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Health and Social Justice$
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Jennifer Prah Ruger

Print publication date: 2009

Print ISBN-13: 9780199559978

Published to Oxford Scholarship Online: February 2010

DOI: 10.1093/acprof:oso/9780199559978.001.0001

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Justice, Capability, and Health Policy

Justice, Capability, and Health Policy

(p.79) 4 Justice, Capability, and Health Policy
Health and Social Justice

Jennifer Prah Ruger (Contributor Webpage)

Oxford University Press

This chapter provides a workable operationalization of health capabilities, and seeks a shared standard of health based on the demands of social justice and the right to health in terms of health equity. The health capability paradigm offers a trans‐positional conception of health that reflects the ‘view from everywhere’. This chapter delineates the relationship between health capabilities, health functionings, health needs and health agency, introducing shortfall in equality —— deviations of individuals or groups from a standard —— as a means for judging public policies affecting health. It emphasizes that although many factors influence health, health policy is one of the most important determinants; thus there is need for efficiency in health policy, and for joint clinical and economic solutions to achieve optimal levels of health and reduce inequalities in individuals' capabilities to be healthy. It argues for a differential allocation of resources to mitigate shortfall inequality. It critically analyzes the ethics of the social determinants of health and surveys and responds to criticisms of the capability approach.

Keywords:   trans‐positionality, view from everywhere, right to health, health functioning, health needs, health agency, shortfall inequality, health policy, efficiency, social determinants of health

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