Tolan Paper Asserts Health Equity as a Matter of Justice

Health equity is as essential a form of justice as equity in criminal and civil legal protections, say Patrick and colleagues in a recently published National Academy of Medicine paper, Life Span and Legal/Policy Research as Dual Focuses for Identifying and Implementing Opportunities to Realize Health Equity. "...To ensure that all social groups have equal opportunity to reach their full potential as healthy as possible over their life span, there is need to reduce and eliminate systematic differences in the health of groups and communities whose poor health status is often due to social class and social positions in society."

Tolan is a professor in the Curry School of Education and director of Youth-Nex: The U.Va. Center to Promote Effective Youth Development. His co-authors include Velma McBride Murry, PhD, Vanderbilt University; Angela Diaz, MD, Icahn School of Medicine at Mount Sinai; and Robert Seidel, MLA, McDaniel College.

From the paper:

Our perspective is grounded in the proposition that health equity should be central or more significant than any other concern, principle, criterion, or value when prioritizing a national scientific agenda, setting care goals, organizing research and evaluation, and formulating practice advisories and policy. The lens of how a given topic or task relates to health equity or lack thereof should be front and center. Use of this framework has the potential to advance health equity as a priority for our nation and entails not simply favoring diversity of samples, attending to epidemiological variations, and mounting good faith efforts for greater access to care for those with fewer resources, but encompasses the integration of health equity as fundamental in formulating specific scientific questions as well as framing the overall research agenda.

Viewing health equity as a core concept of social justice includes tending to all aspects of scientific inquiry, including research designs and methods and the organizing, interpreting, and evaluating of scientific findings. We do not suggest that ideas presented here are novel, as we are not the first to argue for this approach. Nor do we claim to provide detailed comprehensive arguments addressing the numerous issues that arise in privileging this perspective over other frameworks that have emerged to address health equity and justice. With this disclaimer, we begin our discussion outlining the foundation, implications, and some key features of and basis for our position noted here, and will delve into a few of the primary ensuing implications.

This discussion paper was stimulated by conversations at a meeting on May 11, 2015, convened by the Board on Children, Youth, and Families of the National Academies of Sciences, Engineering, and Medicine. Other papers arose from this meeting and will be published as NAM Perspectives throughout 2016. Access the papers at and sign up for the perspectives listserv at Watch the full recording of the May 11, 2015 meeting, at Social Justice and Health Equity Tab.

Read the report and paper:
Life Span and Legal/Policy Research as Dual Focuses for Identifying and Implementing Opportunities to Realize Health Equity