SOC in MED QUIZ 2

LECTURE 4: Cultures and Meanings of Health

Learning Objectives
Define Culture and How it intersects with Meaning of Health
Explore why culture is a determinant of health
Discuss how material objects, social relations, and ideas shape and influence culture
Discover the relative importance of culture in relation to health
Determine the cultural importance of health care practitioners and healers

What is Culture?
Refinement or Development?
Group Membership?
Learning, Sharing, and Socializing?
A Belief System?

most common
"Culture consists of patterns, explicit and implicit, of and for behavior acquired and transmitted by symbols, constituting
the distinctive achievement of human groups, including their embodiment in artifacts; the essential core of culture
consists of traditional (i.e., historically derived and selected) ideas and especially their attached values; culture systems
may, on the one hand, be considered as products of action, on the other as conditioning elements of further action."

Book said
What we currently regard as "culture” could be best described as practices that are learned, shared, and transmitted,
and that guide the behaviour and actions of members of a culture sharing group.

Characteristics of Culture
- Include notions of membership in a culture-sharing group
- Elements of learning, sharing, and common beliefs and values that provide a frame of reference for members of
the culture sharing group
- Provide a lens and worldview for members of culture sharing group to interpret and understand life
- Culture is transmitted through shared tangible and intangible elements that are only understood by members of
the group

Culture, Race and Ethnicity

Culture, Race, and Ethnicity all represent categorical differences among individuals;
These terms all suggest a transmission of some sort from one generation to another
- Race implies common genetic characteristics
- Ethnicity loosely refers to the origin of birth for a group of individual

The Formation of Culture

Culture is based on ideological, technological, and sociological subsystems (White, 1975)
Structure is based on 3 Factors
1. Artifacts
2. Social Structures and Relationships
3. System of Belief
Each of these component is interdependent (White, 1975; Huxley, 1955)

Systems of Artifacts
- Visible, Tangible material objects, and Technologies, that are part of a group’s day-to-day living
- Basic Necessities that allow members of a culture-sharing group to protect, feed, and amuse themselves
- The Structure and Organization of a culture-sharing group not only influences How individual behave, but also
Regulates the role of the individual with respect to the longer cultural system
Does Culture Affect Health?
Western Views
- Emphasis the use of prescription medicines to target and treat specific ailments
- In based on values such as the patient’s right to self-determination and autonomy
- Believes care should be provided by professionals
Aboriginal Views
- Understanding of health are seen as inseparable from religion and spirituality
- Health belief are often based on supernatural phenomena
- Care is often delivered by a “Medicine Man” or shaman from the Aboriginal community
Culture Impacts:
- The relationship between care giver and patient
- The way we communicate about our needs and illnesses
- Thoughts about who should communicate with health care providers
- Our assumptions about the body and the causes of illness
- Our beliefs about what is appropriate care and whether we it when we needed it

Is Culture a Social Determinant of Health?

Social Determinants of Health are Non-Medical Factors that often impact (or determine) the health of individuals and
societies
- Includes socioeconomic status, the built environment, culture, and health-related behaviours of individuals
Culture and Health are part of a Larger interrelated organization of factors that influence the well-being of an individual,
a community, or society at large

Modern Medical Culture

- North American Medical Culture values Objectivity and Scientific rationalities
- “True Knowledge” can only be achieved when science and medicine intersect
- Reliance on biomedical practices
Germ Theory
- Shifted the focus from healing to disease
- Focused efforts on identifying invading pathological organisms as the cause of illness
- Substantiated the biological foundations of bodies
- Has Become the basis for modern medicine and a focus on “Best evidence” when deciding care
- Allows Practitioners to see physical illnesses as separate from the patients’ psychological consciousness and
from social and cultural factors
- The body; is seen as a machine – separate parts working independently from each other; allows practitioners to
isolate each body part from the whole. The physical body, in theory, is then reducible to the sum of its parts
- The mind; body dichotomy isolates mental issues as distinct & not connected with the “physical body”
- Is more concerned with causes than relationship
- Has medicalized many issues and conditions that were previously not treated, diagnosed, or discussed as
medical conditions
- Often medicalizes conditions when new treatments are developed or there is a new way to define the condition
- Overestimates the importance of biological factors and medical technologies, and underestimates the role of
non-medical factors related to social relations or culture

Culture in Professional Health Sectors

- Culture developed as a need to regulate health care providers to ensure the “authority” of those practicing
- Knowledge passed on to “hand-picked” apprentices as a way to control access; created an elite class of
disciplines, while disadvantaging other disciplines, while disadvantaging other disciplines.

