Understanding Health Inequalities And Justice

The need for informed analyses of health policy is now greater than ever. The twelve essays in this volume show that public debates routinely bypass complex ethical, sociocultural, historical, and political questions about how we should address ideals of justice and equality in health care. Integrating perspectives from the humanities, social sciences, medicine, and public health, this volume illuminates the relationships between justice and health inequalities to enrich debates. Understanding Health Inequalities and Justice explores three questions: How do scholars approach relations between health inequalities and ideals of justice? When do justice considerations inform solutions to health inequalities, and how do specific health inequalities affect perceptions of injustice? And how can diverse scholarly approaches contribute to better health policy? From addressing patient agency in an inequitable health care environment to examining how scholars of social justice and health care amass evidence, this volume promotes a richer understanding of health and justice and how to achieve both. The contributors are Judith C. Barker, Paula Braveman, Paul Brodwin, Jami Suki Chang, Debra DeBruin, Leslie A. Dubbin, Sarah Horton, Carla C. Keirns, J. Paul Kelleher, Nicholas B. King, Eva Feder Kittay, Joan Liaschenko, Anne Drapkin Lyerly, Mary Faith Marshall, Carolyn Moxley Rouse, Jennifer Prah Ruger, and Janet K. Shim.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Important links between health and human rights are increasingly recognised, and human rights can be viewed as one of the social determinants of health. A human rights framework provides an excellent foundation for advocacy on health inequalities, a value-based alternative to views of health as a commodity, and an opportunity to move away from public health action being based on charity. This text demystifies systems set up for the protection and promotion of human rights globally, regionally, and nationally. It explores the use and usefulness of rights-based approaches as an important part of the toolbox available to health and welfare professionals and community members working in a variety of settings to improve health and reduce health inequities. Global in its scope, Health Equity, Social Justice, and Human Rights presents examples from all over the world to illustrate the successful use of human rights approaches in fields such as HIV/AIDS, improving access to essential drugs, reproductive health, women's health, and improving the health of marginalised and disadvantaged groups. Understanding human rights and their interrelationships with health and health equity is essential for public health and health promotion practitioners, as well as being important for a wide range of other health and social welfare professionals. This text is valuable reading for students, practitioners, and researchers concerned with combating health inequalities and promoting social justice.

Explores the moral dilemmas posed by disparities in health across nations Contributors to this volume considers whether health inequalities are a result of global distributive inequalities and are therefore of concern to those promoting global redistributive justice. Case studies include > The migration of health care practitioners from developing to developed nations > The impact of climate change > The social determinants of health outcomes > The effects of pharmaceutical legislation--and international bad practices more generally--on securing access to life-saving drugs in the developing world > The differential effect of these practices on men and women, especially with respect to HIV/AIDS These cases are explored alongside theoretical questions of definition, responsibility and moral relevance to discover the scope of responsibilities that developed nations have towards poor health in developing nations.

Tackling Health Inequalities: Lessons from International Experiences provides a unique perspective on health inequalities in Canada and elsewhere. This exciting new volume brings together experiences from seven wealthy developed nations -- the United States, Australia, Britain and Northern Ireland, Canada, Finland, Norway, and Sweden -- to analyze their contrasting approaches to reducing avoidable health problems. Some nations are successfully responding to health inequalities, but Canada and the United States are not among them. Why is this, and what can we learn from other nations? Through a political economy lens, Tackling Health Inequalities considers how societal structures and institutions shape the distribution of economic, political, and social resources that affect health disparities amongst the population. The volume then goes on to examine how governing authorities come to either confront or ignore these health inequalities and the conditions that create them. Through these illustrations, it encourages governing authorities that are tackling health inequalities to continue their efforts and directs those that are not -- such as in Canada and elsewhere -- towards what must be done. This groundbreaking text shows the primary lessons from these international experiences: that citizens in Canada and elsewhere need to educate themselves about the importance of tackling health inequalities, and then build the political and social movements that will compel governmental authorities to take action. This volume will serve as a rich resource for professionals and general readers interested in health studies, nursing, social work, public policy, and political economy.

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

Societies make decisions and take actions that profoundly impact the distribution of health. Why and how should collective choices be made, and policies implemented, to address health inequalities under conditions of resource scarcity? How should societies conceptualize and measure health disparities, and determine whether they've been adequately addressed? Who is responsible for various aspects of this important social problem? In Health and Social Justice, Jennifer Prah Ruger elucidates principles to guide these decisions, the evidence that should inform them, and the policies necessary to build equitable and efficient health systems world-wide. This book weaves together original insights and disparate constructs to produce a foundational new theory, the health capability paradigm. Ruger's theory takes the ongoing debates about the theoretical underpinnings of national health disparities and systems in striking new directions. It shows the limitations of existing approaches (utilitarian, libertarian, Rawlsian, communitarian), and effectively balances a consequentialist focus on health outcomes and costs with a proceduralist respect for individuals' health agency. Through what Ruger calls shared health governance, it emphasizes responsibility and choice. It allows broader assessment of injustices, including attributes and conditions affecting individuals' "human flourishing," as well as societal structures within which resource distribution occurs. Addressing complex issues at the intersection of philosophy, economics, and politics in health, this fresh perspective bridges the divide between the collective and the individual, between personal freedom and social welfare, equality and efficiency, and science and economics.

Social justice has always been a core value driving public health. Today, much of the etiology of avoidable disease is rooted in inequitable social conditions brought on by disparities in wealth and power and reproduced through ongoing forms of oppression, exploitation, and marginalization. Tackling Health Inequities raises questions and provides a starting point for health practitioners ready to reorient public health practice to address the fundamental causes of health inequities. This reorientation involves restructuring the organization, culture and daily work of public health. Tackling Health Inequities is meant to inspire readers to imagine or envision public health practice and their role in ways that question contemporary thinking and assumptions, as emerging trends, social conditions, and policies generate increasing inequities in health.