideas Technology Immigrants

9 A Global Perspective GLOBALIZATION Transcends all boundaries Involves Migration Erases perceived differences Ignores local definitions Seeps through porous borders Is IRREVERSIBLE

10 A Global Perspective MIGRATION MIGRATION is the movement of people across borders, usually for the purpose of employment or acquiring a new residence. It occurs within countries (Internal rural to urban) or External through daily commuting, seasonal relocation or internationally.

11 Globally Mobile Populations BY THE NUMBERS Nearly ONE BILLION annually Predicted to increase to 1.5 Billion in ten years

12 Globally Mobile Populations INCLUDE: Immigrants Refugees Migrant Workers International Adoptees

13 Globally Mobile Populations INCLUDE (Cont d.): Trafficking Victims Displaced Persons Tourists Business Travelers

14 Globally Mobile Populations MIGRATION TRENDS: 212 million worldwide immigrants One million come to the U.S. annually

15 Globally Mobile Populations MIGRATION TRENDS: Worldwide one of every 35 is a migrant In urban areas one of every 6 is a migrant

16 Globally Mobile Populations MIGRATION TRENDS: Million USA 12.3 Million Russian Federation 10.8 Million Germany 7.3 Million Saudi Arabia 7.2 Million Canada

17 Globally Mobile Populations MIGRATION TRENDS-USA Tripled in the last 30 years Largest continuous wave in US history No longer from Scandinavia, Western and Eastern Europe, but Asia, Africa, and Arab Countries

18 Globally Mobile Populations MIGRATION TRENDS-USA Today, the United States is the largest recipient of international migrants.

19 Globally Mobile Populations MIGRATION TRENDS Not a New Phenomenon

20 Globally Mobile Populations MIGRATION TRENDS Different in Character Cyclical but continual Global rather than western Overwhelmingly female

21 Globally Mobile Populations MIGRATION TRENDS Different in Character Nationality Religion Socioeconomic status

22 Globally Mobile Populations 1912 Nationalities Irish, Italians, Germans Religions Catholic, different protestant faiths Socioeconomic status Craftsmen Laborers USA EXPERIENCE 2011 Nationalities Asians, Africans, Arabs Religions Hindu, Muslim, Buddhist Socioeconomic status Professionals Skilled Technocrats

23 Globally Mobile Populations MIGRATION TRENDS Not new but recurring Change in characteristics and context From melting pot to the mosaic From blue collar to white collar workers

24 Globally Mobile Populations MIGRATION Migration is one of the defining issues of the twenty-first century. It is now an essential, inevitable and potentially beneficial component of the economic and social life of every country and region.

25 Globally Mobile Populations MIGRATION TRENDS Migrants bring NEW culture Religion Language Cultural practices and norms

26 Globally Mobile Health Professionals HEALTH WORKFORCE Mirror three major trends Cultural value differences Linguistic and language differences Racial and ethnic differences

27 Globally Mobile Health Professionals HEALTH WORKFORCE 59 Million Health Care Workforce 2/3 Health Service Providers 1/3 Health Management Support Workers

28 Globally Mobile Health Professionals HEALTH WORKFORCE Shortages Maldistribution Skill Mix Gender Public/Private

29 Globally Mobile Health Professionals HEALTH WORKFORCE Tug of war Lack of standardized data elements Lack of comparable data base

30 Globally Mobile Health Professionals HEALTH WORKFORCE How to mitigate grave imbalances Balance the right move without damaging the right to basic standards of care

31 Globally Mobile Health Professionals HEALTH WORKFORCE NURSES ARE: Largest global health workforce Largest global health workforce in any country

32 Globally Mobile Populations Globally Mobile Health Professionals GLOBAL PERSPECTIVE Freedom Security Opportunity

33 Globally Mobile Populations Globally Mobile Health Professionals GLOBAL PERSPECTIVE World poverty Readily affordable transportation Communications revolution Increased demand for workers Changes in immigration policy Growing worker networks

34 Changing Demographics - Global

35 Changing Demographics - Global

36 Changing Demographics - Global

37 Changing Demographics - Global WOMENS MIGRATION Feminization and coloration of labor Empowerment and women's rights

38 Changing Demographics - USA RACE TRENDS % of US population will come from Asians People of color are a majority in 48 of the nations largest 100 cities Hispanics largest ethnic minority

39 Changing Demographics - USA RACE TRENDS Five states have minority majorities California Hawaii New Mexico Texas Florida

40 Changing Demographics - USA RACE TRENDS Five states have non-white populations around 40% Georgia Maryland Mississippi New York Arizona

41 Changing Demographics - USA RELIGIOUS TRENDS Islam fastest growing religion

42 Changing Demographics - USA TREND The United States is becoming more

43 Changing Demographics - USA TREND Becoming more

44 Changing Demographics - USA Health Workforce Trends 1.1 million immigrants account for 17% of U.S. healthcare providers 13% are nurses

45 Changing Demographics - USA Health Workforce Trends MIRROR: Racial and ethnic disparities in patient outcomes Cross-cultural value differences Linguistic and language differences

46 Changing Demographics - USA Health Workforce Trends Representation in health professions low Under-representation in management and administrative positions Racial disparities have worsened

47 Changing Demographics - Global MEANS Diversity in age, race and religion challenge responses to health care delivery, practices and outcomes.

48 This Means That COLOR Matters

49 Prejudice Matters PREJ-U-DICE Judgment or preconceived idea before the facts are known; usually unfavorable; marked by fear, intolerance, or hatred Webster, New World Dictionary

50 Prejudice Matters Stereotype + Categorization = Prejudice Prejudice + Social Context = Discrimination Gordon Allport, The Nature of Prejudice

51 Changing Demographics - Global MEANS Can no longer conceptualize disease over there or disease seen here

52 Changing Demographics - Global MEANS Expanding our view about health and care Understanding that migrants bring new cultural dynamics and influence

53 Changing Demographics - Global HEALTH CARE PROFESSIONALS R E S P E C T just a little bit

54 Changing Demographics - Global MEANS Humane Treatment Ethical Practices Lens of Opportunity

55 Changing Demographics - Global MEANS Universal Human Right EVERYONE has the right to leave any country, including his own, and to return to his country.

56 Defining Issues SUMMARY I was taught the way to progress is neither swift nor easy. Marie Curie

57 Defining Issues SUMMARY World Poverty Economic Inequalities Feminization of Labor Globalization

58 Defining Issues SUMMARY Migration Diversity Cultural Competence Embedded Social Justice Issues

59 Defining Issues SUMMARY Martin Luther King, Jr. We are tied together in a single garment of destiny, in the web of mutuality. 1968

60 Defining Issues SUMMARY. Collaboration is Key

61 Health is a valuable resource a basic human right and a global public good that needs to be practiced and promoted by the global community. Ilona Kickbusch Yale University, 2002

62 Barbara L. Nichols, DHL, MS, RN, FAAN President and Chief Executive Officer Barbara Nichols Consulting

Slide 1. Slide 2 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY. Slide 3 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY

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