Hahn Robert A, Muntaner Carles
Department of Anthropology, Emory University, Atlanta, Georgia, USA.
Dalla Lana School of Public Health, Social Equity and Health, University of Toronto, Toronto, Canada.
Health Equity. 2020 Jun 12;4(1):249-254. doi: 10.1089/heq.2019.0116. eCollection 2020.
There is a widely held belief in a universal right to the highest attainable standard of health. This essay shows how this right is conceptually unclear, unattainable, and a distraction from a more concrete and attainable right: a right to equitable access to available resources for health (RARH), including equitable access to the social determinants of health. It clarifies conceptual and theoretical issues in the RARH: its underlying theory rooted in historical, economic, and axiological rationales; its concept of component resources and their availability, equity, sustainability; and the redistribution of wealth and power, metrics, and ethics. The advancement of global health equity requires explicit theorizing of what underlies a right to health. The right to the highest attainable standard of health fails in this regard. The RARH provides a desirable, actionable, and measurable foundation for global health equity.
人们普遍认为存在享有可达到的最高健康标准的普遍权利。本文阐述了这项权利在概念上如何不清晰、无法实现，并且偏离了一项更具体且可实现的权利：公平获取现有卫生资源的权利（RARH），包括公平获取健康的社会决定因素。它阐明了RARH中的概念和理论问题：其基于历史、经济和价值论依据的基础理论；其组成资源的概念及其可得性、公平性、可持续性；以及财富和权力的再分配、衡量标准和伦理。全球卫生公平的推进需要对健康权的基础进行明确的理论化。在这方面，享有可达到的最高健康标准的权利未能做到。RARH为全球卫生公平提供了一个理想的、可操作的和可衡量的基础。
