Social gradients and unjust health outcomes

Authored by: Sridhar Venkatapuram

Routledge Handbook of Development Ethics

Print publication date:  July  2018
Online publication date:  July  2018

Print ISBN: 9781138647909
eBook ISBN: 9781315626796
Adobe ISBN:


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This chapter presents Margaret Whitehead’s influential health equity principles and how their shortcomings motivate looking to theories of social and global justice for more robust analyses and guidance for social action. However, this seems to be profoundly complicated by what we are learning in social epidemiology. Social determinants of health research produce new insights into the social causation and distribution of morbidity and mortality. In specific, the research shows that health outcomes are profoundly determined by where one stands on the social hierarchy and interactions with social conditions from the local to the global. The research challenges many of the starting assumptions in Anglo-American theories of social justice, most importantly that health is not just a function of healthcare but affected by all basic social institutions. The chapter presents some of the basic findings of social epidemiology and implications of theories of justice, as well as some of the many possible future directions of the area.

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