Globalization and Health最新文献

{"title":"What is the purpose of ultra-processed food? An exploratory analysis of the financialisation of ultra-processed food corporations and implications for public health.","authors":"Benjamin Wood, Ella Robinson, Phillip Baker, Guillermo Paraje, Mélissa Mialon, Christoffer van Tulleken, Gary Sacks","doi":"10.1186/s12992-023-00990-1","DOIUrl":"10.1186/s12992-023-00990-1","url":null,"abstract":"<p><strong>Background: </strong>In recent decades there has been a global rise in consumption of ultra-processed foods (UPFs) to the detriment of population health and the environment. Large corporations that have focused heavily on low-cost manufacturing and extensive marketing of UPFs to maximise profits have driven this dietary transition. The same corporations claim to serve the interests of multiple 'stakeholders', and that they are contributing to sustainable development. This paper aimed to test these claims by examining the degree to which UPF corporations have become 'financialised', focusing on the extent to which they have prioritised the financial interests of their shareholders relative to other actors, as well as the role that various types of investors have played in influencing their governance. Findings were used to inform discussion on policy responses to improve the healthiness of population diets.</p><p><strong>Methods: </strong>We adopted an exploratory research design using multiple methods. We conducted quantitative analysis of the financial data of U.S. listed food and agricultural corporations between 1962 and 2021, share ownership data of a selection of UPF corporations, and proxy voting data of a selection of investors between 2012 and 2022. We also conducted targeted narrative reviews using structured and branching searches of academic and grey literature.</p><p><strong>Results: </strong>Since the 1980s, corporations that depend heavily on manufacturing and marketing UPFs to generate profits have been increasingly transferring money to their shareholders relative to their total revenue, and at a level considerably higher than other food and agricultural sectors. In recent years, large hedge fund managers have had a substantial influence on the governance of major UPF corporations in their pursuit of maximising short-term returns. In comparison, shareholders seeking to take steps to improve population diets have had limited influence, in part because large asset managers mostly oppose public health-related shareholder proposals.</p><p><strong>Conclusions: </strong>The operationalisation of 'shareholder primacy' by major UPF corporations has driven inequity and undermines their claims that they are creating 'value' for diverse actors. Measures that protect population diets and food systems from the extractive forces of financialisation are likely needed as part of efforts to improve the healthiness of population diets.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92153480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The politics of glyphosate regulation: lessons from Sri Lanka's short-lived ban.","authors":"Tim Dorlach, Sandya Gunasekara","doi":"10.1186/s12992-023-00981-2","DOIUrl":"10.1186/s12992-023-00981-2","url":null,"abstract":"<p><strong>Background: </strong>Glyphosate is the world's most used herbicide and a central component of modern industrial agriculture. It has also been linked to a variety of negative health and environmental effects. For instance, the International Agency for Research on Cancer classified glyphosate as \"probably carcinogenic to humans\" in 2015. This has motivated widespread political demands for stricter glyphosate regulation but so far few governments have followed through.</p><p><strong>Methods: </strong>We conduct a case study of Sri Lanka, which in 2015 became the first and so far only country in the world to adopt and implement a complete glyphosate ban. But this ban proved to be short-lived, as it was partially reversed in 2018 (and later fully revoked in 2022). To explain the political causes of Sri Lanka's pioneering glyphosate ban and its subsequent reversal, we employ process tracing methods drawing on publicly available documents. Our analysis is theoretically guided by the multiple streams framework and the concept of self-undermining policy feedback.