July 28, 2021
Health justice is an emerging framework for using law and policy to eliminate unjust health disparities. Learn more about the history of health justice and its current movement.
Regular access to healthcare prevents diseases, improves quality of life, and increases life expectancy. Unfortunately, not everyone is ensured this access, and those who are privileged because of their race, gender, citizenship, and economic status are more likely to receive consistent care. As people aim to create a more equitable society, a concept known as health justice is gaining momentum. Health justice is a framework to remove barriers to healthcare and improve health outcomes for all people through research, community action, and legislation.
Health justice is more than just creating health equity, it’s recognizing the barriers that stand in the way of access to healthcare and working to remove them. To identify these barriers, we study social determinants of health, or SDOH, which are non-medical factors that influence health. Things like economic status, housing, transportation, and education all have an impact on a person’s ability to access healthcare, purchase healthy foods, and care for oneself.
Understanding social determinants of health has a positive impact on health outcomes overall and SDOH account for 30-55% of health outcomes. The World Health Organization lists poverty as the most impactful social determinant of health. People living in poverty are not only financially unstable, they are less likely to have stable housing, consistent employment, or receive preventative healthcare. Improving negative SDOH increases life expectancies and reduces national healthcare costs.
In 2005, the World Health Organization launched the Commision on Social Determinants of Health with the goal of unearthing healthcare disparities and implementing evidence-based actions to improve access around the world. In the United States, medical practices and larger health systems are now integrating SDOH screenings into appointments to check for factors that could have a hidden impact on a person’s health.
While large-scale health systems have only begun addressing SDOH, health justice activists have sought to call attention to negative SDOH such as racism and poverty for much longer. In 1972, The Black Panthers demanded an end to the economic and racial-based disparities through access to healthy foods, adequate housing, and healthcare.
At that time, laws permitting segregated health clinics and hospitals had been wholly overturned but the years of segregation left hospitals who cared for Black Americans underserved and neglected. The Black Panthers saw these issues and argued that the government should provide free healthcare for all Black and oppressed people, healthcare that would not only cure illness but prevent it as well. The Black Panthers went on to establish free clinics and led the way in Sickle Cell Disease screening, an often overlooked condition which primarily affects people with African ancestry.
Years later in 1985, Secretary Margaret Heckler created “The Heckler Report,” the first large scale study of minority health in the United States. Because of this report, the Office of Minority Health (OMH) was created to improve the health of racial and ethinc minorities in the United States. The OMH is responsible for implementing and promoting policies, practices, and community health resources that strengthen cultural competency and health outcomes for communities of color.
In March 2010, the Affordable Care Act was signed into law with the purpose of reducing the number of people lacking health insurance. 10 years later, it continues to increase access to insurance and healthcare for all people, especially BIPOC communities.
As research unveils further the impacts of social determinants of health, healthcare systems, lawmakers, and activists are looking to promote alternative systems of care, including single payer healthcare, a type of universal healthcare system where everyone receives healthcare paid for by the government through our taxes. Research indicates that a single-payer healthcare system would save 13% in national healthcare expenses yearly and save 68,000 American lives per year.
Medicare for All is one proposed solution to implement a single-payer healthcare system in the United States. On March 27, 2021, Reps. Pramila Jayapal and Debbie Dingell introduced the Medicare for All Act to congress with the goal of eliminating financial barriers to care and reducing national spending. A single-payer system accounts for SDOH in ways private insurance simply can’t — it would cushion the blow of poverty by providing healthcare to all people, regardless of their ability to pay.
Globally, SDOH are addressed by organizations like the World Health Organization. Recognizing that health is more than individual actions, they seek to address global policies and guide government agencies to reduce healthcare inequalities influenced by financial, geographical, and cultural barriers. The World Health Organization hopes at least 1 billion people worldwide will have Universal Healthcare by 2023 and sets achieving universal health care as a “strategic goal.”
In the 19th century, Black Midwives made up about half of the midwives in the United States. They provided abortions, prenatal care, delivered babies and were an essential part of a community. After the Civil War, reproductive health was heavily medicalized so that white doctors could have a financial advantage over midwives, especially Black midwives, who they called “barbarous.” Restrictions on women’s entrance into medical school were put in place, and more conservative-shifting social norms were used to have abortion criminalized. As a result, abortion was heavily restricted or made illegal in most states and remained that way until 1973.
Roe V Wade was a historic court ruling which legalized abortion federally and affirmed the practice as a consititutional right. This ruling improved abortion safety and allowed for advancement of abortion procedures and because of this, abortion is safer than pre-Roe and continues to be one of the safest medical procedures performed.
Unfortunately, the right to safe and accessible abortion is not available to all pregnant people. Some states have laws which would criminalize doctors who perform abortions, make it illegal to have an abortion after 6 weeks in gestational age, or require medically unecessary waiting periods. These state restrictions along with poverty, racism, and immigration status often make access to abortion difficult, which impacts the physical health of pregnant people. States with more abortion restrictions have higher instances of infant and maternal mortality, especially for women of color. The fight to protect abortion access is more than protecting the ruling of Roe V. Wade, it’s fighting any restriction on reproductive bodily autonomy.
Reproductive health justice focuses on a person’s right to control their bodily autonomy, when and whether they have children, as well as their sexuality and gender.
Organizations like the Center for Reproductive Rights aim to increase access to birth control, and believe that everyone has the right to decide whether or not to have children. They work to remove barriers to contraceptive services through research, advocacy, and litigation.
HPV, or human papillomavirus, is a viral infection linked to cervical cancers and cancers of the throat, vulva, and penis. Developed in 2006, a vaccine that prevents 70% of viral strands linked to cervical cancer is readily available for most people seeking care. Promoting understanding of the HPV vaccine through family practice outreach and comprehensive sexual education allows people to make well-informed choices surrounding their sexual health and have greater access to the vaccine should they choose to receive it. It’s worth noting that while much of reproductive health justice focuses on the right to receive care, it also fights to protect those who wish to refuse care. From 2006 to 2008, migrant women were mandated to receive the HPV vaccine upon entry to the United States while vaccination for citizens was and continues to be optional. Thanks to health justice advocates who argued that this mandate was excessive, the rule was overturned in 2008.
Other reproductive health justice issues include increased screening for underdiagnosed illnesses like endometriosis. Endometriosis is a condition where the tissue that lines the uterus grows elsewhere often causing severe pain, irregular menstruation, and gastrointestinal issues. It’s a debilitating disease for many, but can take up to ten years to receive a diagnosis.
Abortion is a medical procedure that gives pregnant people the choice to end a pregnancy. There are many reasons a person may choose abortion and wanting one is reason enough to have one. Abortion advocates work to ensure all people have total bodily autonomy through actions directed at removing barriers to abortion care and shifting the stigma surrounding the procedure.
Improving access to abortion is an important aspect of health justice. The option to have your abortion at home via medication abortion allows for those with barriers to care, such as lack of transportation or childcare, to terminate their pregnancy safely from where they are the most comfortable.
Hey Jane provides telehealth medication abortion sevices for adults under 10 weeks pregnant. Confirm that you live in an eligible state here and then speak with one of our licensed abortion providers. After that, your abortion medications will arrive in an unmarked box in 1-3 days.