Economic Globalization and the Social Determinants of Urban Health: European Policy Approaches and their Implications for Canada

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1 Economic Globalization and the Social Determinants of Urban Health: European Policy Approaches and their Implications for Canada Dennis Raphael, PhD School of Health Policy and Management York University Globalization and Health Meeting, Ottawa: Dec

2 Today s Presentation Economic Globalization, Canadian Cities, and the Social Determinants of Urban Health The Importance of Cities Effects of Globalization on Canada s Cities Canadian Responses European Responses Implications for Canada 2

3 Globalization, Canadian Cities, and the Social Determinants of Urban Health Economic globalization shapes public policy activity in both developing and developed nations. These developments are relevant to the social determinants of urban health. 81% of Canadians live in urban areas: Over a third of Canadians (35%) live in just three urban areas: Toronto, Vancouver, and Montréal. Increasing evidence that living conditions in cities are becoming increasingly threatening to the health of their residents. 3

4 The Importance of Cities I Cities have become especially important as engines of growth for national economies. Cities produce commercial opportunities and jobs through new products and services. Cities typically account for a disproportionately strong share of a country s GDP per capita. In terms of social infrastructure, cities provide the wealth that finances the health, education, and pensions that provide for high value society. Source: What Policies for Globalising Cities?: Rethinking the Urban Policy Agenda by the Organisation for Economic Cooperation and Development,

5 The Importance of Cities II The modern city also concentrates unemployed and other marginalised people: Cities have to deal with the challenges of economic adjustment, poverty and social cohesion, and in many cases with higher criminality. Source: What Policies for Globalising Cities?: Rethinking the Urban Policy Agenda by the Organisation for Economic Cooperation and Development,

6 Emerging European Urban Issues Competitiveness vs. cohesion: Making policy that supports the growth of the market economy but raises challenges for societal functioning. Explicit versus implicit urban policy: The extent to which public policy specifically addresses city-related issues. Multi-level governance vs. institutional autonomy: Who actually owns urban policy? Administrative vs. functional understandings of cities: Concern with horizontal integration of structures across cities and regions. Short vs. long-term perspectives: Focus on short-term reactive measures versus positive long-term approaches. Legitimate vs. post-democratic governance of urban policy: Concern about involving the population in democratic discussions about the course of future urban policymaking. Source: Harding, A. (2007). Globalization, Spatial Economic Change and Urban Policy. In What Policies for Globalising Cities? Rethinking the Urban Policy Agenda. Paris: OECD. [Canada is not doing well on any of these issues-dr] 6

7 Effects of Globalization on Canada s Cities Bryant, Raphael, Schrecker, and Labonte (2011) identify health and quality of life issues emerging in Canadian cities. Growing income gap Growing and deepening poverty A food crisis A housing crisis Exclusion of newcomers and racial minorities. 7

8 Canadian Responses Re: ongoing urban crises, the Federation of Canadian Municipalities (FCM) has raised the red flag about these issues. Yet, globalization has not been placed on the public policy agenda within the context of urban health and well-being. A 2012 FCM report -- The road to jobs and growth: Solving Canada s municipal infrastructure challenge -- contained one reference to globalization: (). The recent resurgence of interest in the role and importance of infrastructure, which is driven partly by a massive and growing infrastructure deficit following decades of neglect, and partly by the pressures of globalization and increased competition, saw public investment in infrastructure reach just over three percent in The State of Canada s Cities and Communities has NO mention of globalization (FCM, 2012).

9 In Canada Economic globalization is frequently used as a justifying discourse in Canada for shifts and not positive ones -- in the form of the Canadian welfare state. 9

10 European Responses I There has been extensive European activity concerned with globalization and urban life and issues of health and well-being of urban dwellers is an important part of this activity. Much work has been organized under the auspices of the European Union, the Council of Europe, and the European Federation. Large number of governmental-commissioned reports that focus on its effects and measures of responding to pressures through public policy action. 10

11 European Responses II Globalization informs the work of academic researchers in a wide range of areas that include income and wealth, employment and working conditions, housing, social exclusion, integration of immigrants, and numerous other issues best described as quality of life. Much of this work is done by research networks linked to government structures and academic research units. 11

12 Source: Begg, I., Draxler, J., & Mortensen, J. (2008). Is Social Europe fit for globalization? A study of the social impact of globalisation on the European Union. 12 Brussels: European Union.