- The White Coat ceremony is a rite of passage in the culture of medical professions
- This ceremony, celebrates the transition of a student into the clinical realm and is symbolic of a person’s entry
into the professional health sectors
Culture in the Popular Health Sectors
 - Often conceptualized as the informal health care system, includes lay information sharing

- Sharing happens through social networks such as one’s family or community or on the internet
- Allows individuals to “diagnose and treat” their own symptoms
- Is the largest sector in health care
- Influences how we experience health and illness and our beliefs about what we should do in response
Culture in the Folk Health Sector
- Seen as a link between the professional and the popular sector
- Health care is administered by a practitioner (i.e., a Shaman or a doctor of Ayurvedic medicine).
- Also known as complementary and alternative medical care.
- Practitioners within the folk health sector look to gather information about patterns and harmony in their
patients

Fear and Illness across Cultures

- Cultural beliefs about health and illness are often imbued with fear
- How individuals understand and respond to their illnesses is often dependent on their culture.
- The cultural guidelines that shape an individual’s behaviour or worldviews also affect how individuals handle
situations perceives as “misfortune”
- Due to cultural fears about certain diseases/illnesses, people may be afraid to disclose symptoms – this can lead
to misdiagnoses
- People may not admit to being sick/ill if it’s frowned upon by their peers or co-workers
- People may also fear stigmatization if they disclose a disease/illness that is culturally sensitive such as a mental
illness, cancer from smoking, or HIV/AIDS

Examples of Alterative Healers

- Religious Healer
- Magician Healer
- Traditional Chinese Healer
- Aboriginal Healer

Are they Effective?

- Critics contend that the practice of these alterative forms of medicine or healing requires “blind faith” on the
part of patients and possibly the acceptance of supernatural forces and cosmic influences
 - However, those who use these types of healers/medicine do perceive that they work

Cultural Competency
- The ability of systems to provide care to patients with diverse values, beliefs and behaviours, including tailoring
delivery to meet patients’ social, cultural, and linguistic needs (Betancourt, 2002)
- The idea that health care professionals can be trained in cultural competency, however, is contentious, and
assumes a “one size fits all” approach to cultural groups and their health
- Cultural competency training may create stereotypical views of patients and their cultural rituals, views or
practices and may actually become barriers to health.
- Health care professionals need to focus on understanding individual patients and building relationship with then
in order to meet their specific needs, regardless of their culture.

Summary
- It is important to understand the common factors that constitute culture
- Health beliefs and norms around health and illness are often transmitted in cultures
- Although culture may be shared among individuals, members of a culture-sharing group not homogeneous and
may or may not adhere to all aspects of their culture.
- Culture should be seen as dynamics and changing; constantly in flux
- The dominant biomedical culture in North America is based on objectivity and scientific rationality
- Other frameworks of understanding health and illness are not as widely accepted

Lecture 5: Identity, Intersectionality, and Health

Learning Objectives
- Discuss the impact social identity can have on one’s health
- Explore how social structures form individual identity
- Define intersectionality
- Examine the relationship between intersectionality and health

The Parable of the River

- Physicians’ role is to help or save people
- But if they are so busy pulling people out of the river
- how do they ever have time to find out why people are in the river in the first place?
- What is the meaning hidden in the parable of the river?
“Upstream” Factors in Health
Upstream factors play an important role in promoting wellbeing and preventing illness.

Social Identity
- Social identity includes
o where we come from
o our education and career
o our gender and sexual identity
o our family background
o our race and ethnicity
o our interests
o our dreams

- People from varying social backgrounds and cultures have differing levels of risks posed by upstream factors.
- When these people “fall into the river,” how they respond and experience being in the river varies according to
their social identity.
Each of us experiences common events or situations…
 - being a woman
- being a man
- going to university
- belonging to a social class
- being a dancer
- being an athlete
and yet we experience these things in our own individual, unique way; different from how others experience the same
things.

