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Workshop 1.5 Title: Globalization: Trade, Population Mobility and International Security Organizers: W. Kwong, DW MacPherson Presenters: 1. DW MacPherson. Globalization: the inter- dependency of population mobility, security and trade 2. M Riestra Venegas. Migrant Labour - Mexico and the USA. 3. N Motus / J Weekers. Globalizing Public Health. 4. P Van Krieken. The relationship between health and migration.

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Globalization: the inter- dependency of population mobility, security and trade Douglas W. MacPherson MD, MSc(CTM), FRCPC

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International Metropolis - Vienna, September 15-19, 2003 3 What is Globalization ? "It is yet another Civilized Power, with its banner of the Prince of Peace in one hand and its loot-basket and its butcher-knife in the other." -- Mark Twain, in his essay, To the Person Sitting in Darkness, 1901, describing the United States playing the European-style imperialist game in the Philippines.To the Person Sitting in Darkness

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International Metropolis - Vienna, September 15-19, 2003 4 What is Globalization ? "For globalism to work,...The hidden hand of the market will never work without a hidden fist -- McDonald's cannot flourish without McDonnell Douglas, the designer of the F-15. And the hidden fist that keeps the world safe... is called the United States Army, Air Force, Navy and Marine Corps." -- in "What the World Needs Now", by Thomas Friedman, New York Times, March 28,1999." -- from Backing Up Globalization with Military MightBacking Up Globalization with Military Might

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International Metropolis - Vienna, September 15-19, 2003 5 What is Globalization ? Is a long-term process of global integration represented by the increasing rate of accessing international venues, driven by: advances in trade, telecommunications, transportation balanced by international security considerations due to population mobility

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International Metropolis - Vienna, September 15-19, 2003 6 Globalization and Mobility? Implications for Population and Public Policy understanding the process measuring past and current impacts evaluation of policy consequences looking to the future & preparing today.

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International Metropolis - Vienna, September 15-19, 2003 7 Mobility/Migration the process Three Considerations*: 1.The People 2.The Phases of Migration Pre-departure Transit Post-arrival The Outcome Determinant Differentials (Prevalence Gaps) *MacPherson, Gushulak. Human mobility and population health. Perspect Biol Med 2001

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International Metropolis - Vienna, September 15-19, 2003 8 The People

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International Metropolis - Vienna, September 15-19, 2003 9 Migration Health - Context

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International Metropolis - Vienna, September 15-19, 2003 10 Globalization and Migration Push pull factors of : population: size, demographics and biometrics processes of movement prevalence gaps: source and host countries E ducation & training Cultural influences and beliefs Behaviour Language Health

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International Metropolis - Vienna, September 15-19, 2003 11 International Tourist Movements Magnitudes - people WTO data. 2002* projected

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International Metropolis - Vienna, September 15-19, 2003 12 International Tourist Movements Magnitudes (people sources) WTO data.

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International Metropolis - Vienna, September 15-19, 2003 13 Global Tourist Movements Magnitudes (economics) WTO data. 2001 = US $463 Billion

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International Metropolis - Vienna, September 15-19, 2003 14 Immigration to Canada 1860-2001 WW IWW IIHungarian Revolt

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International Metropolis - Vienna, September 15-19, 2003 15 Immigration to Canada 1860-2001 Europeanization Multi-culturalization

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International Metropolis - Vienna, September 15-19, 2003 16 Immigration to Canada

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International Metropolis - Vienna, September 15-19, 2003 17 The Phases

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International Metropolis - Vienna, September 15-19, 2003 18 Pre-departure Phase Effect may be: negative: e.g., poverty, lower education, poorer health systems neutral: e.g., similarity in environment, education, genetics/biology positive: e.g., healthier behaviours

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International Metropolis - Vienna, September 15-19, 2003 19 Transit Phase Advances in Transportation technology, accessibility and affordability has virtually eliminated the health risks associated with the movement phase EXCEPT: trafficking in humans smuggling in humans

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International Metropolis - Vienna, September 15-19, 2003 20 Post-arrival Phase Effects of pre and transit phases plus: Balance of imported cultural, genetic, behavioural influences with host destination determinants: e.g., health care, environment BUT attainable socio-economic goals now permit reverse migration not possible in previous generations of migrants VFR effect: Visiting Friends and Relatives on recent migrant and 1 st generation.

