Week 6: Public Health Ethics, Social Justice and Poverty
1. Social Justice vs. Market Justice
Public health nurses are also guided by the principles of market justice and social justice (Cornerstones of Public Health Nursing, MDH 2007). The economy of the United States has been shaped by the concept of market justice. Under this principle, people are entitled only to those things that they have acquired by their own individual efforts, actions, or abilities. The principle of social justice on the other hand is that the benefits of society should be fairly and equitably distributed to assure the functioning of society as a whole. Social justice reflects the belief that everyone should have the same access to societal resources and those societal resources should be used to provide the greatest good for the greatest number. Market justice reflects the belief that people deserve what they earn. At times, the principles of market justice and social justice are in conflict. Both perspectives have value. However, citizens do not necessarily agree with each other on which form of justice or set of beliefs should direct how health care is provided to the population as a whole. Review the Market Justice-Social Justice Table 13.4 (p. 257) and section on Market Justice vs. Social Justice (p. 256) in Schoon, Porta, & Schaffer (2019) to answer the following questions.
- Which concept of justice is the best fit for you? Explain. No right or wrong answer. This is only an opportunity for reflection.
- Pick either market or social justice and explain how advocating for that type of justice could improve the health of vulnerable populations and eliminate health disparities.
- Why is it important for you to understand your beliefs around social justice?
2. Unnatural Causes Reflection
While we all will die, the video “Unnatural Causes” introduces you to what is called excess death. For instance, the video considers death in populations as it relates to unexpected age of death, degree of suffering, and to what degree causes are due to preventable diseases compared to what we would expect. Population health is shaped by social and economic conditions in which we are born, live, and work. Though this video is dated, many of the issues addressed may still have relevance. After watching the video, answer the following questions.
- How may your position on the class pyramid affect your health? Provide examples.
One’s position on the class pyramid can have a significant impact on their health. Individuals with higher socio-economic status (SES) tend to have better health outcomes, due to access to better quality healthcare, healthy food options, and safe environments. On the other hand, individuals with lower SES tend to have higher rates of chronic diseases and lower life expectancy, due to factors such as lack of access to preventive care, exposure to environmental pollutants, and unhealthy living conditions. For example, individuals in lower SES communities may have a higher risk of obesity and cardiovascular disease due to limited access to healthy food options and lack of opportunities for physical activity.
- What social changes have been most responsible for the 30-year increase in American life expectancy over the 20th century?
Over the 20th century, there have been many social changes responsible for the increase in American life expectancy, including improvements in public health practices, such as the widespread use of vaccines and antibiotics, and advancements in medical technology. Additionally, social changes such as the promotion of healthier lifestyles and better access to healthcare have also contributed to the increase in life expectancy.
- Identify at least two public health issues addressed in the video, and provide a rationale for if these currently remain issues. Include any associated/potential lasting effects of these public health issues.
Two public health issues addressed in the video are health disparities and environmental degradation. Health disparities continue to be a major public health issue, as low SES communities continue to experience higher rates of chronic diseases and lower life expectancy. Environmental degradation remains a significant public health issue, as exposure to environmental pollutants can lead to long-term health consequences such as respiratory problems, cardiovascular disease, and cancer.
- Identify a local issue that came to mind for you in viewing this film in the community where you live, work, or play. What can public health nurses do to influence change related to this issue?
If I were a public health nurse in a local community, I could identify issues such as food insecurity and lack of access to quality healthcare. Public health nurses can play a crucial role in influencing change related to these issues by providing health education and resources to community members, advocating for policy change, and collaborating with local organizations to address these public health concerns.
3. Health Equity & Health Disparities
- Provide an actual example in which your local community has met/addressed health equity or health disparity needs within your community. What health concerns or social determinants were addressed? How did your community address this need? What population benefited from this initiative?
- Identify a health equity or health disparity concern in your local community that still needs to be addressed. Identify and describe at least 2 causes or social health determinants associated with this concern. What population is most vulnerable? What are the potential long-term consequences for the vulnerable population if this concern is not addressed? Describe an example of a community or systems level of practice public health intervention to address this public health concern.