Developing an Ethical/Social Justice Surveillance System (ESJSS): A Methodological Framework

Efforts to reduce the unequal impacts and generations of systemic disadvantage and inequality in healthcare for black and brown communities became amplified and were made more urgent during the COVID-19 pandemic. Moreover, public health surveillance systems have been challenged to address the vulnerabilities that residents within these environments and experiences. This paper describes the methodology used to develop a public health ethics and bioethics surveillance system grounded in empathy and care ethics. This surveillance system was designed to assess the prevalence of ethical and social justice violations relative to the COVID-19 vaccines administration. The authors describe the methods used to establish content validity of the questionnaire, evaluate the data, and compare three ethical theories (i.e., deontology, utilitarianism, and care ethics) that would best undergird public health ethics to increase health equity.