Cargando…

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

BACKGROUND: Regional trade agreements are major international policy instruments that shape macro-economic and political systems. There is widespread debate as to whether and how these agreements pose risks to public health. Here we perform a comprehensive systematic review of quantitative studies o...

Descripción completa

Detalles Bibliográficos
Autores principales: Barlow, Pepita, McKee, Martin, Basu, Sanjay, Stuckler, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343316/
https://www.ncbi.nlm.nih.gov/pubmed/28274238
http://dx.doi.org/10.1186/s12992-017-0240-x
_version_ 1782513343601311744
author Barlow, Pepita
McKee, Martin
Basu, Sanjay
Stuckler, David
author_facet Barlow, Pepita
McKee, Martin
Basu, Sanjay
Stuckler, David
author_sort Barlow, Pepita
collection PubMed
description BACKGROUND: Regional trade agreements are major international policy instruments that shape macro-economic and political systems. There is widespread debate as to whether and how these agreements pose risks to public health. Here we perform a comprehensive systematic review of quantitative studies of the health impact of trade and investment agreements. We identified studies from searches in PubMed, Web of Science, EMBASE, and Global Health Online. Research articles were eligible for inclusion if they were quantitative studies of the health impacts of trade and investment agreements or policy. We systematically reviewed study findings, evaluated quality using the Quality Assessment Tool from the Effective Public Health Practice Project, and performed network citation analysis to study disciplinary siloes. RESULTS: Seventeen quantitative studies met our inclusion criteria. There was consistent evidence that implementing trade agreements was associated with increased consumption of processed foods and sugar-sweetened beverages. Granting import licenses for patented drugs was associated with increased access to pharmaceuticals. Implementing trade agreements and associated policies was also correlated with higher cardiovascular disease incidence and higher Body Mass Index (BMI), whilst correlations with tobacco consumption, under-five mortality, maternal mortality, and life expectancy were inconclusive. Overall, the quality of studies is weak or moderately weak, and co-citation analysis revealed a relative isolation of public health from economics. CONCLUSION: We identified limitations in existing studies which preclude definitive conclusions of the health impacts of regional trade and investment agreements. Few address unobserved confounding, and many possible consequences and mechanisms linking trade and investment agreements to health remain poorly understood. Results from our co-citation analysis suggest scope for greater interdisciplinary collaboration. Notwithstanding these limitations, our results find evidence that trade agreements pose some significant health risks. Health protections in trade and investment treaties may mitigate these impacts. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12992-017-0240-x) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-5343316
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-53433162017-03-10 The health impact of trade and investment agreements: a quantitative systematic review and network co-citation analysis Barlow, Pepita McKee, Martin Basu, Sanjay Stuckler, David Global Health Research BACKGROUND: Regional trade agreements are major international policy instruments that shape macro-economic and political systems. There is widespread debate as to whether and how these agreements pose risks to public health. Here we perform a comprehensive systematic review of quantitative studies of the health impact of trade and investment agreements. We identified studies from searches in PubMed, Web of Science, EMBASE, and Global Health Online. Research articles were eligible for inclusion if they were quantitative studies of the health impacts of trade and investment agreements or policy. We systematically reviewed study findings, evaluated quality using the Quality Assessment Tool from the Effective Public Health Practice Project, and performed network citation analysis to study disciplinary siloes. RESULTS: Seventeen quantitative studies met our inclusion criteria. There was consistent evidence that implementing trade agreements was associated with increased consumption of processed foods and sugar-sweetened beverages. Granting import licenses for patented drugs was associated with increased access to pharmaceuticals. Implementing trade agreements and associated policies was also correlated with higher cardiovascular disease incidence and higher Body Mass Index (BMI), whilst correlations with tobacco consumption, under-five mortality, maternal mortality, and life expectancy were inconclusive. Overall, the quality of studies is weak or moderately weak, and co-citation analysis revealed a relative isolation of public health from economics. CONCLUSION: We identified limitations in existing studies which preclude definitive conclusions of the health impacts of regional trade and investment agreements. Few address unobserved confounding, and many possible consequences and mechanisms linking trade and investment agreements to health remain poorly understood. Results from our co-citation analysis suggest scope for greater interdisciplinary collaboration. Notwithstanding these limitations, our results find evidence that trade agreements pose some significant health risks. Health protections in trade and investment treaties may mitigate these impacts. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12992-017-0240-x) contains supplementary material, which is available to authorized users. BioMed Central 2017-03-08 /pmc/articles/PMC5343316/ /pubmed/28274238 http://dx.doi.org/10.1186/s12992-017-0240-x Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Barlow, Pepita
McKee, Martin
Basu, Sanjay
Stuckler, David
The health impact of trade and investment agreements: a quantitative systematic review and network co-citation analysis
title The health impact of trade and investment agreements: a quantitative systematic review and network co-citation analysis
title_full The health impact of trade and investment agreements: a quantitative systematic review and network co-citation analysis
title_fullStr The health impact of trade and investment agreements: a quantitative systematic review and network co-citation analysis
title_full_unstemmed The health impact of trade and investment agreements: a quantitative systematic review and network co-citation analysis
title_short The health impact of trade and investment agreements: a quantitative systematic review and network co-citation analysis
title_sort health impact of trade and investment agreements: a quantitative systematic review and network co-citation analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343316/
https://www.ncbi.nlm.nih.gov/pubmed/28274238
http://dx.doi.org/10.1186/s12992-017-0240-x
work_keys_str_mv AT barlowpepita thehealthimpactoftradeandinvestmentagreementsaquantitativesystematicreviewandnetworkcocitationanalysis
AT mckeemartin thehealthimpactoftradeandinvestmentagreementsaquantitativesystematicreviewandnetworkcocitationanalysis
AT basusanjay thehealthimpactoftradeandinvestmentagreementsaquantitativesystematicreviewandnetworkcocitationanalysis
AT stucklerdavid thehealthimpactoftradeandinvestmentagreementsaquantitativesystematicreviewandnetworkcocitationanalysis
AT barlowpepita healthimpactoftradeandinvestmentagreementsaquantitativesystematicreviewandnetworkcocitationanalysis
AT mckeemartin healthimpactoftradeandinvestmentagreementsaquantitativesystematicreviewandnetworkcocitationanalysis
AT basusanjay healthimpactoftradeandinvestmentagreementsaquantitativesystematicreviewandnetworkcocitationanalysis
AT stucklerdavid healthimpactoftradeandinvestmentagreementsaquantitativesystematicreviewandnetworkcocitationanalysis