</p><p><strong>Results: </strong>Glyphosate regulation rose to the top of the Sri Lankan political agenda in 2014 when a local scientist linked glyphosate exposure to an epidemic of Chronic Kidney Disease of Unknown Origin (CKDu). A glyphosate ban was eventually adopted in June 2015 by the newly elected government of Maithripala Sirisena. The ban was a political commitment made to the Buddhist monk Rathana Thero and his party, which had supported Sirisena during his presidential campaign. The ban's partial reversal in 2018, implemented through sectoral exceptions, was the result of continued lobbying by export-oriented plantation industries and increased political concerns about potential negative effects on the large and structurally powerful tea sector. The reversal was further aided by the scientific community's failure to corroborate the hypothesized link between glyphosate and CKDu.</p><p><strong>Conclusions: </strong>The case of Sri Lanka suggests that strict glyphosate regulation becomes more likely when coupled with locally salient health risks and when decision-making authority is de-delegated from regulatory agencies back to the political executive. Meanwhile, the short-lived nature of the Sri Lankan ban suggests that strict glyphosate regulation faces political sustainability threats, as the apparent lack of cost-effective alternative herbicides motivates persistent business lobbying for regulatory reversal.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92153479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare workers' freedom of movement in times of pandemics: an emerging norm of customary international law.","authors":"Andrés Constantin, Aliya Sternstein","doi":"10.1186/s12992-023-00985-y","DOIUrl":"10.1186/s12992-023-00985-y","url":null,"abstract":"<p><strong>Background: </strong>A shortage of healthcare workers can hinder the ability to prepare for and respond to global security threats caused by diseases that are prone to pandemics. During the COVID-19 pandemic, the shortage of healthcare workers became a growing concern worldwide. Recognizing these challenges, countries adopted measures to ensure healthcare workers' freedom of movement in the face of the COVID-19 pandemic. As the WHO continues the negotiation process to reform the 2005 International Health Regulations and to adopt a new Pandemic Treaty, with one key provision relating to healthcare workers' mobility, questions remain as to whether States will actually adopt a binding international legal instrument or whether its effectiveness will be watered down by the intrinsic vulnerabilities of an international legal system that has (too) often been unable to tame geopolitical interests. Considering these challenges, we assessed the emergence of a norm of customary international law allowing the free movement of healthcare workers during pandemics.</p><p><strong>Methods: </strong>Our study examined the laws and policies adopted during the COVID-19 pandemic concerning healthcare workers' mobility in 10 countries, representing all continents. The country selection was based on regional representation and a preliminary analysis indicating their early adoption of measures related to healthcare workers' mobility. Temporal limits were set. To gather relevant data, we employed various methods including research databases, media sources, and the COVID-19 Law Lab database.</p><p><strong>Results: </strong>Our research identified and assessed instances of state practice and evidence of opinio juris to determine whether a norm of customary international law mandating states to ensure healthcare workers' freedom of movement during pandemics exists. The findings indicate a strong consensus towards ensuring the free movement of healthcare workers in times of pandemics as a way to respond to outbreaks of disease. Within months, Argentina, Colombia, Kenya, South Africa, India, Japan, Spain, the United Kingdom, Canada, and the United States, ten nations representing most regions of the world, recognized, as law, the practice of excluding healthcare workers from prohibitions on movement.</p><p><strong>Conclusion: </strong>Ultimately, this discussion is critical for global health because if a norm does exist in this regard, it will further strengthen pandemic legal preparedness efforts. As such, it becomes clear that the reform of the 2005 International Health Regulations and/or the adoption of a new pandemic treaty will bolster the strength of this emerging norm of customary international law and crystallize it. These legal instruments would propel a norm that is already in the process of formulation into existence. Thus, crystallizing a norm that is otherwise emerging among states.