The relationship between international trade and non-nutritional health outcomes: A systematic review of quantitative studies

Abstract

Markets throughout the world have been reducing barriers to international trade and investment in recent years. The resulting increases in levels of international trade and investment have subsequently generated research interest into the potential population health impact. We present a systematic review of quantitative studies investigating the relationship between international trade, foreign direct investment and non-nutritional health outcomes. Articles were systematically collected from the SCOPUS, PubMed, EconLit and Web of Science databases. Due to the heterogeneous nature of the evidence considered, the 16 included articles were subdivided into individual level data analyses, selected country analyses and international panel analyses. Articles were then quality assessed using a tool developed as part of the project. Nine of the studies were assessed to be high quality, six as medium quality, and one as low quality. The evidence from the quantitative literature suggests that overall, there appears to be a beneficial association between international trade and population health. There was also evidence of the importance of foreign direct investment, yet a lack of research considering the direction of causality. Taken together, quantitative research into the relationship between trade and non-nutritional health indicates trade to be beneficial, yet this body of research is still in its infancy. Future quantitative studies based on this foundation will provide a stronger basis on which to inform relevant national and international institutions about the health consequences of trade policies.

Is trade liberalisation a vector for the spread of sugar-sweetened beverages? A cross-national longitudinal analysis of 44 low- and middle-income countries

“…A recent study on the imposition of price increases on SSBs via taxes in Berkeley shows that the price elasticity was much larger than expected (Falbe et al., 2016). This suggests that it may be possible to reap the benefits of trade liberalisation (Burns et al., 2016, Chemingui et al., 2010, Umaña-Peña et al., 2014) while countering the problems through targeted taxes, although clearly it will be necessary to ensure that these are non-discriminatory to comply with trade deals.…”

“…A systematic literature review of quantitative studies by Burns et al. showed an overall beneficial association between international trade or FDI and population health, but this review only addressed non-nutritional health outcomes (Burns et al., 2016). One cross-country longitudinal study examined the link between trade and investment liberalisation and sales of SSBs in LMICs (Stuckler et al., 2012).…”

The nexus between international trade, food systems, malnutrition and climate change

“…There is a limited literature of systematic reviews and analyses of specific trade agreements identify various ways in which trade liberalization can affect food systems [11][12][13][14][15][16][17][18][19][20][21][22] . Three key pathways emerge from this literature: trade in raw or finished food commodities; increased foreign investment in domestic production, manufacturing and distribution of foods; and influence on regulatory policy space.…”

The health impact of trade and investment agreements: a quantitative systematic review and network co-citation analysis

“…These include, among others, alcohol, tobacco, public health policymaking, and social protection programmes. Instead, previous reviews were relatively narrow in scope, with one previous review of the effects of trade and FDI on health systems, a second on non-nutritive health outcomes, and a third on the effects of RTAs on food environments [24–26]. Other analyses of RTAs and health are summaries, theoretical overviews, and policy commentaries, with contradictory claims [7, 12, 14, 27, 28].…”