The Philippines Diaspora and Gulf Oil A case study Ann Marie Kimball, MD, MPH

Learning Objectives To understand the “push” and “pull” of Philippines emigration for employment To understand the “push” and “pull” of Philippines emigration for employment Appreciate the importance of chronic diseases such as coronary artery disease in developing countries such as Philippines Appreciate the importance of chronic diseases such as coronary artery disease in developing countries such as Philippines To economically describe the importance of remittances to the economy of the Philippines To economically describe the importance of remittances to the economy of the Philippines To describe the occupational safety and disability discrimination issues in overseas contract work. To describe the occupational safety and disability discrimination issues in overseas contract work.

Disciplines Medicine Medicine Demography Demography Public Health Public Health Economics Economics Political Science Political Science Law Law

A Worker from the Philippines: Philippines is archipelago nation in South East Asia Philippines is archipelago nation in South East Asia Total population is 83,054,000 Total population is 83,054,000 GDP for is 5,856 per capita GDP for is 5,856 per capita Total health expenditure per capita is 174, 3.2% GDP Total health expenditure per capita is 174, 3.2% GDP

“Heart Disease”- ASCVD, Isn’t that only a “developed” country problem? Developing countries have double burden: acute infectious diseases (uncontrolled) and chronic diseases at rates similar to developed countries Developing countries have double burden: acute infectious diseases (uncontrolled) and chronic diseases at rates similar to developed countries The latter point is often obscured by the former The latter point is often obscured by the former Cardiovascular Disease is the leading cause of death WORLDWIDE Cardiovascular Disease is the leading cause of death WORLDWIDE Caused more than 25% of deaths in Caused more than 25% of deaths in 2001.

Philippines: High Prevalence Cardiovascular Disease is leading cause of Death, seventh cuase of morbidity Cardiovascular Disease is leading cause of Death, seventh cuase of morbidity Hypertension is second cause of mortality, fifth cause of morbidity Hypertension is second cause of mortality, fifth cause of morbidity Diabetes is 9 th cause of mortality Diabetes is 9 th cause of mortality

Population is GROWING As of 2004 growth rate of 2.3% As of 2004 growth rate of 2.3% Majority of women have at least one unwanted child Majority of women have at least one unwanted child Fertility rate 3.5 Fertility rate 3.5 Family Size is inversely related to family wealth Family Size is inversely related to family wealth Low contraceptive prevalence Low contraceptive prevalence

Remittances Large part of national economy: $2.7 billion in first six months of Large part of national economy: $2.7 billion in first six months of Philippine Overseas Employment Administration promotes overseas employment for Philippinos Philippine Overseas Employment Administration promotes overseas employment for Philippinos

Occupational Safety Transnational corporations adopt “local level” of regulation Transnational corporations adopt “local level” of regulation This is legal This is legal All worker protections of “home” country can be ignored i.e. ADA etc. All worker protections of “home” country can be ignored i.e. ADA etc.