The Globalised Health Industry (AQA A-Level Sociology): Revision Notes
The Globalised Health Industry
Understanding global health inequalities
The concept of a globalised health industry emerges when examining the vast disparities in health outcomes across the world. While we might expect health to be universally prioritised, the reality reveals a complex global system where health outcomes vary dramatically based on economic, political, and social factors.
Global health inequalities refer to the differences in health status and healthcare access both between countries and within individual nations. These inequalities demonstrate that health is not simply a matter of individual choice or biology, but is heavily influenced by broader structural factors.
The global health divide
A stark health divide exists between developed and developing nations. In low-income countries, average life expectancy stands at just 57 years, whilst in high-income countries, it reaches 80 years - a difference of 23 years. However, this disparity is not limited to comparisons between nations.
Within countries, socio-economic position plays a determining role in health outcomes. The lower an individual's socio-economic status within any country, the higher their risk of poor health.
A striking example of this can be seen in Glasgow, where men in Calton have a life expectancy of 53.9 years - actually lower than the average for many developing countries.
WHO's key facts on global health inequality
The World Health Organisation (2014) identified five critical facts that illustrate the extent of global health inequalities:
- Health inequities are preventable and could be reduced through appropriate government policies
- 21,000 children die daily before reaching their fifth birthday
- 99% of maternal deaths occur in developing countries
- 95% of tuberculosis deaths happen in the developing world, highlighting how diseases of poverty remain concentrated in poorer regions
- 80% of chronic diseases are found in low- and middle-income countries
These statistics demonstrate that health outcomes are not randomly distributed globally but follow clear patterns related to economic development and social conditions.
The pharmaceutical industry and 'big pharma'
The term 'Big Pharma' refers to the global pharmaceutical industry, which faces various criticisms regarding its practices and priorities. Ben Goldacre (2012) exposed several concerning practices within this $600 billion industry, including:
- Hiding unflattering trial data whilst exaggerating the benefits of medications
- Paying doctors to endorse drugs through peer-reviewed journals
- Creating or rebranding illnesses to expand drug markets, such as promoting hormone replacement therapy whilst downplaying breast cancer risks
- Funding medical education and influencing professional training
However, critics of 'Big Pharma' arguments often overlook the industry's contributions to medical advancement. The rapid development of Ebola vaccines during the 2014-15 African crisis demonstrates the pharmaceutical industry's capacity for innovation when motivated.
Marxist perspective on global health
Marxist theory explains global health inequalities as a product of the capitalist global system. According to this perspective, health inequalities stem from a system that prioritises profit over people's wellbeing, particularly affecting poorer developing countries.
Marxists argue that developing countries experience poor health outcomes because:
- Rich developed countries exploit their cheap labour and resources
- Global capitalism maintains developing countries in poverty to serve the interests of wealthy nations
- Transnational corporations benefit from keeping certain regions economically disadvantaged
However, examples like Cuba challenge purely economic explanations of health outcomes. Despite being a very poor Caribbean nation, Cuba has prioritised healthcare and achieved some of the world's best health services, demonstrating that social capital and government policy choices can overcome economic limitations.
Case study: Bhutan's alternative approach
Case Study: Bhutan's Health-Focused Approach
Bhutan provides an interesting contemporary example of alternative approaches to health and wellbeing. Rather than focusing solely on economic growth, Bhutan's government policy centres on Gross National Happiness (GNH) rather than Gross Domestic Product.
To achieve this goal, Bhutan has:
- Banned tobacco and certain advertisements for products like Coca-Cola and Pepsi
- Restricted traffic lights and certain TV channels including MTV
- Prioritised policies that promote both happiness and health
Bhutan ranks highly on the UN's Human Development Index (HDI), which measures multiple factors contributing to health including child mortality rates, life expectancy, access to clean water and sanitation, and access to adequate nutrition and shelter.
International policies affecting health
Structural Adjustment Programmes (SAPs) represent a controversial aspect of global health policy. These programmes, offered by the World Bank and International Monetary Fund, typically require developing countries to reduce welfare spending, including healthcare expenditure, in exchange for loans.
The impact of SAPs on health is particularly damaging because:
- Cuts to health spending disproportionately affect the most vulnerable populations
- Women and the poor are hit hardest by reduced healthcare access
- Already unhealthy populations face further barriers to healthcare
This creates a cycle where those with the greatest health needs face the most barriers to accessing care.
Research evidence: Income inequality and health
Wilkinson and Pickett (2010) conducted extensive research examining the relationship between income and health across multiple countries. Their findings revealed a counterintuitive pattern:
Key Research Findings:
- Average national income shows no correlation with population health outcomes
- Income inequality within countries strongly correlates with health outcomes
- Countries with narrow income gaps (like Japan and Scandinavian countries) enjoy better health across all social classes
- Countries with broad income inequality (like the USA) experience poorer health outcomes even among wealthier populations
This research suggests that relative inequality, rather than absolute poverty, plays a key role in determining population health outcomes.
Key Points to Remember:
- Global health inequalities exist both between countries (57 vs 80 years life expectancy) and within countries (Glasgow's Calton example)
- 'Big Pharma' practices include hiding negative trial data and creating markets for drugs, but the industry also contributes to medical advances
- Alternative approaches like Bhutan's Gross National Happiness show that economic wealth isn't the only path to good health outcomes
- Income inequality within countries correlates more strongly with health outcomes than absolute income levels
- International policies like Structural Adjustment Programmes can worsen health outcomes by forcing cuts to healthcare spending in vulnerable populations