THE traditional and historic bases for differentiating domestic and international health in Western nations have, as a result of profoundly changing epidemiology I ^ and demographics, lost meaning. International health has been viewed as independent and unrelated to the domestic health sector as a legacy of colonialization, and as a result of distinctive economic development issues, cultural backgrounds, and regionalism of health problems. Four phenomena have contributed to an unprecedented internationalization of domestic health: I) the re-emergence of a deadly infectious disease pandemic with the human immunodeficiency virus (i); 2) health effects anticipated from environmental exploitation and decay (global warming, ozone depletion, toxic and radioactive waste disposal, deteriorating air and water quality, deforestation and desertification) (2, 3); 3) a shift in immigration patterns such that developing world peoples comprise a majority of immigrants to Western nations (84% of 643, 000 immigrants to the United States in 1988 were of Latin American or Asian origin) (4), and are often foci of endemic and epidemic diseases, both infectious and noninfectious; 4) an emerging global economic interdependence, independent of but heightened by the facts that the United States is now a debtor nation, and that Japan leads in international health funding. © 1989 Journal of Public Health Policy, Inc.

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World Health Acquired Immunodeficiency Syndrome international cooperation economics environmental health health care organization and management health care organization human public health Editorial