The health impacts of globalisation: a conceptual framework

The main health determinants are identified and structured by means of a conceptual model, which is based on an analysis of existing health models. The nature of the determinants (institutional, socio-cultural, economic, and environmental) and their level of causality (proximate, distal, and contextual) are combined into a basic framework that conceptualises the complex multi-causality of population health. Contemporary globalisation is defined as an intensification of cross-national cultural, economic, political, social and technological interactions that lead to the establishment of transnational structures and the global integration of cultural, economic, environmental, political and social processes at various levels.

The following features of globalisation are distinguished: global governance structures, global markets, global communication and diffusion of information, global mobility, cross-cultural interaction, and global environmental changes. The conceptual framework, subsequently, links features of globalisation with health determinants and specifies how distal and proximate health determinants are affected by globalisation. This study has resulted in valuable insights in health effects resulting from globalisation. The described conceptual framework could give a meaningful contribution to further empirical research by serving as a 'think-model' and is a useful tool to structure future explorations of the health implications of globalisation by means of scenario analysis.