PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY Presented by Barbara L. Nichols, DHL, MS, RN, FAAN
Overview of Globalization
A Global Perspective Four Policy Issues Globalization Migration Demographics Policy Changes
A Global Perspective Globalization Migration
A Global Perspective GLOBALIZATION A borderless world Globalization: the international movement of technology, ideas, labor, products, and professional education and standards
A Global Perspective GLOBALIZATION MEANS MOBILITY OF: Capital Organizations Ideas Technology Immigrants
A Global Perspective GLOBALIZATION Transcends all boundaries Involves Migration Erases perceived differences Ignores local definitions Seeps through porous borders Is IRREVERSIBLE
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.
Globally Mobile Populations BY THE NUMBERS Nearly ONE BILLION annually Predicted to increase to 1.5 Billion in ten years
Globally Mobile Populations INCLUDE: Immigrants Refugees Migrant Workers International Adoptees
Globally Mobile Populations INCLUDE (Cont d.): Trafficking Victims Displaced Persons Tourists Business Travelers
Globally Mobile Populations MIGRATION TRENDS: 212 million worldwide immigrants One million come to the U.S. annually
Globally Mobile Populations MIGRATION TRENDS: Worldwide one of every 35 is a migrant In urban areas one of every 6 is a migrant
Globally Mobile Populations MIGRATION TRENDS: 2010 42.8 Million USA 12.3 Million Russian Federation 10.8 Million Germany 7.3 Million Saudi Arabia 7.2 Million Canada
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
Globally Mobile Populations MIGRATION TRENDS-USA Today, the United States is the largest recipient of international migrants.
Globally Mobile Populations MIGRATION TRENDS Not a New Phenomenon
Globally Mobile Populations MIGRATION TRENDS Different in Character Cyclical but continual Global rather than western Overwhelmingly female
Globally Mobile Populations MIGRATION TRENDS Different in Character Nationality Religion Socioeconomic status
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
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
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.
Globally Mobile Populations MIGRATION TRENDS Migrants bring NEW culture Religion Language Cultural practices and norms
Globally Mobile Health Professionals HEALTH WORKFORCE Mirror three major trends Cultural value differences Linguistic and language differences Racial and ethnic differences
Globally Mobile Health Professionals HEALTH WORKFORCE 59 Million Health Care Workforce 2/3 Health Service Providers 1/3 Health Management Support Workers
Globally Mobile Health Professionals HEALTH WORKFORCE Shortages Maldistribution Skill Mix Gender Public/Private
Globally Mobile Health Professionals HEALTH WORKFORCE Tug of war Lack of standardized data elements Lack of comparable data base
Globally Mobile Health Professionals HEALTH WORKFORCE How to mitigate grave imbalances Balance the right move without damaging the right to basic standards of care
Globally Mobile Health Professionals HEALTH WORKFORCE NURSES ARE: Largest global health workforce Largest global health workforce in any country
Globally Mobile Populations Globally Mobile Health Professionals GLOBAL PERSPECTIVE Freedom Security Opportunity
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
Changing Demographics - Global
Changing Demographics - Global
Changing Demographics - Global
Changing Demographics - Global WOMENS MIGRATION Feminization and coloration of labor Empowerment and women's rights
Changing Demographics - USA RACE TRENDS 2050 90% 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
Changing Demographics - USA RACE TRENDS Five states have minority majorities California Hawaii New Mexico Texas Florida
Changing Demographics - USA RACE TRENDS Five states have non-white populations around 40% Georgia Maryland Mississippi New York Arizona
Changing Demographics - USA RELIGIOUS TRENDS Islam fastest growing religion
Changing Demographics - USA TREND The United States is becoming more
Changing Demographics - USA TREND Becoming more
Changing Demographics - USA Health Workforce Trends 1.1 million immigrants account for 17% of U.S. healthcare providers 13% are nurses
Changing Demographics - USA Health Workforce Trends MIRROR: Racial and ethnic disparities in patient outcomes Cross-cultural value differences Linguistic and language differences
Changing Demographics - USA Health Workforce Trends Representation in health professions low Under-representation in management and administrative positions Racial disparities have worsened
Changing Demographics - Global MEANS Diversity in age, race and religion challenge responses to health care delivery, practices and outcomes.
This Means That COLOR Matters
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
Prejudice Matters Stereotype + Categorization = Prejudice Prejudice + Social Context = Discrimination Gordon Allport, The Nature of Prejudice
Changing Demographics - Global MEANS Can no longer conceptualize disease over there or disease seen here
Changing Demographics - Global MEANS Expanding our view about health and care Understanding that migrants bring new cultural dynamics and influence
Changing Demographics - Global HEALTH CARE PROFESSIONALS R E S P E C T just a little bit
Changing Demographics - Global MEANS Humane Treatment Ethical Practices Lens of Opportunity
Changing Demographics - Global MEANS Universal Human Right EVERYONE has the right to leave any country, including his own, and to return to his country.
Defining Issues SUMMARY I was taught the way to progress is neither swift nor easy. Marie Curie
Defining Issues SUMMARY World Poverty Economic Inequalities Feminization of Labor Globalization
Defining Issues SUMMARY Migration Diversity Cultural Competence Embedded Social Justice Issues
Defining Issues SUMMARY Martin Luther King, Jr. We are tied together in a single garment of destiny, in the web of mutuality. 1968
Defining Issues SUMMARY. Collaboration is Key
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
Barbara L. Nichols, DHL, MS, RN, FAAN President and Chief Executive Officer Barbara Nichols Consulting Barbara.nichols@att.blackberry.net