Measuring Health Status & Disparities

Social Class
- One element of our social identity
- Portrays economic stratification in society
- Tied to the concept of socioeconomic status (SES) this concept was invented by Sociologist Max Weber
- Comprises one’s income, education and/or occupation.
- A measure of one’s place or position in a society’s economy
- Often referred to as the “social gradient”

Connection of Social Class to Health

Studies Demonstrating the Connection of SES to Health •

- Research demonstrates that health varies as a result of social inequities.
o The Black Report (1980) demonstrated that while overall health in England had improved since
the1950s, there were increasing inequities in individual health status.
▪ This inequality was a result of differences in social class or socio-economic status.
- Acheson Report (1998) and the Marmot Review (2010) confirmed the results of the Black Report.
 - The Whitehall Study (2012)
o This study of the British civil service demonstrated that health status varies throughout the hierarchy of
positions.
o Those in higher positions, thus with higher social status, had better health outcomes.
- Mustard (1997)
o The study conducted in Manitoba examined the effects of education and income.
o It found similar results regarding the connection with health.
▪ The burden of inequities increases as people get older.
▪ Income has more effect than education.
Social Gradient and Health
- It has been demonstrated that inequities in the social gradient adversely affect those with less means.
- However, the magnitude of these effects is also dependent on the age and life course of those experiencing hard
times.
- This leads to the need for carefully timed interventions to effectively mitigate adverse effects.
Race and Ethnicity
- Another element of our social identity
- Can be a source of pride and collective identity but also a source of discrimination and stress
- Some policies and practices that supported racial discrimination and segregation continue today.
o These structures may create inequities and injustice.
Race and Health
- As with social class, research demonstrates a connection between individual health and race/ethnicity.
- African Americans experience the worst health status, particularly in comparison to Caucasian Americans.
- In Canada, First Nations people experience health outcomes similar to African Americans.
- Four possible models explaining the health variance among different races are o
o genetic variation o
o differences in lifestyle and behaviour
o level of psycho-social stress from life circumstances
o social inequalities
- After extensive examination, the social inequalities model is the most plausible.
- Demonstrates the key role of social determinants of health and illness
Race and Medical Services
- Social inequalities faced by African Americans and First Nations people are compounded by their poor
interactions with the medical system.
- Problems with the medical system range from being uninformed participants in research to an inability to access
adequate care due to government reserve policies and structures.
- Remote reserve communities in Canada compound the lack of available health care service.
- As a result these particular races experience health inequities.
-
The remoteness of many rural communities in Canada limits adequate health provision and can be a systematic barrier
for certain populations.

Possible Strategies to Eliminate Race Inequalities

- Programs should be developed within the community, rather than imposed from outside.
- Instead of focusing on individuals, effective solutions take a more collective approach and focus on the broader
community.
- The emphasis is on tackling the social determinants of health by combating racism and racial stereotyping.
Gender
- An additional component of our social identify Current society is primarily structured on a binary view of being
either male or female.
- Interpretations of what it means to be feminine or masculine are cultural and thus socially driven and not
connected to our physical gender.
- Institutional structures reinforce male privilege and dominance, which is oppressive to women and those men
who do not identify with traditional forms of masculinity.
Gender and Illness Experiences
- Women live longer than men but experience higher rates of morbidity.
- Possible reasons include:
o psychological factors
▪ like stress and challenging life events
o health-related behaviours
▪ like exercise or smoking
o social contextual factors
▪ like family structure, work, and age
- These health differences may actually be associated with our beliefs and ideas associated with masculinity and
femininity.
o Being ill or seeking help is seen as being “weak” and or feminine.
- Regardless of why health inequities exist, it is important to increase gender equalities.
- Men and women need to have similar access to resources.
- We need to reduce patriarchal structures (male domination) that make women more vulnerable to illness and
disease.
- We must address the underlying causes of oppression and inequality that can result in illness.