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10636805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72209068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Policies to prevent zoonotic spillover: a systematic scoping review of evaluative evidence.","authors":"Chloe Clifford Astbury, Kirsten M Lee, Ryan Mcleod, Raphael Aguiar, Asma Atique, Marilen Balolong, Janielle Clarke, Anastassia Demeshko, Ronald Labonté, Arne Ruckert, Priyanka Sibal, Kathleen Chelsea Togño, A M Viens, Mary Wiktorowicz, Marc K Yambayamba, Amy Yau, Tarra L Penney","doi":"10.1186/s12992-023-00986-x","DOIUrl":"10.1186/s12992-023-00986-x","url":null,"abstract":"<p><strong>Background: </strong>Emerging infectious diseases of zoonotic origin present a critical threat to global population health. As accelerating globalisation makes epidemics and pandemics more difficult to contain, there is a need for effective preventive interventions that reduce the risk of zoonotic spillover events. Public policies can play a key role in preventing spillover events. The aim of this review is to identify and describe evaluations of public policies that target the determinants of zoonotic spillover. Our approach is informed by a One Health perspective, acknowledging the inter-connectedness of human, animal and environmental health.</p><p><strong>Methods: </strong>In this systematic scoping review, we searched Medline, SCOPUS, Web of Science and Global Health in May 2021 using search terms combining animal health and the animal-human interface, public policy, prevention and zoonoses. We screened titles and abstracts, extracted data and reported our process in line with PRISMA-ScR guidelines. We also searched relevant organisations' websites for evaluations published in the grey literature. All evaluations of public policies aiming to prevent zoonotic spillover events were eligible for inclusion. We summarised key data from each study, mapping policies along the spillover pathway.</p><p><strong>Results: </strong>Our review found 95 publications evaluating 111 policies. We identified 27 unique policy options including habitat protection; trade regulations; border control and quarantine procedures; farm and market biosecurity measures; public information campaigns; and vaccination programmes, as well as multi-component programmes. These were implemented by many sectors, highlighting the cross-sectoral nature of zoonotic spillover prevention. Reports emphasised the importance of surveillance data in both guiding prevention efforts and enabling policy evaluation, as well as the importance of industry and private sector actors in implementing many of these policies. Thoughtful engagement with stakeholders ranging from subsistence hunters and farmers to industrial animal agriculture operations is key for policy success in this area.</p><p><strong>Conclusion: </strong>This review outlines the state of the evaluative evidence around policies to prevent zoonotic spillover in order to guide policy decision-making and focus research efforts. Since we found that most of the existing policy evaluations target 'downstream' determinants, additional research could focus on evaluating policies targeting 'upstream' determinants of zoonotic spillover, such as land use change, and policies impacting infection intensity and pathogen shedding in animal populations, such as those targeting animal welfare.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10634115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71521177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internet use, cardiometabolic multimorbidity, and death in older adults: a multi-cohort study spanning developing and developed countries.","authors":"Ziyang Ren, Shuangbo Xia, Jinfang Sun, Duoduo Wang, Yushan Du, Ning Li, Jufen Liu","doi":"10.1186/s12992-023-00984-z","DOIUrl":"10.1186/s12992-023-00984-z","url":null,"abstract":"<p><strong>Background: </strong>Internet use is a double-edged sword for older adults' health. Whether internet use can prevent cardiometabolic diseases and death in older adults remains controversial.</p><p><strong>Methods: </strong>Four cohorts across China, Mexico, the United States, and Europe were utilized. Internet use was defined using similar questions. Cardiometabolic diseases included diabetes, heart diseases, and stroke, with 2 or more denoting cardiometabolic multimorbidity. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale and Europe-depression scale. The competing risk analysis based on subdistribution hazard regression, random-effects meta-analysis, and mediation analysis were utilized.</p><p><strong>Results: </strong>A total of 104,422 older adults aged 50 or older were included. Internet users (vs. digital exclusion) were at lower risks of diabetes, stroke, and death, with pooled sHRs (95% CIs) of 0.83 (0.74-0.93), 0.81 (0.71-0.92), and 0.67 (0.52-0.86), respectively, which remained significant in sensitivity analyses. The inverse associations of internet use with new-onset cardiometabolic diseases and death were progressively significant in Mexico, China, the United States, and Europe. For instance, older internet users in Europe were at 14-30% lower cardiometabolic risks and 40% lower risk of death. These associations were partially mediated by reduced depressive symptoms and were more pronounced in those with high socioeconomic status and women. Furthermore, patients with prior cardiometabolic conditions were at about 30% lower risk of death if they used the internet, which was also mediated by reduced depressive symptoms. However, certain cardiometabolic hazards of internet use in those aged < 65 years, with low socioeconomic status, men, and single ones were also observed.