perspectives on g lobalization perspectives on globalization and health … · 2018-04-03 ·...
TRANSCRIPT
Slide 1 PERSPECTIVES ON GLOBALIZATION
AND
HEALTH POLICY
Presented by
Barbara L. Nichols, DHL, MS, RN, FAAN
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Slide 2 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
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Slide 3 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
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Slide 4 Overview of Globalization
PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
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Slide 5 A Global Perspective
PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Four Policy Issues
• Globalization• Migration• Demographics• Policy Changes
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Slide 6 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
A Global Perspective
Globalization
Migration
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Slide 7 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
A Global Perspective
GLOBALIZATION
A borderless world
Globalization: the international movement of technology, ideas, labor, products, and professional education and standards
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Slide 8 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
A Global Perspective
GLOBALIZATION MEANS
MOBILITY OF:
CapitalOrganizationsIdeasTechnologyImmigrants
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Slide 9 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
A Global Perspective
GLOBALIZATION
Involves Migration
Is IRREVERSIBLE
Transcends all
boundaries
Ignores local
definitions
Seeps through porous borders
Erases
perceived
differences
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Slide 10 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
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.
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Slide 11 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
BY THE NUMBERS
Nearly ONE BILLION annually
Predicted to increase to 1.5 Billion in ten years
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Slide 12 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
INCLUDE:
ImmigrantsRefugeesMigrant WorkersInternational Adoptees
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Slide 13 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
INCLUDE (Cont’d.):
Trafficking VictimsDisplaced PersonsTouristsBusiness Travelers
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Slide 14 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
MIGRATION TRENDS:
212 million worldwide immigrants
One million come to the U.S. annually
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Slide 15 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
MIGRATION TRENDS:
Worldwide one of every 35 is a migrant
In urban areas one of every 6 is a migrant
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Slide 16 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
MIGRATION TRENDS:
42.8 Million USA
12.3 Million Russian Federation
10.8 Million Germany
7.3 Million Saudi Arabia
7.2 Million Canada
2010
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Slide 17 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
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
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Slide 18 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
MIGRATION TRENDS-USA
Today, the United States is the
largest recipient of international
migrants.
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Slide 19 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
MIGRATION TRENDS
Not a New Phenomenon
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Slide 20 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
MIGRATION TRENDS
Different in Character
Cyclical but continual
Global rather than western
Overwhelmingly female
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Slide 21 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
MIGRATION TRENDS
Different in Character
Nationality
Religion
Socioeconomic status
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Slide 22
1912
Nationalities
• Irish, Italians, Germans
Religions
• Catholic, different
protestant faiths
Socioeconomic status
• Craftsmen
• Laborers
2011
PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
Nationalities
• Asians, Africans, Arabs
Religions
• Hindu, Muslim, Buddhist
Socioeconomic status
• Professionals
• Skilled Technocrats
USA EXPERIENCE
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Slide 23
Not new but recurring
Change in characteristics and context
From melting pot to the mosaic
From blue collar to white collar workers
MIGRATION TRENDS
PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
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Slide 24
MIGRATION
PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
“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.”
