Industrial clusters have existed since the early days of industrialization. Clusters exist because of the fact (or perception) that competing firms in the same industry derive some benefit from locating in proximity to each other. These benefits are external to the firm and accrue to similar firms in proximity. Examples include the cotton mills of Lancashire, automobile manufacturing in Detroit, and information technology firms in Silicon Valley. At the firm level, the presence of firms in the same industry, which are located in proximity (in the same region), are expected to increase internal productivity. At the industry level, it is possible to see quantifiable localized benefits of clustering which accrue to all firms in a given industry or in a set of interrelated industries. The sources of this productivity increase in regions where an industry is more spatially concentrated: knowledge spillovers, dense buyer–supplier networks, access to a specialized labor pool, and opportunities for efficient subcontracting. At the metropolitan area level, productivity increases from access to specialized financial and professional services, availability of a large labor pool with multiple specializations, inter-industry information transfers, and the availability of less costly general infrastructure. At the interregional scale, these gains are expected to lead to industry concentration in metropolitan and other leading urban regions. To obtain a complete picture of clustering, one must also consider its absence. If manufacturing and service clusters are associated with regional economic growth, the absence of productive clusters suggests the absence of growth and lagging regions.
Valeria Marina Valle, Caroline Irene Deschak, and Vanessa Sandoval-Romero
International migration flows have long been a defining feature of the Americas and have evolved alongside political and phenomenological shifts between 2009 and 2018, creating new patterns in how, when, and why people move. Migration is a determinant of health, and for the nations involved, regional changes create new challenges to defend the universal right to health for migrants. This right is repeatedly guaranteed within the global agenda, such as in the 1948 Universal Declaration of Human Rights by the United Nations; the 1966 International Covenant on Economic, Social, and Cultural Rights; and the 2015 United Nations Sustainable Development Goals (SDGs), especially SDG 3 regarding health and well-being, and SDG 10, which aims to reduce inequalities within and among countries. The 2018 Global Compact for Safe, Orderly and Regular Migration confirms a worldwide partnership highlighting protection of migrants’ right to health and services. The literature reviewed on migration and health in the Americas between 2009 and 2018 identifies two distinct publication periods with different characteristics in the Central and North American subregions: 2009 to 2014, and 2015 to 2018. The first period is characterized by an influx of young adult migrants from Central America to the United States who generally traveled alone. During the second period, the migration flow includes other major groups, such as unaccompanied minors, pregnant women, disabled people, people from the LGBTIQ+ community, and whole families; some Central Americans drew international attention for migrating in large groups known as “caravans.” In South America, the 2010–2015 period shows three defining tendencies: intensification of intra-regional cross-border migration (with an 11% increase in South American migrants from 2010 to 2015 and approximately 70% of intra-subregional migration), diversification of countries of origin and extra-regional destination, and the persistence of extra-continental emigration. Social determinants of health have a foundational relevance to health and well-being for migrants, such as age, housing, health access, education, and policy environment. Guiding theories on migration and health include Push-and-Pull Theory, Globalization Theory, Transnationalism, Relational Cultural Theory, and Theory of Assimilation. Migration and health was analyzed through the lens of five disciplines (Management, Social Work, Communication, Education, Information Science & Library Science, Law): clinical medicine, social sciences, health (general), professional fields, and psychology. There is an overrepresentation of literature in clinical medicine, demonstrating a strong bias towards production in the United States. Another gap perceived in the literature is the minimal knowledge production in South America and the Caribbean, and a clear bias towards publication in the North American continent. At the regional level, the Pan American Health Organization (PAHO)’s agenda serves to highlight areas of success and opportunities for future research, particularly in two areas: strengthening partnerships, networks, and multi-country frameworks; and adopting policies, programs, and legal frameworks to promote and protect the health of migrants. As these strategic lines of action aim to provide the basis for decisions regarding migrant health in the region, they should be considered two important avenues for further academic exploration.