</p><p><strong>Conclusion: </strong>Enhancing internet usage in older adults can reduce depressive symptoms and thus reduce the risks of cardiometabolic diseases and death. The balance of internet use, socioeconomic status, and health literacy should be considered when popularizing the internet in older adults.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71480758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National governance and excess mortality due to COVID-19 in 213 countries: a retrospective analysis and perspectives on future pandemics.","authors":"Ricardo Eccard da Silva, Maria Rita Carvalho Garbi Novaes, Cesar de Oliveira, Dirce Bellezi Guilhem","doi":"10.1186/s12992-023-00982-1","DOIUrl":"10.1186/s12992-023-00982-1","url":null,"abstract":"<p><strong>Background: </strong>National governance may have influenced the response of institutions to the Covid-19 pandemic, being a key factor in preparing for the next pandemics. The objective was to analyze the association between excess mortality due to COVID-19 (daily and cumulative per 100 thousand people) and national governance indicators in 213 countries.</p><p><strong>Method: </strong>Multiple linear regression models using secondary data from large international datasets that are in the public domain were performed. Governance indicators corresponded to six dimensions: (i) Voice and Accountability; (ii) Political Stability and Absence of Violence/Terrorism; (iii) Government Effectiveness; (iv) Regulatory Quality; (v) Rule of Law and (vi) Control of Corruption. The statistical analysis consisted of adjusting a multiple linear regression model. Excess mortality due to COVID-19 was adjusted for potential confounding factors (demographic, environmental, health, economic, and ethnic variables).</p><p><strong>Results: </strong>The indicators Control of Corruption, Government Effectiveness, Regulatory Quality and Rule of Law had a significant inverse association (p < 0.0001) with the estimated excess mortality in 2020, 2021 and 2022. Furthermore, the governance indicators had a direct significant association (p < 0.0001) with the vaccination variables (People_fully_vaccinated; Delivered population; The total number of vaccination doses administered per 100 people at the country level), except for the variables Vaccination policies and Administration of first dose, which were inversely associated. In countries with better governance, COVID-19 vaccination was initiated earlier.</p><p><strong>Conclusion: </strong>Better national governance indicators were associated with lower excess mortality due to COVID-19 and faster administration of the first dose of the COVID-19 vaccine.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10619274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71422962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing public health preparedness and response in the European Union- a review of regional simulation exercises and after action reviews.","authors":"Mari Nythun Utheim, Mohamed Gawad, Karin Nygård, Emily Macdonald, Monica Falk","doi":"10.1186/s12992-023-00977-y","DOIUrl":"10.1186/s12992-023-00977-y","url":null,"abstract":"<p><strong>Background: </strong>Improving response capacities in the EU requires a good overview of capacities at both country and Union level. The International Health Regulations (2005) Monitoring and Evaluation framework assesses capacities in countries. It includes semi-quantitative tools such as State Parties Annual Report (SPAR) and Joint External Evaluation (JEE). After Action Reviews (AAR) and Simulation Exercises (SimEx) were included to identify weaknesses in the functionality of capacities which are not addressed bySPAR and JEE. This study presents an analysis of the use of qualitative tools at regional level, in Europe. It aims to identify their added value by comparing them to standardised monitoring tools and lessons learned from COVID-19, and considers ways to improve their use in assessing capacities in the EU.</p><p><strong>Methods: </strong>We included 17 SimEx and 2 AAR organised by the European Commission between 2005 and 2018. We categorised a total of 357 recommendations according to the IHR (2005) core capacities and to the target audience of the recommendation. We analysed the data using language analysis software. Recommendations to countries were compared to SPAR and JEE indicators. Recommendations to EU agencies were compared to the current mandates of the EU agencies, and to lessons learnt during COVID-19.