We turn now to a discussion of the normative dimension of healthinequalities. We begin in this section with a look at healthinequalities among residents of the same state. We first examine theconcept of health equity which is often employed as anormative standard in the public health literature for evaluating suchinequalities. We then turn to the philosophical literature, providingan overview of the most prominent accounts of the justice of healthinequalities. In the two remaining sections of this entry, we firstdiscuss the relevance of individual responsibility for health justicebefore concluding with a discussion of the justice of global healthinequalities.
The concept of health equity is often used to refer to justdistributions of health, where health inequities are understood to bedifferences or disparities in health that are avoidable, unnecessary,and unfair (Whitehead 1992). Health inequalities aretherefore in principle observable differences in the health amongindividuals and groups. Health inequities are healthinequalities that are unjust. (For discussion of the ways in whichhealth inequality metrics may themselves be value-laden see King 2016;see Asada 2019 for a good discussion of challenges in measuring healthinequities).
Sudhir Anand, Public Health, Ethics, and Equity
While the concept of health equity is frequently invoked as anormative standard by scholars, policymakers, and public healthpractitioners, there is a good deal of disagreement regarding itsmeaning. There is disagreement, first, on which health differences areavoidable. Some suggest that health differences are avoidableonly if they are caused by social processes rather than natural orbiological processes (Chang 2002; Whitehead 1992). Others argue thatthis understanding is too constrained (Preda & Voigt 2015; Wilson2011). Even if health differences caused by natural processes are notavoidable in the sense of being preventable, these critics suggest,they may be avoidable in the sense of being treatable. Moreover, ifinequalities in health are inequitable in part because they areunchosen, as luck egalitarians claim, then it makes sense to identifyavoidable health inequalities as those that are amenable tointervention (Preda & Voigt 2015: 30). 2ff7e9595c
Commentaires