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implications on health, Huynen et al. (2005) build a multilevel conceptual framework
which connects the determinants of globalization to population health, as demonstrated
in figure III.1.2.
Figure III.1.2: Model of linkages and globalization of health
Source: Huynen et al. (2005, fig. 3)
In their attempt to a more global approach, Huynen et al. (2005) identify three strata of
factors that would lead to a given health outcome: (i) contextual factors, (ii) distal
determinants and (iii) proximal determinants. The first set of factors, the contextual
factors relate to the global (a) governance structure, (b) markets and communication
means, (c) mobility, (d) cultural flows and (e) environmental changes. The second set of
factors, or the distal factors, can be summarized in (a) health and health related issues, (b)
income and wealth distribution and trade in goods and services, (c) education and literacy
and (d) habitat and information. The third and last set, the proximal determinants, is
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