Public Health, Ethics, and Equity

In the last fifty years, average overall health status has increased worldwide, but it is increasingly clear that this achievement has not been equally distributed. Inequities in health have denied many people equality of opportunity. This book builds an interdisciplinary understanding of health equity with contributions from distinguished philosophers, anthropologists, economists, and public-health specialists.

It is widely recognized that health is influenced by a variety of social, economic and environmental factors, and not just by access to health care. The extensive empirical literature on the social determinants of-- and inequalities in-- health has yet to be matched by an appreciation of the normative underpinnings of health equity.

Health equity expresses a commitment of public health to social justice, which raises a series of ethical issues. Why, if at all, should a concern with health equity be singled out from the pursuit of social justice in general? What is the extent of social--as opposed to individual--responsibility for health? What ethical problems arise in evaluating population health and health inequalities? How sensitive should the pursuit of health equity be to contextual considerations in contrast to universal values?

In addressing these important questions, this volume examines the foundations of health equity. With contributions from distinguished philosophers, anthropologists, economists, and public-health specialists, it centres on five major themes: what is health equity?; health equity and its relation to social justice; health inequalities and responsibilities for health; ethical issues in health evaluation and prioritization; and anthropological perspectives on health equity.