School of Health Policy and Management, 56014York University, Toronto, Ontario, Canada.
Int J Health Serv. 2021 Apr;51(2):206-225. doi: 10.1177/0020731420981857. Epub 2020 Dec 25.
Despite unprecedented global wealth creation, health inequity-the unjust health inequality between classes and groups among and within countries-persists, reviving the relevance of social justice as a lens to understand and as an instrument to intervene in these issues. However, the theoretical aspects and polysemous character of social justice as applied in the field of public health are often assumed rather than explicitly explained. An intersectional justice approach to understanding health inequality, inequity, and injustice might be useful. It argues that preexisting class-, race/ethnicity-, and gender-based health injustice and the socially differentiated impacts of the COVID-19 pandemic are shaped, interconnectedly, by economic maldistribution, cultural misrecognition, and political misrepresentation. Pursuing health justice requires analyses, strategies, and interventions that integrate the economic, cultural, and political spheres of redistribution, recognition, and representation, respectively. Such an intersectional approach to health justice is even more relevant and compelling in light of the COVID-19 pandemic. This article is broadly about class, race/ethnicity, and gender political economy of public health-but with a narrower focus on maldistribution, misrecognition, and misrepresentation, shaping social and health injustices.
尽管全球财富创造前所未有，但健康不平等——国家内部和国家之间的阶级和群体之间的不公平健康不平等——仍然存在，这使社会正义作为理解和干预这些问题的工具重新具有现实意义。然而，在公共卫生领域应用的社会正义的理论方面和多义性特征往往是假设的，而不是明确解释的。从理解健康不平等、不平等和不公正的角度来看，交叉正义方法可能是有用的。它认为，先前存在的基于阶级、种族/民族和性别的健康不公正以及 COVID-19 大流行带来的社会差异影响，是由经济分配不均、文化误解和政治代表性不足相互交织形成的。追求健康正义需要分别对经济、文化和政治领域进行分析、制定战略和进行干预，以实现再分配、承认和代表性的综合。鉴于 COVID-19 大流行，这种健康正义的交叉方法更加相关和必要。本文广泛涉及公共卫生的阶级、种族/民族和性别政治经济学，但更侧重于塑造社会和健康不公正的分配不均、误解和代表性不足。
