by Will Rogers
Justice in healthcare can take many different forms. It is a vital subject that every provider and practitioner needs to grapple with. In this post, we’ll cover a few of the common questions that will come up over the course of a healthcare provider’s work.
We’ll look at justice in healthcare as it relates to a time of a pandemic, social determinants, mental health considerations, and health disparities that often arise and exist when there is injustice in healthcare.
Dr. David Stevens wrote about this topic in A Christian Healthcare Worker's Response to COVID-19. Justice in healthcare is a tough topic, but it’s compounded during a pandemic, and it quickly becomes way more difficult to discuss. Allocating limited resources raises the ethical issue of justice—how do you treat patients fairly? How do you care for people—especially when so many more people need life and death care—and quickly?
Dr. Stevens offers the following advice: First, you always want to be as impartial as the situation allows. Second, do the best you can for the most people with the resources you have. Third, without enough time, personnel, supplies, or supplies, at some point you will be forced to decide who gets and who doesn’t get your limited resource. You have the moral obligation to be constantly working to get the resources you need, so you won’t have to continue to make utilitarian decisions. Lastly, be sure to continue reading for more wisdom in the area of healthcare during a pandemic.
According to Healthy People 2020, “Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.”
This is an issue of justice in healthcare because professionals must be committed to looking at the whole person, not just the malady. If a person is born and lives in an area with pollution, crime, violence, a poor education system, and few job opportunities, their health concerns will stem from those social determinants. Hospitals, clinics, doctors, and practitioners must be prepared to address these social issues if we want to see widespread improvements in health.
Undiagnosed and untreated mental health disorders can lead to an array of serious ramifications including substance abuse, homelessness, interpersonal violence, and more.
Ensuring that patients can access healthcare is vital. This might look like hiring community health workers to help navigate difficult systems or accepting patients who are uninsured or underinsured. Helping those who have difficulty navigating complex healthcare systems is a way to ensure that there is justice in healthcare.
Another way to focus on justice in healthcare is to concentrate efforts on eliminating the health disparities we see that are based on race in the US. According to the Centers for Disease Control and Prevention, “Community- and faith-based organizations, employers, healthcare systems and providers, public health agencies, policymakers, and others all have a part in helping to promote fair access to health.”
The population health impact of COVID-19 has exposed longstanding inequities that have systematically undermined the physical, social, economic, and emotional health of racial and ethnic minority populations and other population groups that are bearing a disproportionate burden of COVID-19.
According to the National Institutes of Health, although significant progress has been made in narrowing the gap in health outcomes (NCHS, 2016), the elimination of disparities in health has yet to be achieved. Despite overall improvements in health over time, some health disparities persist.
For example, while national infant mortality rates decreased overall by 14 percent from 2004 to 2014, Native Americans and Alaskan Natives have an infant mortality rate that is 60 percent higher than the rate for their white counterparts (HHS, 2014) and in 2013, infants born to African American mothers experienced the highest rates of infant mortality. Sadly, African Americans were 30 percent more likely than whites to die prematurely from heart disease in 2010, and African American men are twice as likely as whites to die prematurely from a stroke. Addressing these persistent health disparities in every way that you can is another way to fight for justice in healthcare.
There are so many more issues facing us when it comes to justice in healthcare. However, trying to learn and start to address these four areas, from how we handle these issues in a time of a pandemic, social determinants, mental health considerations, and health disparities, we’ll begin the process of creating a world where there truly is justice in healthcare.