SANTA PAULA, CALIFORNIA - CIRCA 1980's: A small-town barbershop, Santa Paula, CA.

The Road to Systemic Change: Health Justice, Equity, and Anti-Racism

By Keon L. Gilbert and Jerrell DeCaille

The health justice movement helps to marry social justice models with equity frameworks.

This critical partnership advances health equity through community-based approaches to health care and social services, collaborations that minimize duplicative services, and the creation of sustainable relationships to advocate for systemic change.

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Photo of doctor's exam room.

Using Health Justice to Identify Inequities Experienced by Employees with Disabilities

By Katherine Macfarlane

Disability discrimination negatively impacts the health of people with disabilities, yet disability law often overlooks discrimination’s health consequences. A health justice framework does not. It recognizes that discrimination impacts health, and then goes a step further, highlighting how legal systems are complicit in perpetuating health injustice. That wider lens better captures the lived experiences of those who experience discrimination, including people with disabilities.

My own work explores disability law’s insistence that disability be confirmed through medical examination. Without confirmation from a health care provider, disability does not exist, and reasonable accommodations need not be provided. A health justice framework has deepened my understanding of the harm those encounters impose. Identifying the full scope of the harm people with disabilities endure is the first step toward dismantling the systems that cause it.

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Top view of white cubicles in modern office with white walls and carpeted floor. 3d rendering.

Challenges Faced by Employees with Disabilities amid the Return to In-Person Work

By Doron Dorfman

Over a year into the COVID-19 pandemic, many employers are calling workers who had been fulfilling their roles remotely back into the office.

In May 2021, for example, Jamie Dimon, the CEO of JPMorgan Chase told employees that by July, they were expected to come back into their offices for at least a few days a week, adding that remote work “just doesn’t work for those who want to hustle. It doesn’t work for spontaneous idea generation. It doesn’t work for culture.” In July 2021, Apple announced its plan to require employees to be in the office at least three days a week.

These calls for getting back to the office raise particular quandaries for employees with disabilities, many of whom have disproportionally borne the brunt of pandemic layoffs.

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Gloved hand holding medical rapid test labeled COVID-19 over sheet of paper listing the test result as negative.

How Long COVID Is Forcing a Reckoning with the Neglect of Post-Infectious Chronic Illnesses

By Colleen Campbell

While post-viral illnesses are not new, they have been considerably neglected by the public health, medical, and scientific communities. This invisibility has, in many ways, been constructed by institutional neglect and medical sexism.

The COVID-19 pandemic is now causing a reckoning with this institutional neglect. This is because COVID Long Haulers and patient advocates for the chronically ill are forcing an unprecedented recognition for these chronic complex diseases.

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Herndon, USA - April 27, 2020: Virginia Fairfax County building exterior sign entrance to Mom's Organic Market store with request to wear face mask due to covid-19 pandemic.

The Current COVID-19 Surge, Eugenics, and Health-Based Discrimination

By Jacqueline Fox

COVID has shown us that the burdens and inequities that characterize everyday life for many Americans are not merely vestiges of an older time, but an honest reflection of our unwillingness to treat everyone with dignity and respect.

We have undergone an ethical stress test in the last 18 months. While many people have exhibited heroic commitments to their fellow citizens, much of our governmental response is indefensible in a society that professes to care for all of its members. This implies we are not such a society.

Rather, we are a society riddled with healthism — discrimination based on health status — and eugenics — a pseudo-science that arbitrarily elevates some human traits over others, much as we do with breeding dogs and horses.

As a result, although we are armed with the power to prevent much harm, we lack the will or inclination to use that power for our most vulnerable. Instead, we place different values on people’s lives using arbitrary definitions of quality, and treat people differently based on their health status. Examples include placing a lower value on a life because a person is older, disabled, or overweight.

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A worker gives directions as motorists wait in lines to get the coronavirus (COVID-19) vaccine in a parking lot at Dodger Stadium, Friday, Jan. 15, 2021, in Los Angeles.

