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During the COVID-19 pandemic, a majority of essential workers were racial and ethnic minorities, who were unable to stay at home or socially distance themselves, resulting in racial disparities in COVID-19. However, many COVID-19 emergency preparedness laws did not address employment conditions. Although most stay-at-home orders included social distancing mandates and other measures to stop the community spread of COVID-19, these requirements were not mandatory for essential businesses. Moreover, even though national and state worker health and safety laws required the adoption of policies to stop the workplace spread of COVID-19, these laws were not enforced. Thus, many racial and ethnic minorities were infected and died from COVID-19 because the emergency preparedness laws and plans did not address their increased exposure to COVID-19 due to employment conditions. This chapter paper proceeds as follows: Section II examines how the failure for emergency preparedness laws to provide all essential workers with paid sick leave, workers compensation, hazard pay, and health and safety protections has resulted in racial disparities in COVID-19 infections and deaths. Section III discusses why addressing employment conditions in emergency preparedness laws is consistent with state public health powers, an efficient use of limited public health funding, and an effective way to eradicate racial disparities in infections and deaths. Finally, based on state examples, Section IV provides suggestions for revising the Model State Emergency Health Powers Act, including mandatory collection and public reporting of workplace infections and deaths disaggregated by race, ethnicity, occupation, and job.
More than half of all intimate partner homicides involve a firearm and firearms are frequently used by perpetrators of intimate partner violence (IPV) to injure and threaten victims and survivors. Recent court decisions undermine important legal restrictions on firearm possession by IPV perpetrators, thus jeopardizing the safety of victims and survivors. This article reviews the history and recent developments in the law at the intersection of IPV and firearm violence and proposes a way forward through a health justice framework.
The prison-industrial complex has historically operated as a mechanism for social control generally and as a tool to restrict women’s reproductive capacities specifically. Reproductive justice is a domain within the practice of health law. However, health law as currently practiced is ill-equipped to understand how the carceral state functions as a structural determinant of health or how legacies of oppression have facilitated the abridgment of incarcerated women’s reproductive capacities.
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.
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.
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.
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.
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.
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.
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.
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.
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.
On June 11, 2020, Michael Hickson died of complications of COVID-19. The father of five was forty-six years old. He had contracted the infection the previous month while in a nursing home, and he was transferred on June 2 to a hospital in Austin, Texas. A Black man, Michael Hickson had a career as an auto insurance claims estimator, a career cut short when he experienced sudden cardiac arrest at just forty-three years of age. Complications left him with quadriplegia, blindness, and brain injuries. Although he had difficulty speaking and remembering things, Michael Hickson continued to participate in his family’s life, joking with his children and talking with his wife about their lives.
Few people, if they paused to reflect on the question, would disagree with the idea that various aspects of a person’s identity have a bearing on their experiences in the world. There are differences in how a person of twenty-five years versus one of sixty-five years mediates a dispute, trains to run a marathon, or walks into a dance club. Completing a graduate degree versus dropping out of high school affects the opportunities a person has when applying for a job or running for office. Identifying as a woman, a man, or neither will affect a person’s experience of serving in the military, seeking a job promotion, or being the primary caregiver for young children (at least in many locales). Most of these variations in experience have little to do with persons’ biological differences. Instead, they grow out of social environments and others’ expectations. To the identifiers of age, education, and gender suggested above, we can add race, disability, immigrant status, sexual orientation, and other markers of identity. And it is the intersection of those multiple various aspects of a person’s identity, combined with personal choices and life experiences, that make each person distinctive and shape each person’s experience.
The Translational Science TS22 conference in Chicago in April 2022 was the first time post-pandemic that members of the Association of Clinical and Translational Science were able to meet up in person to share scientific advances. Given the remaining level of risk due to COVID-19, the meeting was designed as hybrid allowing virtual participation to some of the presentations. Prior to the meeting, JCTS Junior Editors were invited to report on the plenary sessions of the meeting. The present perspective constitutes a summary of three plenary sessions.
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