Globalization, Health, and Structural Violence 317and pollution. The industries of wealthier communities
and states create the majority of the pollutants that are
changing the earth today. Yet the impact of these pollut-
ants is often felt most keenly by those who do not have the
resources to consume, and thus pollute, at high rates.
For example, increasing emissions of greenhouse gases,
as a consequence of deforestation and human industrial ac-
tivity, have resulted in global warming. As the carbon emis-
sions from the combustion of petroleum in wealthy nations
warm the climate globally, the impact will be most severe
for individuals in the tropics because these populations
must contend with increases in deadly infectious diseases
such as malaria. Annually it is estimated that 1.5 million to
2.7 million deaths worldwide are caused by malaria, mak-
ing it the fifth largest infectious killer in the world. Chil-
dren account for about 1 million of these deaths, and more
than 80 percent of these cases are in tropical Africa. It is
possible that over the next century, an average temperature
increase of 3 degrees Celsius could result in 50 million to
80 million new malaria cases per year.^18
Experts predict that global warming will lead to an
expansion of the geographic ranges of tropical diseases
and to an increase the incidence of respiratory diseases
due to additional smog caused by warmer temperatures.
As witnessed in the 15,000 deaths attributed to the 2003
heat wave in France, global warming may also increase
the number of fatalities.^19 To solve the problem of globalPoverty and Health
With an ever-expanding population, a shocking number
of people worldwide face hunger on a regular basis, lead-
ing to a variety of health problems including premature
death. It is no accident that poor countries and poorer
citizens of wealthier countries are disproportionately mal-
nourished. All told, about 1 billion people in the world are
undernourished. Some 6 million children age 5 and under
die every year due to hunger, and those who survive often
suffer from physical and mental impairment.^17
In wealthy industrialized countries a particular version
of malnourishment—obesity—is becoming increasingly
common. Obesity primarily affects poor working-class
people who are no longer physically active at their work
(because of increasing automation) and who cannot af-
ford more expensive, healthy foods to stay fit. High sugar
and fat content of mass-marketed foods and “super size”
portions underlie this dramatic change. The risk of dia-
betes, heart disease, and stroke is also greatly increased in
the presence of obesity. High rates of obesity among U.S.
youth have led public health officials to project that the
current generation of adults may be the first generation to
outlive their children due to a cause other than war.Environmental Impact and Health
Just as the disenfranchised experience a disproportionate
share of famine and associated death, this same population
also must contend with the lion’s share of contaminantsThe scientific definition of malnutrition includes undernutrition as well as excess consumption of
foods, healthy or otherwise. Malnutrition leading to obesity is increasingly common among poor work-
ing-class people in industrialized countries. Starvation is more common in poor countries or in those
that have been beset by years of political turmoil, as is evident in this emaciated North Korean child.Visual Counterpoint© Allison Wright/Corbis © AP Photo/Caritas Hong Kong, Kahn Zellweger, HO(^17) Hunger Project 2003; Swaminathan, M. S. (2000). Science in response to
basic human needs. Science 287, 425; Historical atlas of the twentieth cen-
tury. http://users.erols.com/mwhite28/20centry.htm.
(^18) Stone, R. (1995). If the mercury soars, so may health hazards. Science
267, 958.
(^19) World Meteorological Organization, quoted in “Increasing heat waves
and other health hazards.” greenpeaceusa.org/climate/index.fpl/7096/
article/907.html.
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