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Injury and globalisation
Injury and globalisation
  1. I Roberts
  1. Correspondence to:
 Professor Ian Roberts
 London School of Hygiene and Tropical Medicine, 49–51 Bedford Square, London WC1B 3DP, UK;

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The injury prevention community cannot overlook the consequences of macroeconomic policies

Some years ago, there was a TV advert for the Guardian newspaper, which became an advertising classic. It showed a young man, short hair, tattoo, drainpipe trousers and bovver boots, pelting towards an old man ambling his way down the street. When the lout catches up, he grabs the old man and flings him down, clearly a vicious unprovoked assault. But then the camera moves back to show the whole picture. A pile of bricks, fallen from a crane, is about to flatten the old guy. The viewers were wrong. The “lout” was saving his life. We need the whole picture in order to really know what is going on.

To prevent injury we need to understand its causes and this also requires that we look at the whole picture. The macroeconomic determinants of injury are not evident at the site of injury and are never captured by injury surveillance systems. Nevertheless, they have a huge effect on the injury incidence rate. Of these, the neoliberal trade policies that are being championed by the governments of the economically powerful nations are likely to be the most important.


The captains of industry are excited about policies that facilitate transnational trade because of their potential to increase profits. It is more profitable to manufacture goods in low income countries where wages are low than in high income countries where workers enjoy higher wages and standards of living. But the people in low income countries cannot afford to buy expensive manufactured goods and so the finished goods have to be transported back to markets in high income countries. Much of this so called “trade” is not international trade at all but the movement of materials within transnational corporations. Nevertheless, it requires cheap …

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