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Slide 25 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
Migrants bring NEW culture
• Religion
• Language
• Cultural practices and norms
MIGRATION TRENDS
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Slide 26 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Health Professionals
Mirror three major trends
• Cultural value differences
• Linguistic and language differences
• Racial and ethnic differences
HEALTH WORKFORCE
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Slide 27 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Health Professionals
59 Million Health Care Workforce
• 2/3 Health Service Providers
• 1/3 Health Management Support Workers
HEALTH WORKFORCE
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Slide 28 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Health Professionals
Shortages
Maldistribution
Skill Mix
Gender
Public/Private
HEALTH WORKFORCE
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Slide 29 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Health Professionals
Tug of war
Lack of standardized data elements
Lack of comparable data base
HEALTH WORKFORCE
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Slide 30 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Health Professionals
How to mitigate grave imbalances
Balance the right move without damaging the right to basic standards of care
HEALTH WORKFORCE
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Slide 31 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Health Professionals
NURSES ARE:
Largest global health workforce
Largest global health workforce in any country
HEALTH WORKFORCE
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Slide 32 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
Globally Mobile Health Professionals
Freedom
Security
Opportunity
GLOBAL PERSPECTIVE
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Slide 33 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Globally Mobile Populations
Globally Mobile Health Professionals
World poverty
Readily affordable transportation
Communications revolution
Increased demand for workers
Changes in immigration policy
Growing worker networks
GLOBAL PERSPECTIVE
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Slide 34 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - Global
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Slide 35 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - Global
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Slide 36 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - Global
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Slide 37 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - Global
Empowerment and women's’ rights
Feminization and coloration of labor
WOMENS MIGRATION
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Slide 38 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - USA
People of color are a majority in 48 of the nations largest 100 cities
2050 – 90% of US population will come from Asians
RACE TRENDS
Hispanics largest ethnic minority
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Slide 39 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - USA
RACE TRENDS
Five states have “minority” majorities
• California• Hawaii• New Mexico• Texas• Florida
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Slide 40 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - USA
RACE TRENDS
Five states have non-white populations
around 40%
• Georgia• Maryland• Mississippi• New York• Arizona
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Slide 41 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - USA
RELIGIOUS TRENDS
Islam fastest growing religion
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Slide 42 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - USA
TREND
The United States is becoming
more
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Slide 43 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - USA
TREND
Becoming more
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Slide 44 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - USA
Health Workforce Trends
1.1 million immigrants account for 17% of U.S. healthcare providers
13% are nurses
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Slide 45 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - USA
Health Workforce Trends
MIRROR:
• Racial and ethnic disparities in patient outcomes
• Cross-cultural value differences
• Linguistic and language differences
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Slide 46 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - USA
Health Workforce Trends
• Representation in health professions low
• Under-representation in management and administrative positions
• Racial disparities have worsened
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Slide 47 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - Global
Diversity in age, race and religion challenge responses to health care delivery, practices and outcomes.
MEANS
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Slide 48
This
Means
That
COLOR
Matters
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Slide 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
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Slide 50 Prejudice Matters
Stereotype + Categorization = Prejudice
Prejudice + Social Context = Discrimination
Gordon Allport, The Nature of Prejudice
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Slide 51 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - Global
Can no longer conceptualize “disease over there or disease seen here”
MEANS
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Slide 52 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - Global
Expanding our view about health and care
Understanding that migrants bring new cultural dynamics and influence
MEANS
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Slide 53 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - Global
R
E
S
P
E
C
T
HEALTH CARE PROFESSIONALS
…just a little bit
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Slide 54 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - Global
Humane Treatment
Ethical Practices
Lens of Opportunity
MEANS
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Slide 55 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Changing Demographics - Global
“EVERYONE has the right to leave any country, including his own, and to return to his country.”
MEANS
Universal Human Right
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Slide 56 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Defining Issues
SUMMARY
“I was taught the way to progress is neither swift nor easy.”
…Marie Curie
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Slide 57 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Defining Issues
SUMMARY
•World Poverty
•Economic Inequalities
•Feminization of Labor
•Globalization
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Slide 58 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Defining Issues
SUMMARY
•Migration
•Diversity
•Cultural Competence
•Embedded Social Justice Issues
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Slide 59 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Defining Issues
SUMMARY
Martin Luther King, Jr.
“We are tied together in a single garment of destiny, in the web of mutuality.”
…1968
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Slide 60 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
Defining Issues
SUMMARY
.Collaboration is Key
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Slide 61 PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
“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
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Slide 62
Barbara L. Nichols, DHL, MS, RN, FAAN
President and Chief Executive Officer
Barbara Nichols Consulting
PERSPECTIVES ON GLOBALIZATION AND HEALTH POLICY
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