Health as if everybody counted blog
“Logics of expulsion”
At the Global Health Conference in Montréal last month, I had the privilege of being on a panel with Saskia Sassen, the Robert S. Lynd Professor of Sociology at Columbia University. She is one of the most intellectually sophisticated scholars writing in English (and indeed in various other languages) about how globalization is transforming societies rich and poor alike – and in the process affecting who has the chance to live a long and healthy life.
Saskia Sassen is perhaps most closely identified with her research on the global cities (New York. London, Tokyo) that function as command centres for the world economy. Her subsequent research expanded, in various ways, on how global reorganization of production and (especially) finance has redistributed power. In a 1996 book called Losing Control? Sovereignty in the Age of Globalization, she wrote about the shift of power from citizens to unaccountable coalitions of investors who comprise "a sort of global, cross-border economic electorate, where the right to vote is predicated on the possibility of registering capital." In the preceding year, a Wall Street Journal editorial warned financial markets of the need for "dramatic action" in the federal budget; political scientist Donald Savoie argues that this warning played a major role in the $29 billion in federal spending cuts that followed. At a time when bond markets and credit rating agencies have more say over the fate of many European governments than their own electorates, Sassen's observation is more important than ever.
Her most recent project is even more relevant to population health. She argues that contemporary globalization is generating "a savage sorting of winners and losers" within as well as across national borders, continuing and intensifying a pattern that began with the use of structural adjustment programs – familiar to many in the global health field – as a "disciplining regime" in the aftermath of debt crises. More specifically, she describes new and often brutal "logics of expulsion". One of these involves the phenomenon of land grabs: large-scale purchases or long-term leases of productive agricultural land by food-importing countries or transnational agrifood corporations. North American media have been predictably silent on this topic, but it has received considerable coverage in The Guardian, which is the English-language paper you need to read if you really want to know what is going on in the world.
Another logic of expulsion arises from the aftermath of the 2008 collapse of the market for securities backed by sub-prime mortgages. In a remarkable video of a presentation to a September, 2011 homelessness conference (basically a longer version of her Montréal presentation), Sassen points out that subsequent foreclosures in the United States have created a largely invisible army of close to 30 million displaced people, including many who were renting properties that were foreclosed. The state, through law, has been an active participant in these expulsions. We have, as she points out, gone far beyond the anodyne language of social exclusion that has recently become popular in some social and health policy circles.
Sassen also makes the critical point that profits made from the securities in question were completely unrelated to whether or not the people originally taking out the mortgages had any hope of making the payments; profits were made, rather, by packaging and selling on the mortgages. Predictably, homelessness – which is not good for your health – is on the rise in the United States. Another illustration of the consequences of the crisis in the country where it originated: in September 2011, a record one in seven Americans was receiving the food vouchers commonly known as Food Stamps, and millions more were eligible. Like the proliferation of foreclosures, this new pattern of impoverishment can be traced directly to domestic and international policy choices designed to create new profit centres in the global financial services industry, on the principle that markets know best.
|Photo by Joseph Bergantine,
licensed under a Creative Commons United States licence
In intellectual terms, the events of 2008 confirmed that idea's zombie status (as Bob Evans, featured in my previous posting, would say), but the zombie masters have revived it with frightening tenacity. The statistics from the United States also show that the study of globalization and health can no longer focus on distant countries 'out there'. In the future, wherever we are in the high-income world (think about the 46 percent youth unemployment rate in Spain), globalization's casualties will live among us, sometimes literally in the shadows of the glittering towers where globalization's winners live, work and play.
I have only scratched the surface of Saskia Sassen's work, but have tried to show why everyone concerned with health equity should consider it indispensable. Read it, and you'll quickly understand why the December, 2011 Foreign Policy "top 100 global thinkers" features her as the first sociologist to make the list.