"Small places close to home": toward a health and human rights strategy for the US

Much of the discussion about "health as a human right" has centered on global health initiatives, largely ignoring the application of human rights principles to the significant socioeconomic and racial health disparities in the United States. Given the persistent gaps in insurance coverage and access to quality preventive care in the US, the health and human rights movement has primarily focused its efforts on achieving universal health care coverage. However, this focus has left unaddressed how a human rights strategy might also address the social determinants of health. As Americans' health continues to worsen-the US Institute of Medicine recently reported that the US now fares worse in nine areas of health than 16 peer high-income democracies--a broader social determinants approach is warranted. This article explores the application of international human rights principles, including a "right to health" to the US context, and analyzes how existing domestic law may be used to advance health as a human right for America's most vulnerable populations. It demonstrates that an effective health and human rights strategy must build partnerships among health care providers, public health professionals, and lawyers to identify rights violations, hold officials and systems accountable, and mobilize communities to advocate for systems and policy change.