In the New York Times today, Thomas Friedman made the case that we are beginning to segregate nations worldwide into “worlds of order” versus “worlds of disorder”. In support of this comment, he presents the multi-border exodus from the Middle East to various nation’s of the European Union.
This I know, is not especially revelatory. But it does, of course, have health implications, especially for the young. And believe it or not, we have been making progress in worldwide childhood mortality. In fact, deaths in vulnerable kids have dropped 53% since 1990 according to a recent UNICEF report. Under-5 deaths have declined from a high of 12.7 million in 1990 to 5.9 million in 2015. Nearly half of those deaths (45%) occur in the first month of life. Putting vulnerable families in full flight, and exposed to the elements, without clean water, adequate food, and decent shelter, certainly won’t help.
Friedman has been watching mega-trends, and he is not optimistic that the world will rediscover its sanity any time soon. He cites three trends in particular as the source for future major destabilization. They are:
1. “Mother Nature -climate change, biodiversity loss and population growth in developing countries”,
2. Moore’s law: microchip power doubling every few years assuring expansion of inexpensive information technology, making it difficult for despots to control their populations,
3. Market globalization with every increasing competition for profits – witness the shifting tides of the energy sector these days,
Of course, Tom is right. Poor climate policy, a highjacked or poorly advantaged Internet, and unfettered capitalism with a few mega-winners and many, many losers, is not healthy.
But I think his insights extend beyond the developing world, and are already affecting our own shores. My contention is that bad policy decisions at this moment could significantly undermine our nation’s future health and stability.
For example a wrong-headed approach to immigration that weakens the economic stability of neighbors like Canada and Mexico simply assures an additional future illegal influx of desperate and vulnerable migrants trying to survive. We should be contributing to those nation’s successes, not trying to “wall them off”, because that will help to continue to ensure an additional buffer of sanity and stability on our northern and southern borders.
Similarly, our ignorant denial of global warming is already adversely effecting population and personal health and safety in enumerable ways. Our actions are accelerating these changes, with solutions increasingly out of reach. The great challenge here is to continue to support national energy independence without destroying our environment in the process.
Finally, there’s the special problem of unfettered capitalism. In a nation that relies on “balance of power” to check greed and ignorance – three branches of government, separation of church and state, for-profit versus not-for-profit, corporations versus government – dismantling these boundaries in the name of theoretical gains in efficiency and productivity, is beyond ill-advised.
One need only to critically examine our health delivery system – whose power players are able to manipulate regulation by passing seamlessly from government to academic to industry posts – to appreciate how easy it is to corrupt a system and its policies when unopposed by a significant countervailing force.