The Changing Global Neighborhood

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dean shortellGlobal health, defined as the
distribution of health and disease throughout
the world, has increasing national, state, and local
consequences for economic development,
international security, and human rights.

As Julio Frenk, my colleague at the Harvard School of Public Health, has said, “The world is a single neighborhood.” The two billion airline passengers traveling annually and the 200 million immigrants throughout the world bear testimony to the fact that it is also a very mobile neighborhood. As a result, we are coming to the realization that our own health and that of our family and friends is increasingly dependent on the health of our global neighbors. The current H1N1 swine flu pandemic is one “in our face” reminder.

So, how well are we doing? According to the recent United Nations Millennium Development Goals Report 2009, progress has been made in some areas. This includes eliminating smallpox; virtually eliminating polio; and making some modest advances with HIV/AIDS, malaria, and measles. Also, a greater percentage of the world’s population has access to safe drinking water. But the health of those living in extreme poverty has declined. Seventeen percent of the population in developing countries is malnourished including 25 percent of children, resulting in stunted growth. Maternal mortality continues relatively unabated in sub-Saharan Africa and southern Asia. And there are still 1.4 billion people without adequate sanitation.

These are the current conditions. They do not take into account the likely devastating impact of worldwide climate change, which will have a marked effect on food production, migration patterns, international travel, and foreign policy, in addition to the direct effects on human health. The impact will fall most heavily on our most vulnerable and poorest neighbors, but our entire “global neighborhood” will be affected.

The rapid pace of global change and its impact on global health means that we must accelerate the quest for knowledge and our actions to meet these challenges. One of the cornerstones of our School’s mission is to move our research from “publication to public action.” This current issue of Berkeley Health provides examples. Two of our recent doctoral students, Aubree Gordon and Laura Stachel, discuss their experience conducting field research in Nicaragua and Nigeria respectively. They demonstrate the adaptability that will be required of all public health professionals working in the “global neighborhood.” Neither one ended up studying what she thought she would when she began her travels. Their stories also highlight the importance of capacity building in the developing world if we hope to sustain health improvements over time.

Under the auspices of the School’s Health Initiative of the Americas we have launched the new Migration and Health Research Center with UC Davis. Among its early projects will be to develop and evaluate a binational health insurance program between California and Mexico that could become a model for the nation.Our Center for Global Public Health and its companion Center for Emerging and Neglected Diseases are working together under the banner of the Berkeley Alliance for Global Health in more than 25 countries around the world. You will read about the recent symposium which examined the forces of population growth, migration, and climate change on global health.

These actions taken by our faculty and students, with the support of our staff, will help to ensure that our “global neighborhood” establishes the conditions needed to advance the individual and collective health of all of us. We draw our inspiration not only from each other within the School but globealso from all of you who share our commitment and, in particular, our donors who help make our Campaign slogan “Healthier Lives in a Safer World” a growing reality. There is no greater return on one’s investment.

Best wishes,

Stephen M. Shortell, PhD, MPH, MBA
Dean, School of Public Health
Blue Cross of California Distinguished
Professor of Health Policy & Management
Professor of Organization Behavior

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