Category: Public Health

Envelope from U.S. Citizenship and Immigration Services with the American flag on top/U.S. immigration concept.

Health Justice for Immigrants, Revisited

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By Medha D. Makhlouf

A major contribution of health justice is that it provides a framework for understanding how universal access to health care protects collective, as well as individual, interests. The pandemic has underscored the collective nature of the health and wellbeing of every person living in the United States, regardless of immigration status.

In a 2019 article, Health Justice for Immigrants, I adopted and adapted the health justice framework to the problem of disparities in immigrant access to subsidized health coverage. I argued that, in future health care reforms, health justice requires that immigrants be included in the “universe” of universal access to health care. In this blog post, I revisit this argument in light of the COVID-19 pandemic.

This blog post applies the health justice lens to inequities in immigrant health and access to health care, drawing out lessons for the pandemic and post-pandemic eras. It describes three examples illustrating the utility of health justice for catalyzing cross-sector initiatives to improve health, reducing the role of bias in the design of interventions to address health disparities, and ensuring that such efforts are serving the needs of historically subordinated communities.

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Patient receives Covid-19 vaccine.

What’s the Law on Vaccine Exemptions? A Religious Liberty Expert Explains

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This article is republished from The Conversation under a Creative Commons license. Read the original article.

By Douglas Laycock, University of Virginia

For Americans wary of COVID-19 vaccine mandates, like the sweeping requirements President Joe Biden announced Sept. 9, 2021, it seems there are plenty of leaders offering ways to get exemptions – especially religious ones.

No major organized religious group has officially discouraged the vaccine, and many, like the Catholic Church, have explicitly encouraged them. Yet pastors from New York to California have offered letters to help their parishioners – or sometimes anyone who asks – avoid the shots.

These developments point to deep confusion over how to win a religious exemption. So what are they, and is the government even required to offer the exemptions in the first place?

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Picture of north star in starry night sky.

Health Justice as the Lodestar of Incremental Health Reform

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By Elizabeth McCuskey

Health justice is the lodestar we need for the next generation of health reform. It centers justice as the destination for health care regulation and supplies the conceptual framework for assessing our progress toward it. It does so by judging health reforms on their equitable distribution of the burdens and benefits of investments in the health care system, and their abilities to improve public health and to empower subordinated individuals and communities. Refocusing health reform on a health justice gestalt has greater urgency than ever, given the scale of injustice in our health care system and its tragic, unignorable consequences during the coronavirus pandemic.

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elderly person's hand clasped in young person's hands

Vulnerability Theory and Health Justice

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By Matthew B. Lawrence

If we want to understand how changes to the law might affect health outcomes, we must remain mindful that the law not only regulates how we behave in the world as it is, but also shapes the institutions and structures that make the world the way it is.

The dominant theoretical frameworks of classical liberalism and behavioral economics obscure this critical relationship.

In this blog post, I suggest that health justice and vulnerability theory fill this theoretical gap, and serve as invaluable, and largely complementary, frameworks for understanding health law and policy.

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Bracket fungi, or shelf fungi produce shelf- or bracket-shaped or occasionally circular fruiting bodies called conks. They are mainly found on trees.

Whack-a-Mole, Fungi, and Intersectionality, or What I’ve Learned from Health Justice

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By Mary Crossley

Nearly three decades ago, I published my first law review article considering the law’s ability to address unequal treatment in a health care setting. The newly minted Americans with Disabilities Act was the law, and physicians’ reluctance to provide treatment to infants believed to be infected with HIV was the inequality. Eventually I expanded my horizon beyond disability law to consider potential legal remedies for physician bias across a range of patient traits. As I did so, I described the thread tying together my scholarly projects as “how the law responds (or fails to respond) to instances of health care inequality.”

The key word in that description was “instances.” It suggested that health inequality presents discrete problems for the law to address. Given those problems’ ubiquity, however, policy makers, regulators, and advocates deploying law against health inequities found themselves in a game of Whack-a-Mole. Whack one mole, and another one pops its head up. Address one instance of health injustice, and another pops up. The problem is that, no matter how quick our reaction times are, health inequality surrounds us, firmly embedded in American society. We need to look deeper to find its roots.

Over the last decade, the development of health justice frameworks, along with increasing public and legal attention to social determinants of health, have changed how I frame my scholarship, in several ways.

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A range of contraceptive methods: DMPA, vaginal ring, IUD, emergency contraceptive, contraceptive pills.

Connecting the Dots: Reproductive Justice + Research Justice = Health Justice

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By Monica R. McLemore

I believe that together, reproductive justice and research justice should result in health justice.