Intersectionality
- Rather than focus on one area of social identity and health (such as health and social class, health and race, or
health and gender), researchers are beginning to examine the combined effect of intersecting social and power
relations.
- This is known as intersectionality.
Taking an Intersectional Approach
- It means paying attention to unique health outcomes that are a result of the intersection of power and
identification structures.
- It involves more than just combing data from two or more areas.
- It means examining the interactions between various areas.
- This provides a more nuanced and detailed understanding of health disparities.
 - It will allow for the development of effective strategies both for a specific context and more broadly across
populations.
- Research using an intersectional approach to health inequalities is demonstrating that
o each area of social identity does not equally compound the problem, but rather
o together they create a multiple, complex and interactive effect, in which the outcome is difficult to
predict
- One must consider context, meaning, history, and experience when trying to understand health disparities.
Summary •
- Different components of an individual’s social identity (social class, race, gender) play a part in individual health.
•
- Social class or socioeconomic status comprises an individual’s background, income, education, and occupation.
O
o The lower one’s SES, the poorer one’s health tends to be.
- Race is connected to one’s heritage and physical appearance.
o In North American a Caucasian (white) identity is privileged, which leads to better health.
- Gender is typically considered to be binary according to sex: male and female.
o Patriarchal societies afford great power to men, which results in their better health.
- Intersectionality is the study of the connections of different areas of social identify and their effects on individual
health.

Lecture 6: Politics, Social Justice, and Health

Learning Objectives
- Discuss critical theories of social justice and their application to health
- Distinguish between health advocacy and health activism
- Define important terms related to social movements and health
- Examine movements within health and health care
- Examine connections between broader social movements as they relate to health and illness
How do we balance the duty of the state to protect the health of citizens and the right of individuals to define and
pursue their own health as they see fit?
How can society control the state to ensure that the state always serves society’s interests?
How much power should the state have over society?
Social Movements
- Mobilize people to action
- Form when individuals experience challenges
- Are organized to alter the distribution of Resources
- Aim to change attitudes and laws
- Focus around an issue
- Help citizens make choices
Social Justice
- Social justice is intended to create a society in which all citizens share equal access to treatment and a fair
allocation of resources regardless of their social status.
- Health care is a top priority for Canadians.
- The current health system does not always function on the principle of social justice.
- Disadvantaged groups, including women, refuges, and Aboriginal people, may not enjoy the benefits of social
justice.
Theories on Social Justice
Libertarian o
- Friedrich Hayek and Robert Nozick
- Social justice should not disrupt the market order.
- Core principles for the fair distribution of resources:
1. Justice in acquisition
2. Justice in transfer
3. Rectification
- Classic Utilitarianism (Liberalism)
o John Stuart Mill
o Society is built around mutual expectations and the advantage of voluntary relationships
o Greatest net balance of satisfaction:
▪ The greatest good for the maximum number of people
o May disadvantage vulnerable populations
- Marxism o
o Karl Marx o
o Subsistence rights
▪ Those things that are necessary to sustain life o
o A commitment to promote human equality o
o Three key principles:
o 1. Rights to material resources
o 2. Individual duties to the natural rights of others
o 3. Individuals should serve the common interest
- Rawls o
o Individuals agree how a just society is defined through a social contract. O
o They must determine society’s distribution of four primary goods: wealth and income, rights and
liberties, opportunities for advancement, and self-respect. O
o Key principles:
▪ Each person should have equal right to the most extensive system of personal liberties
compatible with a system of total liberty for all.
▪ Social and economic inequality should be arranged to benefit those who are least well off and
everyone should have the ability to achieve decision making positions.
Social Justice and Health
How does the way societies are organized relate to health?
- Health is often considered a basic human right.
- Many people believe the state should act as a guarantor or provider of health and health care services.

Health Activism

- Occurs when disadvantaged or marginalized groups confront systematic inequities relating to power and
resource allocation in health care
- These groups aim to shed light on inequities in the hope of gaining a greater say for themselves in health care
- Involves a wide spectrum of actions depending on context and type of change desired •
- Is born out of individual concerns, which also have broad social appeal

Health Advocacy
 - Functions within the existing system and the biomedical paradigm
- Consists of experts in the a particular field questioning existing principles and practices rather than being driven
by people outside the system
- Relies on experts’ knowledge and expertise

Health Activism and Advocacy

- Both aim to challenge the status quo and alter research priorities.
- Activism lacks the rigour and scientific methods of advocacy and may be plagued with conflict of interest and
questionable influence.
- Activism is a bottom-up approach, while advocacy is a top-down approach.

Following two years of demonstrations and legal challenges, in 2014 the Federal Court ruled that the Canadian
government’s cuts to refugee health care constituted “cruel and unusual” treatment.

