Health justice is both a community-led movement for power building and transformational change and a community-oriented framework for health law scholarship. Health justice is distinguished by a distinctively social ethic of care that reframes the relationship between health care, public health, and the social determinants of health, and names subordination as the root cause of health inequities.

Although the federal government and several state governments have recognized that structural discrimination limits less privileged groups’ ability to be healthy, the measures adopted to eliminate health disparities do not address structural discrimination. Historical and modern-day structural discrimination in employment has limited racial and ethnic minority individuals’ economic conditions by segregating them to low wage jobs that lack benefits, which has been associated with health disparities. Health justice provides a community-driven approach to transform the government’s efforts to eliminate health disparities, by acknowledging the problem of structural discrimination; empowering less privileged groups to create and implement structural change; and providing support to redress harm.

Health justice seeks, both conceptually and in practice, to strengthen community engagement and empowerment as an integral means of addressing health disparities. In this essay, we explore the nature of communities and their roles in health care/public health. We propose that an ethical principle of respect for communities is a requisite part of health justice. It is this respect for communities that ethically grounds health justice’s calls for greater community engagement and empowerment. Conceptions of health justice, we claim, will gain ethical power and coherence as this principle is more clearly recognized and further developed.

Health justice is an aspirational north star for scholars, practitioners, and anyone who refuses to accept the status quo of profound inequity. But what does health justice mean? How ought we conceptualize it? There is no correct answer to these questions, but any robust rendering of health justice must account for power and politics. This article posits that the path to health justice requires political struggle taking (at least) two forms: (1) building power and (2) breaking power. Building power for health justice means cultivating the political capacity of people who are disproportionately harmed by health inequity, and who therefore have the most at stake. Breaking power involves weakening and destabilizing the economic and political forces that perpetuate health inequity. By surfacing and elaborating these crucial modes of political struggle, this article points to a way forward for achieving health justice.

This Article explores the connections between disability and health justice in service of further tethering the two theories and practices. The author contends that disability should shift from marker of health inequity alone to critical demographic in the analytical and practical application of health justice. This theoretical move creates a more robust understanding of the harms of health injustice, its complexities, and, remedially, reveals underexplored legal and policy pathways to promote health justice.

Just Transition, an organizing and policy framework that has emerged from the climate justice movement, is a powerful upstream response to health disparities created by structural subordination. As the public health field pushes itself to address the “cause of causes” of unjust health disparities, Just Transition offers new possibilities for partnership and collective action. We introduce the Just Transition framework, explain its relevance to the concerns of health justice advocates, and provide some examples of how the two movements might work together.

A health justice approach requires a progressive critique of expertise. This article considers two recent high-profile cases – the mask mandate and medication abortion -- to understand how we should think the mobilization of expertise in the context of public health law. Following from this, the article offers news ways to better understand how to think of the relationship between health law, expertise, and politics.

Civil rights attorneys challenging laws restricting transgender rights and access to healthcare often encounter anti-transgender medical experts in litigation at various stages. The experts often maintain dubious credentials in the relevant area of medical or scientific expertise which presents a challenge that undermines equitable access to justice by introducing pseudo-science into court proceedings. This commentary will discuss the phenomenon and propose a normative path forward.

Racism as a Public Health Crisis Statements (RPHCs) acknowledge the reality that racism must be eradicated to ensure health justice: a fair and just opportunity for all individuals to be healthy. Scholars of critical race theory (CRT) have expressed doubt when it comes to the capacity of law-related institutions to catalyze or sustain anti-racist efforts. These strains of skepticism underscore the question of whether so many RPHCS were adopted precisely because, in many instances, they were merely symbolic acts. This commentary argues that the trend in adopting RPHCs carries signs of interest convergence, and asserts that the alliance between government and the movement for health justice reflected in this phenomenon falls short of the substantive anti-racist action needed to realize health justice. The spate of RPHC adoption, in lieu of passing anti-racist policy or meaningfully empowering people of color, signifies that the movement for health justice must be strategic in determining whether to leverage, or be wary of, the power dynamics which shape political change. The health justice framework must expand its toolkit to include CRT.

Racially disparate policing, prosecution, and punishment harm individuals, families, and communities. These practices must be understood within the context of the development of the criminal legal system as a means of racialized social control. This context permits a critical examination of the way criminalization has been and is still deployed to subject poor and racialized communities to systemic injustices. This commentary frames a call for interventions to integrate a health justice approach to ensure that they advance racial and health equity to promote the well-being of individuals, families, and communities.