</p><p><strong>Results: </strong>Of all extracted recommendations from the exercises, 59% (211/357) targeted EU agencies, 18% (64/357) targeted countries, and 16% (57/357) targeted both. Recommendations mainly addressed areas of IHR coordination (C2), heath emergency management (C7) and risk communication (C10), and not low scoring areas. Recommendations complement SPAR indicators by identifying gaps in functionality. Eight out of ten early lessons learnt during the COVID-19 pandemic had been raised earlier as recommendations from exercises. Exercise reports did not include or result in action plans for implementation, but COVID-19 has accelerated implementation of some recommendations.</p><p><strong>Conclusion: </strong>SimEx/AAR provide valuable insight into public health preparedness at EU level, as they assess functionality of preparedness and response mechanisms, point out gaps, and provide training and awareness on for participants, who often have key roles in public health emergencies. Better follow-up and implementation of recommendations is key to improve the regional preparedness for international public health incidents such as pandemics.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2023-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10612297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66783812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-border utilization of cancer care by patients in the US and Mexico - a survey of Mexican oncologists.","authors":"Michael LaPelusa, Haydeé Verduzco-Aguirre, Fernando Diaz, Fernando Aldaco, Enrique Soto-Perez-de-Celis","doi":"10.1186/s12992-023-00983-0","DOIUrl":"10.1186/s12992-023-00983-0","url":null,"abstract":"<p><strong>Background: </strong>The US-Mexico border is the busiest in the world, with millions of people crossing it daily. However, little is known about cross-border utilization of cancer care, or about the reasons driving it. We designed a cross sectional online survey to understand the type of care patients with cancer who live in the US and Mexico seek outside their home country, the reasons why patients traveled across the border to receive care, and the barriers faced when seeking cross-border care.</p><p><strong>Results: </strong>The online survey was sent to the 248 cancer care providers working in the six Mexican border states who were registered members of the Mexican Society of Oncology. Responses were collected between September-November 2022. Sixty-six providers (response rate 26%) completed the survey. Fifty-nine (89%) reported interacting with US-based patients traveling to Mexico to receive various treatment modalities, with curative surgery (n = 38) and adjuvant chemotherapy (n = 31) being the most common. Forty-nine (74%) reported interacting with Mexico-based patients traveling to the US to receive various treatment modalities, with immunotherapy (n = 29) and curative surgery (n = 27) being the most common. The most frequently reported reason US-based patients sought care in Mexico was inadequate health insurance (n = 45). The most frequently reported reason Mexico-based patients sought care in the US was patients' perception of superior healthcare (n = 38).</p><p><strong>Conclusions: </strong>Most Mexican oncologists working along the Mexico-US border have interacted with patients seeking or receiving binational cancer care. The type of care sought, as well as the reasons for seeking it, differ between US and Mexico-based patients. These patterns of cross-border healthcare utilization highlight unmet needs for patients with cancer in both countries and call for policy changes to improve outcomes in border regions.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10612194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61562032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trade agreements and tobacco control policy: analysis of the impact of FCTC on regulatory contents of trade agreements from 2001 to 2019.","authors":"Tzu-Ying Chen, Ying-Jun Lin, Tung-Liang Chiang, Feng-Jen Tsai","doi":"10.1186/s12992-023-00979-w","DOIUrl":"10.1186/s12992-023-00979-w","url":null,"abstract":"<p><strong>Background: </strong>This study aims to analyze the impact of Framework of Convention of Tobacco Control (FCTC) on regulatory contents of trade agreements from 2001 to 2019.