State autonomy and population health: The experiences of Thailand, Malaysia and South Korea during the East Asian financial crisis

This thesis explores whether the state is a determinant of population health. This is explored by examining whether states are able to preserve their population's health in the face of a financial crisis, as an example of economic globalization. Primarily, two social determinants of health, social cohesion and income inequality, are used to explore this question. A critical analysis of the associated literature demonstrates their link to population health and the role of the state in promoting population health. A discussion of state autonomy and globalization challenges the assertion that states are in decline and identifies that much of the arguments surrounding a decline in the capacity of states to act, or their autonomy, is the result of a mischaracterization of states as absolute. The discussion concludes that globalization does not necessarily constrain the ability of states to act. The thesis discusses the potential causes of financial crises and the East Asian financial crisis specifically. Financial crises are presented as an extreme example of globalization. The case study discusses the population health impacts of the crisis upon Thailand, Malaysia and the Republic of Korea (South Korea or Korea). The exploration of population health impact draws upon measures of poverty, mental health, and unemployment in addition to the social determinants of health. The case study demonstrates that all three states experience impacts from the crisis, although Malaysia is impacted the least severely. The thesis concludes some states are able to act and determine the health of their population in the face of globalization. In the case of Malaysia, its policies preceding the onset of the crisis appear to have played a key role in reducing their impact, but possible differences in its exposure to the global economy and economic structure cannot be discounted. The thesis closes with recommendations for countries currently dealing with financial crises.