Book Reviews


Dying for Growth: Global Inequality and the Health of the Poor
Edited by Jim Yong Kim, Joyce V. Millen, Alec Irwin, and John Gershman
Monroe, Me: Common Courage Press, 2000.
$US 29.95.

Reviewed by Ken Gould


One of the great challenges facing the transnational anti-corporate globalization movement is finding an effective means by which to convey the negative impacts of international financial institutions' (IFIs) policies and transnational corporations' (TNCs) actions on the lives and life courses of individuals. Dying for Growth achieves this goal by presenting a systematic analysis of the effects of transnational institutions on national development trajectories, regional political economies, local socio-economic structures and the constraints and opportunities facing people in their daily struggles for survival. Another challenge facing those whom fight to create a socially just and ecologically sustainable global development path is the need to overcome the general public indifference to the conditions and needs of the world's poorest inhabitants. Dying for Growth makes an important contribution to that effort by using the health of the poor as a measure of the success or failure of the global development project. It is perhaps hardest to turn a blind eye to the suffering of children, especially when that suffering results from lack of access to the basic requirements of life. Clean water, adequate shelter, sufficient nutrition and basic health care are amenities that the world's consumer-class often take for granted. Exposure to the realities of denial of these necessities to hundreds of millions of children may prove to be an effective mechanism to generate the pubic empathy and subsequent political pressure required to reorient transnational development policy.

The primary health threat examined in Dying for Growth is the ascendancy of the neo-liberal economic paradigm. This voracious social affliction was spread by Ronald Reagan, Margaret Thatcher, and Helmut Kohl in the 1980's and has globally metastasized by the dawn of the 21st Century. The primary vectors of this pernicious pathogen have been the IFIs and trade liberalization agreements. The introductory chapters of this volume do an admirable job of tracing the origin of these growth-at-all-costs policies from Bretton Woods through the Uruguay round of GATT negotiations, examining each element of neo-liberal ideology and their direct and indirect impacts on public health. Privatization, "free-trade", the dismantlement of the welfare state, debt servicing, the rise of TNC autonomy, and the removal of national economic policy from the sphere of democratic decision-making are explored and linked to a wealth of empirical data indicating the cost of these policies in terms of human lives.

One of the strengths of this volume is its ability to link analyses of macro-structural processes to an impressive collection of public health data by maintaining a deep dialogue between theory and evidence. The emotional impact of that dialogue is heightened by the presentation of testimonials which illustrate the experiences of the poor as they seek to sustain their children. Those testimonials appear in the second part of Dying for Growth which offers detailed case studies of health decline from Haiti to Russia to Sub-Saharan Africa. The chapters on TNC power which open part three of the volume offer a comprehensive overview of the means by which corporations emerged as the dominant political actors on the face of the earth. The analyses of the social impacts of the corporate takeover of public policy is one of the most compelling features of the book. One of the most interesting chapters comprises part four of Dying for Growth which focuses on the "war on drugs", accurately conceptualized here as a war on the poor. That analysis draws important policy linkages between the attack on the health of the poor in the United States' urban centers, and the attack on peasant aspirations worldwide. Most significantly, the chapter specifies precisely how TNCs and national and transnational elites benefit from the repression of the poor under the guise of anti-drug activities while clearly illustrating that drug eradication is neither an intention nor an outcome of such initiatives. The final substantive section of the volume offers hope through the examination of other development options. A refreshingly uplifting analysis is provided by Aviva Chomsky's chapter on public health in Cuba. Offered as a contrast to the tales of erosion of public health in the "free-trade" world, the chapter provides an overview of Cuba's stunning achievements as one of the last alternative development models to survive the neo-liberal onslaught. "The threat of a good example" is testament to the quality of life achievements in a poor nation made possible by state-socialism. The book closes with a most useful directory of non-governmental and social movement organizations focused on public health, human rights, social justice, and anti-corporate globalization issues offering brief synopses of their activities and contact information. After reading Dying for Growth it is hard to imagine that even the most cynical of readers would not feel somewhat compelled to offer assistance to one or more of these organizations in their struggle to foster a more socially just, ecologically sustainable and humane world order.

In short, Dying for Growth is highly recommended. If you've been looking for an empirically grounded book that you could recommend to colleagues, friends or family members to help explain why you went to Seattle or Washington, DC to get pepper sprayed by agents of the state, Dying for Growth would be an excellent choice. For your courses on globalization, development, corporate power, or public health, Dying for Growth could serve as an important core text. Although the sheer size of the volume may prove daunting for some, a strategic selection of specific chapters could convey much of the theoretical and substantive ideas without scaring off the more skittish members of a "post-literate" society. It is neither a quick read nor a fun read, but it is an essential read for those interested in the rise of corporate-driven neo-liberal ideology and its implications for the fate of the two billion members of the worlds' "underclass", as well as that of the global working-class facing the abyss if they are so unfortunate as to fall ill.


Kenneth A. Gould
Department of Sociology
St. Lawrence University