</p><p><strong>Methods: </strong>A search of trade agreements from'WTO Regional Free Trade Agreement Database' using keywords including \"tobacco\", \"cigarette\", \"smoking\" and \"FCTC\" from May to August 2020 resulted in a total sample of 268 trade agreements, from which 69 trade agreements were coded and analyzed. Provisions in trade agreements, identified via the aforementioned keywords, were categorized into 6 trade measures. The word counts of the provisions containing; FCTC; were calculated. Chi-square tests were applied to analyze the differences of regulatory patterns between different time frames. The import and export values (USD) of tobacco products under trade agreements containing the term \"FCTC\" were further collected from the \"International Trade Statistics 2001-2020\" for understanding the impact of the provision on the trade flow.</p><p><strong>Results: </strong>Among 69 agreements, the percentage of trade agreements containing keyword as \"FCTC\" increased significantly from 0% to 2011 to 12% after 2011. A significant decrease of using trade measures as \"the exclusion list\" was found after 2011 (from 10% to 0). The word counts of provisions containing; FCTC; increased from 24 words in 2011 to 164 words in 2018, and the content of the provisions became more concrete over time. There are six trade agreements containing \"FCTC\", and all these 6 agreements were ratified by European Union (EU). Despite EU ratified trade agreements with \"FCTC\", the import and export values of tobacco products between EU and the other party countries increased with time. But the gap of average trade values between trade agreements with and without \"FCTC\" being widened with time.</p><p><strong>Conclusions: </strong>As a first study evaluated the impact of FCTC on regulatory contents of trade agreements, our study results showed that after countries signed trade agreements containing keyword FCTC, the regulatory contents changed significantly. Further studies are recommended to understand the reason and criteria for incorporating FCTC provisions into trade agreements, especially in the EU.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49676737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of globalization with the burden of opioid use disorders 2019. A country-level analysis using targeted maximum likelihood estimation.","authors":"Guillaume Barbalat, Geeta Reddy, Nicolas Franck","doi":"10.1186/s12992-023-00980-3","DOIUrl":"10.1186/s12992-023-00980-3","url":null,"abstract":"<p><strong>Background: </strong>The \"opioid crisis\" has been responsible for hundreds of thousands deaths in the US, and is at risk of dissemination worldwide. Within-country studies have demonstrated that the rise of opioid use disorders (OUD) is linked to increased access to opioid prescriptions and to so-called \"diseases of despair\". Both have been related to the emergence of globalization policies since the 1980s. First, globalized countries have seen a reorganization of healthcare practices towards quick and easy answers to complex needs, including increased opioid prescriptions. Second, despair has gained those suffering from the mutations of socio-economic systems and working conditions that have accompanied globalization policies (e.g. delocalization, deindustrialization, and the decline of social services). Here, using data with high quality ratings from the Global Burden of Disease database, we evaluated the country-based association between four levels of globalization and the burden of OUD 2019.</p><p><strong>Results: </strong>The sample included 87 countries. Taking into account potential country-level confounders, we found that countries with the highest level of globalization were associated with a 31% increase in the burden of OUD 2019 compared to those with the lowest level of globalization (mean log difference: 0.31; 95%CI, 0.04-0.57; p = 0.02). Additional analyses showed a significant effect for low back pain (mean log difference: 0.07; 95%CI, 0.02-0.12; p = 0.007). In contrast, despite sharing some of the risk factors of OUD, other mental and substance use disorders did not show any significant relationship with globalization. Finally, socio-cultural de jure globalization, which compiles indicators related to gender equality, human capital and civil rights, was specifically associated with the burden of OUD (mean log difference: 0.49; 95%CI: 0.23,0.75; p < 0.001).</p><p><strong>Conclusions: </strong>These findings suggest that OUD may have inherent underpinnings linked to globalization, and more particularly socio-cultural aspects of globalization. Key factors may be increased rights to access prescriptions, as well as increased feelings of despair related to the erosion of local cultures and widening educational gaps.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10577998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41234514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}