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

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

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

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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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

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

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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Scales of justice and gavel on table.

Symposium Introduction: Health Justice: Engaging Critical Perspectives in Health Law and Policy

By Ruqaiijah Yearby and Lindsay F. Wiley

Public health scholars, advocates, and officials have long recognized that factors outside an individual’s control act as barriers to individual and community health.

To strive for health equity, in which everyone “has the opportunity to attain . . . full health potential and no one is disadvantaged from achieving this potential because of social position or any other socially defined circumstance,” many have adopted the social determinants of health (SDOH) model, which identifies social and economic factors that shape health. Yet, health equity has remained elusive in the United States, in part because the frameworks that most prominently guide health reform do not adequately address subordination as the root cause of health inequity, focus too much on individuals, and fail to center community voices and perspectives.

The health justice movement seeks to fill these gaps. Based in part on principles from the reproductive justice, environmental justice, food justice, and civil rights movements, the health justice movement rejects the notion that health inequity is an individual phenomenon best explained and addressed by focusing on health-related behaviors and access to health care. Instead it focuses on health inequity as a social phenomenon demanding wide-ranging structural interventions.

This digital symposium, part of the Health Justice: Engaging Critical Perspectives in Health Law & Policy Initiative launched in 2020, seeks to further define the contours of and debates within the health justice movement and explore how scholars, activists, communities, and public health officials can use health justice frameworks to achieve health equity.

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