Abstract: Health Disparities: The Issue is Justice

Official definitions of health disparities have been diverse and often broad, which can have serious consequences for setting objectives, targets, and resource allocation priorities, and assessing progress. The lecture introduces participants to the challenges of defining health disparities in ways that capture the most important criteria, are conceptually sound, and at the same time lend themselves to measurement, which is essential for accountability. A definition based on principles from the fields of ethics and human rights is proposed, and its rationale discussed: Health disparities do not refer to all possible health differences, nor do they refer to all health differences that warrant concerted public policy attention; they are a specific subset of health differences that are relevant to social justice. Health disparities are systematic, plausibly avoidable health differences adversely affecting socially (including economically) disadvantaged groups. Health disparities may reflect social disadvantage but their causes need not be established; they are unfair in that they place already socially disadvantaged groups at further disadvantage with respect to their health.