ABSTRACT
The authors of Chapter 5 noted Birdsall’s description of globalization as “disequalizing” and her identifi cation of three distinct, although interrelated, kinds of “asymmetries” that characterize its operations. These characteristics must be addressed, at multiple institutional levels, in any serious effort to reduce the toll of millions of readily preventable deaths every year by way of social determinants of health (SDH). In today’s world economic order, unprecedented affl uence for a minority (Figure 13.1)1 coexists with continued massive deprivation for literally billions of people, with dramatic effects on health. Consider, as just one example, the fact that the lifetime risk of death from complications of pregnancy and childbirth for Canadian women is one in 11,000. For women in Niger, one of the world’s poorest countries, it is one in seven (Say, Inoue, Mills, & Suzuki, 2007). Policy prescriptions that presume the ability of countries outside the industrialized world to grow their way out of poverty and into better health (and reductions in health inequity) for their populations have been tried and found wanting over the past two or three decades.
