Globalization, Human Capability, Environments, and Rural and Remote Health

Global forces, including economic, technological and social factors, hold promise for improving human health not only through creation of wealth and enhancing availability of resources, but through introduction of social innovation. The success of such social innovation is in part determined by the capacity and ethical foundations of underlying local institutions. Yet net benefits of economic globalization at the macro level have been asymmetrical, to date, and, in fact, significantly aligned with poverty and wealth, which, in turn, leads to expanding health inequities. Rural and remote populations are especially affected by these conditions, due to their reduced local governance capacity and resources. Yet most of the rural health policy discourse, to date, has focused on physician and hospital services access, rather than on the upstream global processes which can significantly impact rural and remote human viability. Global forces are not limited to economic processes and policies. Global forces can include dimensions of urbanization and population migration, information technology, social policy, and natural environmental degradation and climate change. Our vision is a program of research to examine the complex mechanisms and systems-related factors by which rural people respond to global forces in rural and remote regions, leading to enhanced understanding of the pathways by which these can manifest as health inequities. Working as a team of international researchers and knowledge users and community members, we have adapted the Labonte-Schrecker model of globalization to support a series of case studies of the influences of these forces in different rural and remote settings around the world. The case studies provide opportunities to examine and discuss shared features of pathways of health inequity experienced within different rural population settings and from different global forces.