Academic journal article Canadian Journal of Public Health

Mainstreaming Social Justice: Human Rights and Public Health

Academic journal article Canadian Journal of Public Health

Mainstreaming Social Justice: Human Rights and Public Health

Article excerpt

ABSTRACT

Our interest in a human rights and health discourse emerges from our efforts as social scientists to bring a meaningful social justice perspective to the realm of public health. In Canada, as in many countries, "health" is still firmly within the domain of the biomedical and the clinical. While considerable effort has been made to include more social, economic, and cultural perspectives, efforts to frame these issues as political phenomena have tended to be polarized into either a rich body of theoretical literature or case studies of interventions which have in varying degrees incorporated a social justice approach. What is still missing is a framework of discourse that allows various concepts of social justice to inform policy, intervention strategies, evaluation and evidence-based measures of effectiveness. This commentary examines the human rights discourse as conceptual space from which to build this framework.

MeSH terms: Social justice; human rights; public health

RÉSUMÉ

L'intérêt que suscite le discours sur les droits humains et la santé chez les spécialistes des sciences sociales découle de nos efforts pour communiquer concrètement une perspective de justice sociale dans le domaine de la santé publique. Au Canada comme dans de nombreux pays, « la santé » est encore étroitement associée au domaine biomédical et clinique. Il y a eu des efforts considérables pour aborder la santé selon une perspective sociale, économique et culturelle, mais les tentatives pour voir dans la santé un phénomène politique ont tendance à se diviser en deux camps : d'une part, la somme considérable d'écrits théoriques, et de l'autre, les études de cas axées sur des mesures d'intervention incorporant à des degrés divers une approche de justice sociale. Il manque encore un cadre qui permettrait aux diverses notions du discours sur la justice sociale d'enrichir les politiques, les stratégies d'intervention, l'évaluation et les mesures de l'efficacité fondées sur les résultats. Dans la présente étude, nous examinons le discours sur les droits humains en tant qu'espace notionnel à partir duquel élaborer un tel cadre.

As social scientists working in the field of community-based health promotion, we are perplexed by the lack of debate in Canada surrounding the human rights approach to health. Not only are we hard pressed to find a flicker of interest in the medical establishment, but many of our social justice and health champions are silent on the matter. Given Canada's international prominence in the field of health promotion, one would expect a healthy exchange of views on the validity of a human rights and health model. Is it, as Mann suggests, simply a case of most health professionals being unaware of the key concepts?1 Or is it, as Hussain would have it, that the medical community is not ready to examine its own complicity in the suppression of human rights and freedoms?2

The human rights and health discourse is not a completely new perspective on health protection and promotion. Nor is it the only one to advocate a social justice approach to health and well-being. Many of the concepts have been central to other health "movements" which have sought to deal with the concept of health as a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.3 In Canada, and elsewhere, these ideas were originally formulated in Achieving Health for All: A Framework for Health Promotion" and finds their best expression in The Ottawa Charter?3 Based on the principles of empowerment and community participation, the health promotion movement was, at the time, described by some as "revolutionary".5 Similarly, the human rights and health discourse is not the first to recognize the importance of the conditions in which people can be healthy. Many countries have incorporated a population, or determinants of health perspective in their public health discourse. These determinants include biomedical and lifestyle factors as well as socio-economic, political and cultural influences. …

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