Globalization and Health

Dr. Shahi's lecture on globalization and health was very enlightening and raised several important issues. First of all, the lecture included a significant chunk of information on the urban-rural divide in healthcare. Urban populations are often a lot healthier. They experience lower death rates as well as a overall higher degree of health. This is largely due to infrastructure. Urban areas have a set infrastructure in place that better equips its inhabitants with basic necessities such as food, shelter, and clean water. This infrastructure is often absent in rural areas.
India provides a great example of this dichotomy. India (especially the southern city of Bangalore) is known for the enormous growth that it has experienced over the past decade or so. This growth is very evident in large cities such as Bangalore. Yet, when stepping into the rural areas, one gets a sense of how the distribution of resources heavily favors those in urban areas. People living in rural areas often live in flimsy huts and do not have access to clean water. Building a more solid infrastructure, as was suggested in class, is crucial.

The idea of infrastructure and development was also discussed in the context of birth and death rates. Development leads to empowerment in many ways. People have greater access to healthcare, better sanitation, and cleaner water. This directly leads to low death rates. Once people start feeling secure about their life expectancy and overall well being, they will start having fewer children. A change in birth rates thus often follows a change in death rates.

Interestingly, as Dr. Shahi mentions, much of the positive trends in death have been attributed to advanced medical technologies. Yet, it is development and strong infrastructure that deserve the most credit in these positive trends.

(This is a bit off topic): I was a bit confused about the difference between universal coverage and universal access to healthcare. Aren't these two notions inextricably intertwined? Universal access to healthcare does depend on factors such as language, ethinicity, SES, the distance that one lives from a medical facility, etc. I believe that insurance coverage is one HUGE factor in access to care. Indeed, many people often die or live very unhealthy lives because they do not have proper coverage. Thus, I can notice a slight distinction between the notion of universal coverage and access but are these two concepts really that different? Maybe there is something I am missing to the argument that Dr. Shahi posed in class. Hopefully someone will comment on this blog to clear up my confusion...