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Class, health and justice

S Marchand1, D Wikler, B Landesman

  • 1Program in Medical Ethics, Medical Sciences Center, University of Wisconsin Medical School, Madison 53706, USA.

The Milbank Quarterly
|September 17, 1998
PubMed
Summary
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Social class significantly impacts health, but the exact nature of this health injustice remains unclear. This study explores four distinct ethical goals for addressing health disparities across social classes.

Area of Science:

  • Public Health
  • Social Epidemiology
  • Health Ethics

Background:

  • Class inequalities in health are widely recognized as unjust.
  • The documented link between social class and health status requires deeper ethical clarification.
  • Existing research highlights disparities but lacks a precise definition of the injustice.

Purpose of the Study:

  • To clarify the precise nature of injustice stemming from class inequalities in health.
  • To present and analyze four distinct ethical goals for addressing health disparities.
  • To explore theoretical and empirical factors complicating the understanding of health injustice.

Main Methods:

  • Conceptual analysis of ethical frameworks for health equity.
  • Presentation of four alternative goals for social policy regarding health.
Keywords:
Analytical ApproachHealth Care and Public HealthPhilosophical Approach

Related Experiment Videos

  • Discussion of theoretical issues including personal responsibility and economic inequality.

    • Main Results:

    • Four ethical goals for addressing health inequalities are explicated: maximizing total health, equalizing health between classes, prioritizing the lowest social class, and prioritizing the sickest individuals.
    • The precise nature of health injustice is multifaceted and influenced by differing ethical priorities.
    • Theoretical and empirical complexities, such as personal responsibility for illness and the impact of economic inequality, obscure the definition of injustice.

    Conclusions:

    • Understanding health injustice requires careful consideration of competing ethical objectives.
    • Further research is needed to resolve theoretical and empirical questions surrounding personal responsibility and economic inequality's role in health disparities.
    • Defining and addressing health injustice necessitates a clear ethical framework guiding policy interventions.