I am choosing to focus on research because it is the evidence base that is foundational to clinical care provision and because teaching is generated by research.

Thus, research serves as one root cause of harm associated with clinical care and teaching, and a potential barrier to realizing health justice, which has been outlined as a comprehensive approach to resolve the social determinants of health and develop jurisprudence toward health equity. Research justice is critical to the conceptualization, development and implementation of these measures.

However, the law cannot establish health justice without reproductive justice, at least not for pregnant-capable people. Reproductive health, rights, and justice have been the proverbial canaries in the coal mine when considering the loss of bodily autonomy and human rights.

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police cars lined up.

Health Justice and the Criminal Legal System: From Reform to Transformation

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By Aysha Pamukcu and Angela P. Harris

Using health justice to reframe and reshape the criminal legal system

The demand to “defund the police,” circulated by the Movement for Black Lives and allies after the brutal 2020 murder of George Floyd, was a departure from the usual discourse of police reform. The demand garnered backlash as being both politically unrealistic and potentially dangerous. But in our view, it demonstrates the transformative potential of social movements focused on justice for marginalized communities. As these justice movements build and strengthen partnerships with public health and civil rights advocates, we see the potential of using the health justice framework to reimagine the future of the criminal legal system.

Calls to deploy the American criminal legal system to enforce national health anxieties are not new, but they too often have produced unjust outcomes, such as adopting criminal punishments for people who are HIV-positive or who are dependent on drugs and pregnant.

In contrast, the health justice framework centers the leadership of social movements for justice and inclusion. Such movements have the capacity to rapidly shift the terms of public debate, making previously unimaginable policy initiatives first discussable, and then doable. And centered in values of anti-subordination, justice movements can challenge biases within elite, highly professionalized disciplines like law and public health.

Policy innovations that emerge from this triple alliance of law, public health, and social movements stand a better chance of improving the lives of marginalized communities than those that treat these communities as targets of discipline or charity. The call to defund the police demonstrates some of these possibilities.

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illustration of person tracking his health condition with smart bracelet, mobile application and cloud services.

Expanded Reimbursement Codes for Remote Therapeutic Monitoring: What This Means for Digital Health

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By Adriana Krasniansky

New reimbursement codes for virtual patient monitoring may soon be incorporated into Medicare’s fee schedule, signaling the continued expansion and reach of digital health technologies catalyzed by the COVID-19 pandemic.

In July 2021, the Centers for Medicare & Medicaid Services (CMS) proposed adding a new class of current procedural terminology (CPT) codes under the category of “remote therapeutic monitoring” in its Medicare Physician Fee Schedule for 2022 — with a window for public comments until September 13, 2021. While this announcement may seem like a niche piece of health care news, it signals a next-phase evolution for virtual care in the U.S. health system, increasing access possibilities for patients nationwide.

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Los Angeles, California / USA - May 28, 2020: People in Downtown Los Angeles protest the brutal Police killing of George Floyd.

Health Justice: Love, Freedom Dreaming, and Power Building

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By Jamila Michener

“Justice is what love looks like in public.”

— Cornel West

Simple yet resonant, Cornel West’s rendering of justice draws on an emotion that most people understand on a deep personal level: love. Viewing health justice through the lens of love concretizes it when I am otherwise tempted to treat it as an abstract notion. Love is familiar, intuitive, and tangible. Conceptualizing health justice as a public enactment of love directs my thoughts to the people I cherish most dearly, bringing the reality of the concept into sharp relief.

What do I want for the people I love? Of course, I want them to have access to high-quality health care: primary care doctors, acute care physicians, specialists, nurses, therapists, local hospitals where they will be treated with dignity and much more.

Over and above these features of health care systems, I want the people I love to have the building blocks necessary for healthy living: safe and comfortable housing, nutritious food, supportive social relationships, jobs that offer a living wage, education, freedom from poverty, violence, and exploitation.

Going even further, I want the people I love to have the agency to shape their own lives and the capacity to chart paths in the communities they inhabit. In short, I want them to have power. Power facilitates all the things listed above (i.e., the social determinants of health) on a durable, equitable, and sustainable basis.

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Four individuals embracing each other at the waist.

The Communities of Health Justice

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By Charlene Galarneau

To the extent that communities are the principal contexts for the social relations and institutions most central to health and health care, then communities should be critical moral actors in determining what constitutes health justice.

I propose that the health justice framework may be fruitfully developed in conversation with community justice, a social justice framework for health and health care that centers communities and their notions of health justice within national standards of justice. As Michael Walzer has observed, “Justice is a human construction, and it is doubtful that it can be made in only one way.”

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