Trade Liberalization and the Social Determinants of Health: A Case Study of NAFTA's Impact on Mexico from 1994 to 2005

Given the increased transnationalization of borders and economic interdependence between countries in the Global North and South, it is imperative to address how these trends impact the health and well being of the populations involved. The conventional neoliberal economic framework, however, falls short in explaining these dynamics due to its overemphasis of proximal determinants of health as direct consequences of commodification and free market activities. In congruence with those theoretical limitations, there is a limited assessment of more distal determinants – the social determinants of health (SDOH) – that are arguably more consequential for health and are interrelated with the dynamics of political economies. The relationship between trade liberalization and SDOH, therefore, deserves greater examination through said framework. This thesis seeks to address the aforementioned gaps by assessing the impacts of trade liberalization on SDOH within a case-study analysis of the North American Free Trade Agreement (NAFTA) and its impact on Mexican SDOH pathways in the period between 1994 and 2005. I identify three SDOH pathways for the analysis of NAFTA: employment, regulation, and agricultural commerce. By analyzing the intended impacts of NAFTA and Mexican policies, the quantitative primary, and the qualitative secondary data of the actual outcomes, I find that NAFTA’s impact on SDOH was incredibly nuanced. The agreement produced mixed outcomes on an aggregate basis, but poorer outcomes for specific groups of people. But, the ultimate conclusion of this analysis is that the true impact of trade liberalization on SDOH cannot fully be examined in isolation, for each SDOH factor is inextricably linked with the other and is broadly interrelated with the domestic and global political economies. These findings have implications for further research in identifying SDOH as variables of concern within theories of political economy, as well as variables of concern for future trade and development policies.