Can Vaccine Allocation Plans Legally Respond to Racial Disparities?

By Govind Persad

Recently, Missouri expanded phase 2 vaccination eligibility with the goal of addressing disproportionate COVID-19 impacts.

Specifically, Missouri’s policy applies to “Disproportionately Affected Populations,” which is further defined as: “Populations at increased risk of acquiring or transmitting COVID-19, with emphasis on racial/ethnic minorities not otherwise included in 1B.”

This presents a much-debated and often misunderstood question I explore in a forthcoming University of Illinois Law Review article: can COVID-19 vaccine allocation legally recognize the outsized burden of cases and deaths that racial/ethnic minority communities have borne during the pandemic?

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Disability with technology line icon set.

Reflecting on the Struggle for Disability Rights a Year into the Pandemic

By Amalia Sweet

On March 9, the Petrie-Flom Center and Harvard Law School Project on Disability gathered a panel to discuss the extent to which the pandemic has set back progress toward ensuring the rights of persons with disabilities.

Though calls for solidarity in March 2020 declared the emerging pandemic to be a “great equalizer,” the past 12 months have demonstrated how the pandemic has exacerbated existing social inequalities, disproportionately impacting the already marginalized.

The panel discussion, hosted by Petrie-Flom Center Senior Fellow in Global Health and Rights Alicia Ely Yamin and moderated by Harvard Law School Project on Disability Executive Director Michael Ashley Stein, provided voice to the uniquely and acutely devastating impacts of the pandemic on persons with disabilities, who are still struggling to secure protection of their basic rights.

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hospital equipment

Balancing Health Care Rationing and Disability Rights in a Pandemic

By Yolanda Bustillo and Rachel Perler

Amid the present surge of the coronavirus pandemic, it is crucial that disability rights are a factor in the development of triage protocols.

During the last week of December, the CDC recorded a record of 225,269 new coronavirus cases and 118,948 total hospitalizations. Health care systems across the country have predicted that they soon may face shortages of ventilators, personal protective equipment (PPE), and other limited resources.

In Utah, for example, hospital administrators have implemented informal triage protocols that prioritize patients based on health status, clinical factors, and the time sensitivity of their needed procedures. Hospitals in California have similarly begun rationing care.

If these dire circumstances worsen, hospital systems may apply triage protocols that deviate from best practices and impermissibly discriminate against people with disabilities.

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Centers for Disease Control and Prevention. Georgia, Atlanta USA March 6, 2020.

The Politics of CDC Public Health Guidance During COVID-19

A version of this post first ran in Ms. Magazine on October 28, 2020. It has been adapted slightly for Bill of Health. 

By Aziza Ahmed

In recent months, public health guidance from the U.S. Centers for Disease Control and Prevention (CDC) has become a site of political reckoning.

The agency has taken an enormous amount of heat from a range of institutions, including the executive and the public, during the COVID-19 pandemic. The former has sought to intervene in public health guidance to ensure that the CDC presents the President and administration’s response to COVID-19 in a positive light. The latter consists of opposed factions that demand more rigorous guidance, or, its opposite, less stringent advice.

Importantly, these tensions have revealed how communities experience the pandemic differently. CDC guidance has produced divergent consequences, largely depending on demographics. These differences have been particularly pronounced along racial lines.

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Grocery store.

COVID-19 Highlights the Vital Connection Between Food and Health

By Browne C. Lewis

Together, food insecurity and COVID-19 have proven to be a deadly combination for Black and Brown people.

Data published by the Centers for Disease Control and Prevention indicates that COVID-19 hospitalization rates among Black and Latino populations have been approximately 4.7 times the rate of their white peers. The CDC suggests that a key driver of these disparities are inequities in the social determinants of health.

Healthy People 2020 defines social determinants of health as “conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” The lack of access to good quality food is one of the main social determinants of health. People who eat unhealthy food are more likely to have diet-related medical conditions, like hypertension and diabetes, that make them more susceptible to developing severe or fatal COVID-19.

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