COVID-related racial disparities represent a spectrum of injustices and inequalities. Focusing on food oppression, this essay argues that racism infuses food law and policy in ways that contribute to racially disparate COVID deaths and severe illnesses. USDA nutrition program participants were at a nutritional disadvantage when COVID hit. Yet, government responses focused on food insecurity, not nutritional quality. Racism against a predominantly Black and brown labor force of essential food workers — from fields to meat plants to grocery stores — created tolerance for the administration’s failure to protect or compensate some of the country’s most vulnerable workers. When COVID-driven supply issues threatened to narrow white people’s activities and choices, the favored response was to keep their options open by sacrificing Black and brown workers. A food oppression lens — understanding how corporate interests drive food policy — is necessary to achieve food equality in this pandemic and beyond.

The COVID-19 pandemic has shed light on the challenges of complying with public health guidance to isolate or quarantine without access to adequate income, housing, food, and other resources. When people cannot safely isolate or quarantine during an outbreak of infectious disease, a critical public health strategy fails. This article proposes integrating sociolegal needs screening and services into contact tracing as a way to mitigate public health harms and pandemic-related health inequities.

Vaccine apartheid is creating conditions that make for premature death, poverty, and disease in racialized ways. Invoking vaccine apartheid as opposed to euphemisms like vaccine nationalism, is necessary to highlight the racialized distributional consequences of vaccine inequities witnessed with COVID-19. This commentary clarifies the concept of vaccine apartheid against the historical and legal usage of apartheid. It reflects on the connections and important disjunctions between the two. It places the intellectual property regime under heightened scrutiny for reform and transformation. This commentary finds that drawing on the intersections between a human rights and health justice approach can provide creative and novel approaches for anti-subordination. It concludes that acknowledging and naming the structural injustice of vaccine apartheid is only the first step towards providing redress.

In their article “The Civil Rights of Health,” Harris and Pamukcu offer a framework connecting civil rights law to unjust health disparities with the aims of creating broader awareness of subordination as a root cause of health inequities and inviting policymakers to create new legal tools for dismantling it. They close with a call to action. Here, we take up their call and propose cooperative enterprises as a health justice intervention. To illustrate this conceptualization, we focus on childcare as a system with robust connections to social, economic, and health equity for children, workers, and families.

Recognizing the links between childhood trauma and delinquency, many juvenile delinquency systems now emphasize trauma-informed care. This commentary examines established and emerging research on childhood trauma among American Indian and Alaska Native children and contrasts the development and implementation of “trauma-informed” approaches in state and tribal juvenile systems. It identifies three key innovations present in tribal models and calls for further research to identify best practices that work for Native children and tribal communities.

This article explores how structural failures in major federal environmental regulations —which set a foundation for environmental protections nationwide— have helped create many of the environmental injustices that people of color and low-income communities experience. It continues by examining how local governments have reinforced and compounded the failures in the federal environmental regulatory framework, particularly through local land use decisions. Although states play an important role in environmental policymaking, we propose that local governments are uniquely positioned to utilize a health justice approach to address environmental health inequities. This approach centers partnerships between frontline communities and local governments to develop just solutions that fill gaps within the federal environmental regulatory system and anticipate and mitigate the compounding effects of environmental health inequities.

Data sharing between housing and education agencies will provide housing agencies with resources to assist them with efforts to decrease segregation and mitigate the adverse health outcomes experienced by people of color. The Fair Housing Act has the potential to fulfill its original integrationist purpose if housing and education agencies combine resources and data to create and implement fair housing plans. The Biden Administration’s restored rule to affirmatively further fair housing pursuant to the Fair Housing Act of 1968 which seeks to reduce segregation and increase housing equity. However, it omits most of the processes set forth by the Obama Administration whereby federal agencies provide the proper tools to housing agencies so that they are able to make data-based decisions about housing policies. This article advocates for the sharing of data between housing and education agencies to optimize the positive impact of fair housing not only within housing, but also on the education, employment, and health opportunities for communities of color.

A robust body of research supports the centrality of K-12 education to health and well-being. Critical perspectives, particularly Critical Race Theory (CRT) and Dis/ability Critical Race Studies (DisCrit), can deepen and widen health justice’s exploration of how and why a range of educational inequities drive health disparities. The CRT approaches of counternarrative storytelling, race consciousness, intersectionality, and praxis can help scholars, researchers, policymakers, and advocates understand the disparate negative health impacts of education law and policy on students of color, students with disabilities, and those with intersecting identities. Critical perspectives focus upon and strengthen the necessary exploration of how structural racism, ableism, and other systemic barriers manifest in education and drive health disparities so that these barriers can be removed.

This paper describes the results of a multi-country survey of governance approaches for the use of digital contact tracing (DCT) in response to the COVID-19 pandemic. We argue that the countries in our survey represent two distinct models of DCT governance, both of which are flawed. The “data protection model” emphasizes privacy protections at the expense of public health benefit, while the “emergency response model” sacrifices transparency and accountability, prompting concerns about excessive governance surveillance. The ethical and effective use of DCT in the future requires a new governance approach that is better suited to this novel use of mobile phone data to promote public health.”