Social Movements •

- Consist of collective actions intended to transform society •

- Challenge the boundaries between state and society, public and private •
- Bring the private into the realm of the public, and show how the private is political and how the state is rife with
“private” power relationships
- May challenge dominant definitions of knowledge and science
- Intend to shift culture and knowledge, not just public policy
- Often use radical or confrontational tactics to make a point
- Made up of decentralized, democratic organizations or networks

- Intended to provide a sense of identify for members and create social change through three critical
components:
o Naming : identifying the problem
o Blaming : defining relationships and who is to blame for the problem
o Claiming : moving beyond blaming to laying claim to having the solution
- While social movements contest some social relationships or world views, o
o they often unconsciously embrace other relationships or worldviews as natural, o
o and may actively reinforce them as a way of trying to rally support and legitimacy. •
- Idle No More is an example of this phenomenon. O
o It aims to fight injustices and inequalities faced by First Nations people in Canada, o
 o while also maintaining links among other Indigenous people worldwide
- Have a complex relationship with governments •
- Often operate in flux or cyclical patterns, which are influenced by the political climate or opportunity o
o Political climates can influence a movement’s chances of success or failure
- Often have to work within state structures that may, themselves, make it difficult to enact change •
- May challenge the existing power structures and argue decisions should be made in a different realm than the
state

Why Not Just Use Politics? •

- Political parties may lack clear mandates for action. •

- Political parties may not be seen as representing a specific interest in the same way an interest group or social
movement can. •
- Often representatives of interest groups and social movements have more expertise in an area that members of
political parties.

Health Social Movements (HSM)

- Organized and concentrated efforts to challenge political and scientific authority •

- Their organizational structure is often bottom-up •
- Have effected change in the occupational health of workers, women’s health, AIDS research, and how medical
research in general is carried out •
- Have challenged the view on individual and collective identity

HSMs fall into three broad categories:

1. Health access movements focus on equitable access to medical care and improved provision of health care services

2. Constituency-based health movements focus on health inequalities amongst groups

3. Embodied health movements focus on the lived experience of disease and illness, addressing etiology, diagnosis,
treatment and prevention

Health Access Movements •

- Seek to improve the accessibility, quality, and delivery of medical care •

- Use activities such as labor campaigns, patient advocacy, and activism to improve patient- doctor relations and
force changes in health care delivery •
- May also work with specific groups, such as Indigenous people, to improve sensitivity and access in medical care

Constituency-Based Health Movements •

- Address inequality and inequities based on race, class, gender, ethnicity, and sexual differences •
- Fight unbalanced outcomes, unsound science, and oversights by the scientific community

Embodied Health Movement •

- Focused on a specific disease, illness, or condition •

- Bring together individuals sharing a common experience with illness •
- Seek to build awareness and change political and scientific policy regarding the condition •
- Will often challenge dominant ideas about their condition in both the medical and scientific communities
Why Do We Need Health Social Movements? •

- The imperative of medicalization •

- Illness is now as “normal” as health •
- Health as a moral compass for human experience •
- The politicization of health and the politics of labels (e.g. normal and abnormal)

Summary •

- Canadians view social justice as paramount in our society. •

- The four theories of social justice are libertarian, utilitarian, Marxist, and Rawlsian. •
- Health activism, health advocacy and social movements have different purposes and strategies. •
- We need to question how much control the state should have over citizens and their health. •
- We need to consider how to create a health care system that upholds the principles of social justice.

Lecture 7: Globalization and Health

Learning Objectives
- Explore how globalization relates to individual health
- Discuss specific drivers of globalization
- Describe how the effects of globalization shape responses to current and emergent health concerns
and crises
- Define the concept of “One Health” and its use in understanding the ethical dimensions of local and
international responses to health concerns and crises
Globalization

- Not a new concept o Has been in effect for as long as people have been migrating, communicating, and
socializing
- First introduced as a term in 1983 to describe companies who were moving beyond regional, national,
and international borders for conducting business
- Corporations began to see the possibility of the world as one big market for their products
- Globalization
o is the unrestrained flow of capital, commodities, ideas, technologies, people, and even
pollution across international borders. •
- Glocalization
o is the global expressed in the local, and the local as a particularization of the global.
Global Processes That Influence Social Spheres •
- Ethnoscapes: the flow of people •
- Technoscapes: the flow of ideas through technology •
- Mediascapes: the flow of images •
- Ideoscapes: the flow of ideas, terms, and images •
- Financescapes: the flow of commodities and economics
Than is Globalization bad or good?

