AS A POLITICAL SCIENTIST, Ted Schrecker may seem out of place as a member of the University’s Department of Epidemiology and Community Medicine. But for Schrecker, who is based at the University of Ottawa’s Institute of Population Health, it’s the natural place to connect the forces of globalization and their impact on health.

Since 2002, Professor Schrecker has been investigating how globalization affects population health worldwide. And, in the words of Nancy Birdsall, a former World Bank economist who now directs the US-based Center for Global Development, the word to define worldwide health is “asymmetry.”

As evidence he cites child mortality figures from the World Bank: fully 126 out of every 1,000 children in low-income countries can be expected to die before their fifth birthday. In comparison, six children can be expected to die before this milestone in high-income countries.

Now, Schrecker is working with colleagues across Canada to determine whether globalization will worsen existing health disparities among Canadians, and what to do about it.

“We know that economic status has a significant impact on health in Canada,” says Schrecker. “Simply put, the richer you are, the healthier you tend to be.”

For instance, Schrecker says, people living in the wealthiest areas of Montreal have a life expectancy 11 years longer than those living in the poorest areas of the city. This is comparable to the difference in national average life expectancy between Canada as a whole and Thailand or El Salvador.

Schrecker is apprehensive about the future, because globalization tends to deepen the divides between winners and losers in the global marketplace.“ Many people will simply be left out and left behind. This has happened routinely in US cities in the aftermath of deindustrialization.” He is concerned that, in Canada, exacerbated economic divisions resulting from increased globalization could lead to greater health differences among different groups in the Canadian population.

Professor Schrecker is part of a cross-Canada research team funded by the Canadian Institutes of Health Research (CIHR) for a five-year investigation into globalization and the health of Canadians to find out if this is, indeed, the case. Among many other activities, the team will develop a local-level Globalization-Relevant Index of Disadvantage (GRID) to map specific elements of disadvantage that are related to health in Canada’s major cities. They will also develop contrasting scenarios for the future of economic and health inequalities in major cities that are dependant on how governments at all levels respond to globalization’s challenges.

“An equitable society should try to separate health and wealth,” says Schrecker. But he argues that this is not what is actually happening in North American cities in our globalized economy. “Wealthier households tend to escape to the suburbs,” says Schrecker, citing what former US Secretary of Labor Robert Reich called “the secession of the successful.”

“Such households want schools, roads and personal protection, but not the more complicated services used by lower-income families and individuals living closer to the city’s centre, such as social housing, public transit and community health centres. As a result, they tend to not want their tax dollars being spent in these areas.”

Schrecker continues to pursue the global dimension of his research as well. He and Ronald Labonté, holder of the Canada Research Chair in Globalization and Health Equity at the University, have organized a network of researchers on globalization and health that supports the work of the World Health Organization’s Commission on Social Determinants of Health, established in 2005. The commission’s final report is due in 2008. They also have CIHR funding for a research network on how ethics and public policy should address health in an unequal world.

They are also about to publish a series of three articles in the open-access online journal Globalization and Health in which they explain why the global marketplace has undermined health equity and how the world’s richest and most powerful nations could change this.

“Markets are not evil. They do some things very well,” says Schrecker, also commenting that they can’t be expected to do everything. We need a global health ethic and for institutions that can make responsible spending decisions, he says. “We know that the cost of saving literally millions of lives per year is tiny when compared with what the United States is spending on its military adventure in Iraq, or even with what Britain is spending on widening its M1 freeway.”

“How can we make political leaders and their electorates understand why these contrasts are important?”

Heather Blumenthal is an Ottawa-based writer and editor.