How extractive industries affect health: Political economy underpinnings and pathways

Abstract

A systematic and theoretically informed analysis of how extractive industries affect health outcomes and health inequities is overdue. Informed by the work of Saskia Sassen on "logics of extraction," we adopt an expansive definition of extractive industries to include (for example) large-scale foreign acquisitions of agricultural land for export production. To ground our analysis in concrete place-based evidence, we begin with a brief review of four case examples of major extractive activities. We then analyze the political economy of extractivism, focusing on the societal structures, processes, and relationships of power that drive and enable extraction. Next, we examine how this global order shapes and interacts with politics, institutions, and policies at the state/national level contextualizing extractive activity. Having provided necessary context, we posit a set of pathways that link the global political economy and national politics and institutional practices surrounding extraction to health outcomes and their distribution. These pathways involve both direct health effects, such as toxic work and environmental exposures and assassination of activists, and indirect effects, including sustained impoverishment, water insecurity, and stress-related ailments. We conclude with some reflections on the need for future research on the health and health equity implications of the global extractive order.

Addressing the Environmental, Community, and Health Impacts of Resource Development: Challenges across Scales, Sectors, and Sites

“…The precedents above, combined with the complex dynamics of resource development, have drawn attention to the "cumulative determinants of health impact" [13], linking cumulative thinking with "upstream" factors, including the social and ecological determinants of health [2,42]. Figure 1 depicts the potential for resource development activities to interact as upstream drivers of change in a region of concern, leading to an array of proposed or actual changes in the landscape.…”

“…The cascade also has planetary implications across scales and generations. Cumulative impacts from multiple resource developments within the same landscape are also driven by global processes spanning climate change, corporate power dynamics, urbanization, and other megatrends, with an array of overlapping environmental, community, and health consequences [2,11,27,58,59]. Attention to temporal and spatial dimensions of impacts draws attention to both short-term acute crises and longer-term health implications of global ecological change [60].…”

“…Understanding scalar and differential levels of influence is difficult, but offers a useful point of reference when seeking to understanding intersecting and cumulative environment, community, and health issues in any particular location and landscape. This includes paying particular attention to questions of human scale and the embodied elements of the impacts of resource development, that are spatially experienced very differently depending on multiple factors, including social, cultural, and economic considerations [2,53]. The dynamics of global, national, provincial, and Indigenous resource governance matters here, particularly in light of the power and scale of transnational corporate entities and the ways that global financial decision making plays out regionally, on the ground [2,[7][8][9].…”

“…The health impacts of resource extraction and development exemplify complex issues that stretch across jurisdictional, ecological, disciplinary, and sectoral boundaries [1,2]. Indeed, the health dynamics of resource development and extractive industries can be equally framed as global, national, regional, or more proximal experiences, and underscore the formidable task of designing research and policy that meaningfully addresses the scope of personal, public, population, and planetary health.…”

Foreign aid, the mining sector and democratic ownership: The case of Canadian assistance to Peru

“…Increased emphasis on extractives can, however, come at a high price to local communities. Mining in particular is associated with environmental destruction, human rights abuses, repression, forced displacement—especially of indigenous peoples—local conflict, social tensions, the spread of HIV and AIDS, alcoholism, drug abuse and other health‐related problems, prostitution and violence against women (Grupo de Trabajo sobre Minería y Derechos Humanos en América Latina, 2014; Schrecker et al, 2018). According to a 2009 study commissioned (and subsequently suppressed) by the Prospectors and Developers Association of Canada, an industry group, Canadian companies are responsible for one‐third of the 171 incidents in developing countries that they tracked over a 10‐year period.…”