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International Metropolis - Vienna, September 15-19, 2003 21 Prevalence Gaps

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International Metropolis - Vienna, September 15-19, 2003 22 Refugees & Asylum Seekers by year Worldwide Persons in need of Protection, UNHCR. * est.

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International Metropolis - Vienna, September 15-19, 2003 23 Refugees & Asylum Seekers by Host Region, 1999

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International Metropolis - Vienna, September 15-19, 2003 24 Globalization and Migration 140 million people live outside of their country of birth (1/40 persons) migrants represent > 15% of the population in over 50 countries worldwide OECD, Canada, USA migrants represent ~ 2/3 of population growth 45 million migrants from developing nations will enter the workforce globally to 2015

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International Metropolis - Vienna, September 15-19, 2003 25 Security, Trade & Health Is there a relationship between events distant from health in: time and place Temporally/geographically distant political balance - trade and security vs. health

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International Metropolis - Vienna, September 15-19, 2003 26 Security - Man-made Disasters Malfeasant September 11, 2002 Anthrax in USA War on Terror CBRN Programs Nuclear Weapon Programs

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International Metropolis - Vienna, September 15-19, 2003 27 Security Man-Made Terrorism: Bombings USS Cole, US Embassies Kenya/Tanzania World Trade Center Bali Israel/Palestine Civil disputes violent Balkans Serbia, Kosovo Rwanda/Burundi East Timor Moscow theatre

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International Metropolis - Vienna, September 15-19, 2003 28 Security Man-Made Accidental Bohpol / Union Carbide Three-Mile Island / Nuclear Uruguay Gold Mines / mercury poisoning The Kursk Nuclear Sub- marine

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International Metropolis - Vienna, September 15-19, 2003 29 Security Natural Disasters Environmental Severe Weather Floods Drought Storms hurricanes, tornadoes, Fires

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International Metropolis - Vienna, September 15-19, 2003 30 Security Man-made/Natural Disasters Man-made / Environmental MDR everything Walkerton, Cincinnati VHF Ebola, Hanta SARS BSE Heat deaths: Chicago, Europe

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International Metropolis - Vienna, September 15-19, 2003 31 Security Security involves more than intelligence, police or military services:. Environmental security Social security: language, culture, health, employment...

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International Metropolis - Vienna, September 15-19, 2003 32 Trade, Security, and Health Post-911 World Security trumps trade Health trumps security US Senate Appropriations USD 40 Billion for security: international, border, homeland

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International Metropolis - Vienna, September 15-19, 2003 33 Unlinked Costs Cholera in Peru, South America< 1 Billion USD Plague in India 3 5 Billion USD BSE in UK/Europe25 Billion USD SARS30 Billion USD. War in... Balkans, Priceless Great Lakes/Africa, Balkans, Kosovo, on Terror...

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International Metropolis - Vienna, September 15-19, 2003 34 Travellers shy away from international travel War, pneumonia outbreak, North Korea blamed for decline in Air NZ bookings on key international routes Travellers shy away from international travel War, pneumonia outbreak, North Korea blamed for decline in Air NZ bookings on key international routes Air New Zealand 21 March 2003 http://home.nzcity.co.nz/news/default.asp?id=29857&cat=976

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International Metropolis - Vienna, September 15-19, 2003 35 Migration Measuring Past and Current Impacts Links: health, security and trade Integrated (horizontal, vertical, longitudinal) decision- making mitigates impacts in the other two sectors... = Paradigm shift in local-international public health, economic/trade and security management.

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International Metropolis - Vienna, September 15-19, 2003 36 Migration Measuring Past and Current Impacts The West are nations built on migration The West will grow and compete based on migration The West is changing demographically and biometrically, including health determinants, directly related to migration

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International Metropolis - Vienna, September 15-19, 2003 37 Migration Measuring Past and Current Impacts The Developing Nations are source countries for migration The Developing Nations will grow and compete partly due to migration Are the Developing Nations benefiting; (public health, trade, security) related to migration - see WTO, Cancun September 2003?

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International Metropolis - Vienna, September 15-19, 2003 38 Migration Evaluation of Policy Consequences foreign policy - trade immigration policy international security policy health policy

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International Metropolis - Vienna, September 15-19, 2003 39 Migration Looking to the future & preparing today Challenge to academics & researchers, social scientists, program administrators, and governmental policy makers; and front-line service delivery workers Evidence-based decision-making.

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International Metropolis - Vienna, September 15-19, 2003 40