How extractive industries affect health: Political economy underpinnings and pathways

• Published in: Health & place Vol. 52; pp. 135 - 147
• Main Authors: Schrecker, Ted, Birn, Anne-Emanuelle, Aguilera, Mariajosé
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.07.2018; Elsevier Science Ltd
• Subjects: Activists; Agricultural land; Assassinations & assassination attempts; Economics; Extraction; Health; Health disparities; Health status; Health technology assessment; Indirect effects; Job insecurity; Land acquisition; Occupational safety; Political economy; Politics; Power; Stress
• ISSN: 1353-8292; 1873-2054
• DOI: 10.1016/j.healthplace.2018.05.005

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. •We present an innovative approach to the health effects of extractive industries, adopting a broader than usual definition of these industries.•Drawing on four case examples, two of them region-specific and two considered in global context.•We posit five generic pathways to health outcomes.•Situate those pathways in the context of the global political economy of extraction, in order to.•Identify key issues and priorities for future research in a neglected field.