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正义在解决健康的社会决定因素中的作用。

The Role of Justice in Addressing the Social Determinants of Health.

作者信息

Gilboe Sara, Curran Liz

机构信息

Nottingham Law School, Nottingham Trent University, Nottingham, UK.

出版信息

Int J Soc Determinants Health Health Serv. 2025 Jul;55(3):249-261. doi: 10.1177/27551938251321973. Epub 2025 Feb 24.

Abstract

This article explores social determinants of health (SDH) in the global context and their connection to justice and human rights. Critiquing prevailing top-down approaches, it demonstrates that policy responses can be divorced from local factors necessary for addressing SDH. The authors examine health justice partnerships (HJPs) and how interdisciplinary collaboration between health and legal services can address inequality and health disparities. This discussion is timely given the Hague Declaration on Equal Access to Justice for All by 2030 formulates five pillars of people-centered justice. From the 2023 "Plan of Action" comes a "Joint Statement and Call to Action on the Rule of Law and People-Centered Justice: Renewing a Core Pillar of Democracy," creating alignment between SDH and justice approaches for coordinated action. This article demonstrates how HJPs offer a unique avenue for driving change at the community level, advocating for systemic transformations to address poverty, inequality, and injustice. By driving change from local to international levels, multiple voices provide lenses for problem solving. Using American philosopher Carol C. Gould's theory of human rights, the authors explore how joint-disciplinary perspectives and moving beyond paternalistic intervention through integrating justice, human rights, and democracy can respond to drive outcomes in SDHs.

摘要

本文探讨了全球背景下的健康社会决定因素(SDH)及其与正义和人权的联系。通过批判盛行的自上而下的方法,本文表明政策应对措施可能与解决SDH所需的当地因素脱节。作者研究了健康正义伙伴关系(HJP),以及卫生与法律服务之间的跨学科合作如何能够解决不平等和健康差距问题。鉴于《2030年人人平等获得司法救助海牙宣言》制定了以人为本的正义的五大支柱,这一讨论正逢其时。从2023年《行动计划》中产生了一份《关于法治和以人为本的正义的联合声明与行动呼吁:重振民主的核心支柱》,使SDH与正义方法保持一致以采取协调行动。本文展示了HJP如何为在社区层面推动变革提供了一条独特途径,倡导进行系统性变革以解决贫困、不平等和不公正问题。通过推动从地方到国际层面的变革,多种声音为解决问题提供了视角。作者运用美国哲学家卡罗尔·C·古尔德的人权理论,探讨了跨学科视角以及通过整合正义、人权和民主超越家长式干预如何能够推动SDH取得成果。

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