Securing Health Equity: Philosophical Foundations for Equality and Social Justice in Public Health and Health Care

Project Summary/ Abstract Social justice is the primary ethical value underlying health equity. The public health literature, due to its disciplinary limitations, does not “secure” conceptions of health equity to an in-depth theory of social justice. Political philosophy offers several theories of social justice. Which of these are best suited to health equity? The objective of this

solo-authored book project is to answer this question. The book has three specific aims: To identify and critically assess (1) the implicit ethical goals that underlie much public health research, education, and policy on health equity; (2) the dominant theories of social justice that are frequently applied to public

health and healthcare ethics; and (3) alternative theories of social justice that could be applied to health and healthcare. As the book will be a work in normative bioethics and its primary methodology is philosophical analysis and critical assessment of concepts and arguments, it does not have a hypothesis per se but rather a central claim to be explained and defended. The

central claim is that we need to develop and apply the political philosophical theory of “relational egalitarianism” to health equity. Relational egalitarianism is a theory committed to elucidating and defending relational equality. According to this form of equality, foremost, social justice means that people must be able to stand in front of

each other as equals. Health inequity, according to this theory, occurs primarily when health disparities are caused by or lead to relational inequalities, or both. The innovation of the project is that it will (1) develop relational egalitarianism to apply to health equity as an alternative to dominant analytic theories of social justice, and (2) it will engage in

literature from analytic political philosophy along with theories of structural and interactional racism, sexism, transoppression and ableism from the critical theory literature. Its significance is that it will demonstrate how relational egalitarianism can help guide choices about how health equity should be understood, measured, and

represented in the health sciences, policy, and education. As the reduction of health inequities, which will improve the health of marginalized groups, is frequently cited as a primary goal of public health, the book is of clear