13 Emerging Themes I Profound policy activity in Europe to protect citizens from impacts of economic globalization. Policy integration. Close alliance of government with university-based research centres. 13

14 Emerging Themes II: Problems Stagnating economic performance Increasing social polarization and spatial fragmentation (social exclusion, social cohesion) Immigration puts high demands on cities Urban safety Suburbanization Housing Urban governance Source: Van de Berg, L., Braun, E., and van der Meer (2007). National policy responses to urban challenges in Europe. Aldershot: Ashgate 14

15 Policy Integration I Areas considered separately in Canada such as employment, income and poverty, housing, and exclusion are integrated into general policy discussions in Europe. EU contributes to the European Social Model in order to: Combine economic growth with more and better jobs Provide a high level of social protection and Equal opportunities for all. Source: Guide to EU employment and social policies (2005). 15

16 Policy Integration II The Lisbon Strategy (2000) calls for a common strategy for sustainable development and employment and strengthening social cohesion. It was followed up in 2010 by the Europe 2020 Strategy. Also a Leipzig Charter (2007) on Sustainable Cities. 16

17 Policy Actions and Results Actions are occurring at national, regional, and municipal levels. Incredible range of initiatives concerned with promoting economic competitiveness, employment, social inclusion, and housing. Evaluation tends to be at the macrolevel with rather less evaluation of specific programs impact. 17

18 The Europe 2020 Strategy I Aims to create jobs, and encourage 'green' economic growth and create an inclusive society. The main targets include: raise EU employment rate from 69% to 75%; reduce school drop-out rates to less than 10%; reduce the number of Europeans living in poverty by 25% (equivalent to 20 million people); reduce greenhouse gas emissions by 20% compared to 1990 levels (or by 30% if the conditions are right); 20% of total energy consumption to be from renewable energy and increasing energy efficiency by 20%; 3% of the EU's GDP to be invested in Research and Development. 18

19 The Europe 2020 Strategy II EU states' progress is monitored: states must outline how they intend to meet these targets in 'national reform programmes', which are submitted to the EU Commission, and the European Council evaluates states' progress at one summit each year. Source: The Europe 2020 Strategy (2010). 19

20 Source: Europe 2020 (2012). 20

21 21

22 Alliance of Governments with University-based Research Centres European Policy Centre European Urban Knowledge Network Cities for Local Integration Policy Centre for European Policy Studies CoNet Cohesion Network European Institute for Comparative Urban Research 22

23 Facts or Beliefs? In this process, the Dutch policy on integrated urban renewal shows clear parallels with the experience in other Western European countries, demonstrating that a Western European paradigm of urban policies is in the making: integrated, areabased, with involvement of both public and market partners and residents. Source: Musterda, S. and Ostendorfa, W. (2008). Integrated urban renewal in The Netherlands: a critical appraisal. Urban Research & Practice, 1,

24 Facts or Beliefs II? At the same time it is clear that this new paradigm of urban policies shows the characteristics of a discourse that is not based on research and on empirical facts, but that develops its own momentum from shared beliefs regarding the nature of urban problems and the appropriate policy responses. Source: Musterda, S. and Ostendorfa, W. (2008). Integrated urban renewal in The Netherlands: a critical appraisal. Urban Research & Practice, 1,

25 Facts or Beliefs III Perhaps one way of evaluating these policies is in comparative analysis of indicators of QOL such as those from the Federation of Canadian Municipalities between European and Canadian cities. Work to be done by whom? 25

26 Is a National Approach Useful? Explicit National Policies: UK, France Netherlands, and Belgium Increasing Attention: Germany, Finland, Sweden, Denmark, Italy, and Portugal No Explicit National Policies: Luxembourg, Spain, Greece, and Austria Source: Van de Berg, L., Braun, E., and van der Meer (2007). National policy responses to urban challenges in Europe. Aldershot: Ashgate 26

27 Implications for Canada I Only a handful of researchers are examining the implications of globalization for the health and well-being of Canadians. These efforts are done in isolation from governmental authorities and policymakers. 27

28 Implications for Canada II The Canadian urban policy situation brings to mind Graham Scambler s term disorganized capitalism. Need to form alliances with receptive governments and opposition parties to build momentum for a systematic building of a policy community and national approach(?) able to inform health and quality of life-related urban policymaking in Canada. 28

29 At least one MP in Opposition is Receptive! Now the middle has been hollowed out and is projected to all but disappear in just over a decade. In its place are seniors with inadequate pensions; newcomers with broken promises in place of recognized credentials; youth without jobs and slim on hope; and workers yes, workers in poverty. In other G8 countries, governments have become major players in the financial, economic and cultural life of their cities and it is past time for ours to do the same. Source: Kellway, M. and Keil, R. (2012). Conservative budget at odds with urban Canadian realities. Toronto Star: April

30 Dennis Raphael This presentation and other presentations and related papers are available at: [go to the library there] 30

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