Positive (pros)
 - As society become global, we become more aware of others
- We understand how issues that affect us also affect others
- Globalization influences the health of individuals and populations in positive ways

Negative (cons)
- Global marketplaces can create inequalities between societies
- Small groups of people begin to control the wealth and power
- Globalization influences the health of individuals and populations in negative ways

Global Political Economy •

- First studied in the 1700s as a means to understand the interdependent relationship between politics
and economy •
- Involves determining how the state and the market are intertwined at any given time•
- We currently live in a market-focused society, in which the role of governments is being replaced by
the marketplace. •
- The marketplace has become global, which often allows corporations to function outside the rules and
laws set by a specific government.
Problems with Global Economies •

- The rights of corporations dwarf the rights of individual—this is detrimental to health

Neoliberalism •
- A theory of political economic practices •
- Characterized by strong private property rights, free markets, and free trade •
- The role of the state is to o
o create and preserve military, defense, police, and legal structures and functions required to
secure private property rights
o to guarantee, by force if need be, the proper functioning of markets

Questions to Ask about Neoliberalism

- who is involved in decision-making and where do their interests lie?
- What is the role of the government and corporations in decision-making processes that give advantage
to some people while neglecting other people?
- How does globalization influence how a problem is defined and what solutions are most appropriate to
solve the problem?
Free Market Capitalism •
- Belief that countries will prosper by participating in the world economy and allowing global economics
to influence domestic economies
- Promises increased efficiencies, enhanced quality, and improved allocation
o These promises are often not realized
- Frequently disadvantages poorer countries by creating more poverty and inequality •
- Many countries participate in the global market under unfavorable conditions •
- The need for global corporations to realize a profit often comes at the expense of the most vulnerable
Global Humanitarianism
 - Emphasizes that health is a basic human right for all people around the globe
- Believes that violations of this right demand a global response
Global Ethic of Responsibility •

- The World Health Organization’s report on global humanitarian responses identified the following key
factors related to aid: o
o displacement o
o chronic food insecurity o
o malnutrition
Examples of International Groups Providing Aid •
- International Committee of the Red Cross •
- Doctors Without Borders/Médecins Sans Frontières (MSF) •
- World Vision •
- United Nations International Children’s Emergency Fund (UNICEF) •
- Increasing levels of aid generated through traditional and social media as more people become aware
of needs around the world
More Questions to Ask

- What responsibility do we have to help others globally?

- Are we more willing to help people in our own country, rather than people who live in a distant land?
- Are we more likely to help people who are more “ like” us, even if they live far away?
Global Ethic •

- Global ethic is very complex due to the need to address problems at both local and global levels. •
- Human rights are the core of global justice. o
o Without health one cannot enjoy other human rights. •
- When governments fail to provide basic health entitlements, it is incumbent on wealthy nations to
unite and supply aid.
- Globalization has not increased efficiencies in meeting basic needs for water, food, shelter, and
livelihoods. •
- Public health issues that arise in poorer countries often become the responsibility of humanitarian
organizations. o
o These organizations relieve governments of the responsibility to provide for their citizens. •
- Humanitarian aid may lead to clashes over the rights of citizens from the perspective of the aid worker,
as well as expectations of the aid worker.
Ethical Challenges for Foreign Aid Workers

1. Scarcity of resources and the need to allocate them

2. Historical, political, social, and commercial structures
3. Aid agency policies and agendas
4. Perceived norms around health professionals’ roles and interactions

Global Cultural Politics •

 - Globalization has intensified the relationship between human groups. •
- Globalization has also increased the relationship between humans and other species—animals in
particular. •
- Over time our relationship with animals has included using them as: o
o a food source o
o a companion for company and protection o
o a means to get work done

