Health Equality and Justice: Searching for Analytical Tools in Evaluating Healthcare

Abstract

Laissan Mukharyamova - Doctor of Political Science, Professor, chief of the Department of History, Philosophy and Sociology, Kazan State Medical University, Russian Federation. Email: l.mukharyamova@yandex.ruva@bham.ac.uk

Irina B. Kuznetsova – PhD, Birmingham Fellow, School of Geography, Earth and Environmental Sciences, University of Birmingham, United Kingdom, Senior research fellow, Department of History, Philosophy and Sociology, Kazan State Medical University, Russian Federation. Email: i.kuznetsova@bham.ac.uk

DOI: 10.17323/727-0634-2017-15-4-651-659

This review considers contemporary approaches to social justice in healthcare, which revolve around two main discourses: the idea of individual responsibility and idea of equality. Questions on the interrelation between individual responsibility and social factors are fundamental for contemporary social theories of justice in healthcare. Equality can be understood as economic in nature, as about opportunities, as well as the equality of freedoms. This review analyses the antagonism between approaches of social determinants of health and health as an individual responsibility. Providing medical services depending on personal responsibility for her/his health can increase risks for those who already in negative conditions. The social determinants of health include everyday life conditions, the possibilities for satisfying material needs, the environment and also social, economic and political norms. They are formed by policy, distribution of finance, power and other resources in global, national and local levels, all of which form the main factors of injustice. If social justice is understood in terms of capacities (in the case of health care, we can see it as capacities to offer equal rights in healthcare provision), then healthcare is an imperative equal to social justice. The provision of social justice in health is considered a significant social, economic, ethical and political issue. Therefore, it can be addressed only from an interdisciplinary approach. Recognition of the social factors behind healthcare and necessity of overcoming unfair gaps in health at the international level makes the research of social justice in health and personal responsibility vital.