What is Health Justice?

Definition of Health Justice

A framework and movement focused on:

• eliminating health inequities

• improving access to healthcare

• addressing social determinants of health

• empowering communities affected by injustice

Health justice says health problems are often caused by:

• racism

• poverty

• discrimination

• unequal laws/policies/systems

NOT just personal choices or biology.

Social Determinants of Health

-Conditions affecting health outside hospitals/clinics.

• housing

• education

• employment

• food access

• environment

• transportation

• immigration status

• income

Health justice says healthcare access is only ONE determinant among many.

Root cause of health inequities: Subordination

Systems that disadvantage certain groups.

Examples:

• racism

• classism

• sexism

• discrimination

• poverty

Health justice identifies these systems as the root cause of unequal health outcomes.

Goals of Health Justice

• Universal access to affordable healthcare

• Equity in healthcare/public health

• Prevention-focused care

• Community empowerment

• Fair distribution of health resources

• Democratic/community participation

Community-Led Reform

Communities affected by inequities should:

• lead decisions

• participate in reforms

• shape policies

Experts/lawyers/scholars should SUPPORT communities, not dominate them.

Collective Oversight

Healthcare decisions should involve:

• democratic governance

• public accountability

• community participation

Distributive Justice

Resources should be distributed fairly according to need.

Focus:

• improving outcomes in marginalized communities

• not just reducing costs

Structural Determinants of Health

Health justice focuses on laws/policies that shape:

• healthcare access

• employment

• housing

• education

These structures can either:

• worsen inequities
  OR

• help dismantle inequities

Health Justice & COVID-19: What major inequities did it show?

COVID showed major inequities:

• unequal healthcare access

• racial disparities

• employment risks

• housing inequalities

• lack of protections/resources

Health justice argues responses should be:

• structural

• supportive

• empowering

Black Panther Party (BPP)

Created free health clinics

Young Lords

Community health activism

ACT-UP

• HIV/AIDS treatment activism

These movements helped shape health justice ideas.

Upstream Interventions

Address root causes BEFORE illness develops.

Examples:

• improving housing

• reducing poverty

• increasing food access

• healthcare reform

Case study: What was the patient and their symptoms

Patient

• 56-year-old Spanish-speaking male

Symptoms

• Weakness

• Fatigue

• Difficulty breathing

• Increased shortness of breath

• Leg swelling for 2 weeks

Case study? Past medical history?

• Heart failure

• Coronary artery disease (CAD)

Case study: Social/ Healthcare background

• In process of obtaining Green Card

• Lost access to medications for 1.5 months

• Only has emergency Medicaid

Case study : what did the patient have?

Heart Failure Exacerbation

Signs:

• shortness of breath

• edema/leg swelling

• fatigue

• weakness

Likely worsened because patient stopped medications.

Case study: what made the condition worsen?

Medication Nonaccess

Case study: Immigration status

Green Card process may limit insurance access

Case study: language barrier

• Spanish-speaking patient may face communication barriers

Case study: Insurance issue

Emergency Medicaid only covers limited/emergency care

Case study : Financial/ Access issue

Could not obtain medications

Case study : Structural barriers

This case shows how systems/laws can worsen disease:

• limited healthcare coverage

• interrupted medication access

• delayed preventive care

Case study: Prevention failure

Instead of preventive chronic disease management:

• patient lost treatment access

• condition worsened

• required emergency care

Federally Qualified Health Centers (FQHCs)

community free clinics became the foundation for:Federally Qualified Health Centers (FQHCs)

Purpose:

Provide healthcare to underserved populations.

Praxis Project

Purpose

Supports:

• social change

• collaboration

• community capacity building

Asian Pacific Environmental Network (APEN)

Works for:

• environmental justice

• economic justice

• social justice

using immigrant and refugee leadership.

Critical Perspectives Used in Health Justice

The initiative applies:

• Critical Race Theory

• Feminist Legal Theory

• Queer Theory

• Critical Disability Studies

• LatCrit

• ClassCrit

Areas Connected to Health Justice

Health justice connects health law with:

• education

• immigration

• housing

• labor law

• transportation

• criminal legal system

• food justice