The Food Industry •

- It has evolved over the years from the practice of hunting and gathering to farms operated by multi-
billion-dollar corporations. •
- The gap between the source of our food and our tables is wider than ever before. •
- Food production is regulated by resource- intensive government and industry agencies.
Problems within the Food Industry •
- It is increasingly difficult to trace the origins of our food. o
o Poor controls and regulations in global markets have been blamed for the spread of disease
such as SARS and H1N1. o
o Increasing use of growth hormones and pesticides is blamed for expanding food intolerances
and diseases such as cancer. •
- Global demand for meat has pushed the production to levels once considered unattainable. o
o Current levels and methods of food production are unsustainable and have been blamed for
global issues such as climate change.
It’s Not All Bad News •
- Our relationship with animals also contributes to positive aspects of life, including having animals for
pets and companions. o
o Many people consider their pets to be members of the family. •
- Animals are also used as status symbols or adornments. •
- Animals such as dogs, cats, and rabbits are being used in therapy and other health care interventions.
One Health
A movement aimed at shifting our thoughts about health and health care to a global, interspecies, and
ecological context
One Medicine
- Conceived in the late 1800s •
- An attempt to bring together veterinary medicine and human medicine under one set of practices o
o acknowledging the interdependency between the health of these species •
- The focus on the biomedical model of health in the early 20th century prevented One Medicine from
being actualized
- The development of veterinary medicine as a profession separate from human medicine further
divided health care ideas. •
- For a long time, the linkage between human and animal health remained underdeveloped.
One Medicine Becomes One Health •
 - In the 1960s the idea of One Medicine was reintroduced. •
- One Health is a revised, updated version of One Medicine. •
- It aims to understand the linkage between health and illness in animals and humans. •
- The One Health idea has grown considerably to integrate approaches to health and health care
globally. •
- The 2004 New York conference developed 12 principles regarding the interconnectedness of humans,
animals and the ecosystem.

12 Principles
1. Recognize the essential link between human, domestic animal and wildlife health and the threat disease
poses to people, their food supplies and economies, and the biodiversity essential to maintaining the healthy
environments and functioning ecosystems we all require.

2. Recognize that decisions regarding land and water use have real implications for health. Alterations in the
resilience of ecosystems and shifts in patterns of disease emergence and spread manifest themselves when
we fail to recognize this relationship.
3. Include wildlife health science as an essential component of global disease prevention, surveillance,
monitoring, control and mitigation.

4. Recognize that human health programs can greatly contribute to conservation efforts.
5. Devise adaptive, holistic and forward-looking approaches to the prevention, surveillance, monitoring,
control and mitigation of emerging and resurging diseases that take the complex interconnections among
species into full account.

6. Seek opportunities to fully integrate biodiversity conservation perspectives and human needs (including
those related to domestic animal health) when developing solutions to infectious disease threats.
7. Reduce the demand for and better regulate the international live wildlife and bushmeat trade not only to
protect wildlife populations but to lessen the risks of disease movement, cross-species transmission, and the
development of novel pathogen–host relationships. The costs of this worldwide trade in terms of impacts on
public health, agriculture and conservation are enormous, and the global community must address this trade
as the real threat it is to global socioeconomic security.
8. Restrict the mass culling of free-ranging wildlife species for disease control to situations where there is a
multidisciplinary, international scientific consensus that a wildlife population poses an urgent, significant
threat to human health, food security, or wildlife health more broadly.
9. Increase investment in the global human and animal health infrastructure commensurate with the serious
nature of emerging and resurging disease threats to people, domestic animals and wildlife. Enhanced capacity
for global human and animal health surveillance and for clear, timely information-sharing (that takes language
barriers into account) can only help improve coordination of responses among governmental and
nongovernmental agencies, public and animal health institutions, vaccine/pharmaceutical manufacturers, and
other stakeholders.
10. Form collaborative relationships among governments, local people, and the private and public (i.e., non-
profit) sectors to meet the challenges of global health and biodiversity conservation.
11. Provide adequate resources and support for global wildlife health surveillance networks that exchange
disease information with the public health and agricultural animal health communities as part of early warning
systems for the emergence and resurgence of disease threats.

12. Invest in educating and raising awareness among the world’s people and in influencing the policy process
to increase recognition that we must better understand the relationships between health and ecosystem
integrity to succeed in improving prospects for a healthier planet.

One Health •
- One Health was developed in response to increased health issues related to globalization. •
- With globalization, there is more movement of people across borders, creating greater connections. •
- Due to increased demand, food production has been organized in ways that jeopardize our
ecosystems. •
- Globalization has enhanced our ability to respond to large-scale health crises, locally and globally,
which allows us to develop new ways of thinking about common issues.
Summary •
- Globalization is a complex issue. •
- Currently, the global institutional architecture generally works against the poor. •
- Globalization extends beyond the economies of countries to include issues of culture and social
change. •
- Global Health is one outcome of globalization. •
- Recognizing the interconnectedness of all life demands we think of global solutions to address
problems we face around the world.