---------- Forwarded message ----------
Date: Fri, 19 Nov 1999 09:31:14 -0800 (PST)
From: Stephen Bezruchka <[log in to unmask]>
Subject: WTO is dangerous to your health

Globalization proves hazardout to health of world population [sic]

by Stephen Bezruchka, Op-Ed  Seattle Post-Intelligencer, Nov 18, 1999

Is the WTO dangerous to our health?
Effects of WTO rulings on labor and the environment are a major topic of
discussion where WTO is being debated.  But what about health?  Recent
research findings suggest that free trade can have a strong impact on
human health.  To understand these potential effects we must look at the
big picture of global trade and of health.

Most countries in the world are poor, with the majority of people
subsisting to produce their own food, often supplementing their income, by
sending family members to cities to work in factories or abroad, and
sometimes by engaging in illicit commerce.  Some countries, such as
Nigeria with its oil riches, have immense wealth, centered in a few hands
but not shared with its people.

As it has been carried on throughout much of the world in the last decade
or two, world trade could be more accurately described as
corporate-centered trade.  So-called "free-trade"  has produced great
wealth for corporations and provided poverty-level jobs in these poor
countries for many people.  The mass of people work for unliveable wages,
while an elite in their country profits along with huge corporations.
Study after study confirms that almost everywhere in the developing world
both the absolute numbers of people in poverty is increasing and the gap
between the rich and the poor is climbing to unheard of levels.

But what of the effects in rich countries?  Over the last 25 years, during
which globalization has become the mantra, economically speaking, most of
us in the US have seen a decline or stagnation in our incomes, after
adjusting for inflation.  This has come during a period of record profits
for corporations, and a booming stock market.  The rising tide has lifted
yachts, but not all boats.   The net worth of households from 1983 to 1995
declined for most of us, the bottom 95% of Americans, according to
economist Edward Wolff.  The top 1% holds over 40% of the wealth in this
country, a level comparable to that just before the stock market crash of
1929.

We have begun to look more and more like a third world economy with a
fabulously wealthy elite, surrounded by a mass of people not sharing in
the globalization pie.

Wages haven't grown with inflation, many families need two wage earners,
people hold several jobs, and most enjoy fewer benefits than they used to.
Our current low unemployment rate may have given us a breather in this
increase in inequality, but how long will it last?  Should we be
concerned?  What does rising inequality do to the health of a population?

Many of us think about the health effects of global trade as centering
around increases in pollution as corporations strive to limit
environmental restraints, or on global warming caused by the increased
reliance on cheaper artificially-subsidized fossil fuels, or on the
changes in diet produced by modern foods.  While these effects are real,
they pale in comparison to globalization's effect on increasing
inequality, the most powerful factor affecting our health.

To understand this phenomenon, recognize that the health of the US
population is disgracefully poor in comparison to other rich countries.
In the Health Olympics, the ranking of countries by life expectancy, we
stood 26th in 1994, behind all the other rich countries and a few poor
ones as well.  Should we expect this for the richest and most powerful
country ever?

The health of populations in rich countries is not determined primarily by
the health care system (we have the most sophisticated and expensive so it
cant be that), but rather by the extent of the gap between the rich and
the poor.  Many recent studies verify that populations that tolerate a
greater degree of income hierarchy are less healthy than populations that
are more equitable.   These studies have been done looking at mortality
and income distributions in countries, in our 50 states, and in our 282
standard metropolitan areas (U.S. cities).  They have also looked at
homicide rates, at teen births, and at specific diseases.   These have
been done by independent investigators on many different populations by
different methods and all agree:  the strongest factor affecting health is
the size of the gap between the rich and poor.  Other studies suggest
physiologic mechanisms through which greater hierarchy results in worse
health.  The analysis is as good as the relationship between smoking and
lung cancer, using the criteria first postulated in the US by the Surgeon
General's Report in 1964.  (The data and scientific analyses can be seen
at: http://depts.washington.edu/eqhlth/)

The United States has the greatest wealth and income gap of any rich
country, which is the main explanation for its dismal standing in the
Health Olympics.  We did not always fare so poorly in the race: in 1960,
we were 13th.  As our wealth and income gap has grown, so has our distance
from the finish line.

Globalization accelerates this race to the bottom by paying lower and
lower wages and providing fewer and fewer benefits to most people, while
American CEOs and other management-level staff are paid far more than they
are in any other rich countrys.  Seattle had a middle ranking in
inequality at the last census 10 years ago,  and a middle ranking in
health, but with three of the four richest people living here now, the gap
between the "have too much's" and "just have enough's" is obviously
increasing, as the next census is sure to show.   Our relative standing in
health among cities is sure to decline as well.

Seattle is giving birth to the protest of the century, as tens of
thousands of people plan to come to demonstrate during the WTO ministerial
meetings at the end of November.  This massive display of concern coming
at a time of supposed prosperity shows the extent to which people are
uncomfortable with the effects of globalization.  Local neighborhood
action groups are spreading the word, talking to friends and neighbors,
handing out literature at community events and writing for local
publications.

While these actions will likely not stop the WTO, publicity will show the
world that people do not want to accept the current global economic rules.
"We the people" are the sovereign in the US, and it is up to us to decide
how we are to work together in the world order.  Our health depends on it.

Stephen Bezruchka, MD.  is a faculty member in the  Department of Health
Services, School of Public Health and Community Medicine, University of
Washington and an emergency physician at Virginia Mason and Group Health.








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