Global Health from Two Perspectives

All economies are developing, not just those with relatively small accumulations of capital and infrastructure and low wages. The major challenge for rapid-growth developing countries is internalizing the externalities of occupational health costs, so that basic occupational health services facilitate and support growth and reduce the burden of disease and disability. Economic development does not stop with industrialized, high value-added globalized economies, however. Developed economies in the twentieth century are entering new phases, characterized by a “postmodern” organization, technology-intensive, high-productivity with limited employment growth. The principal concern of employers and decision leaders in these economies is increasingly maintaining exceptionally high levels of productivity in the face of demographic changes that lead to a larger proportion of those who do not work relative to those who do. The role of occupational health in these societies emphasizes a response to growing aversion to risk, elevated expectations for occupational justice, guarantee of productivity in order to support the standard of living in a population that is both rapidly aging and shrinking, and prevention of disability. It is time for the current generation of economists to catch up with Adam Smith, who recognized these trends and addressed them in his model.