Main description:

Inequities and health disparities are the greatest and most pressing social issues of our time. This book explores public health practice through the critical lens of social and structural justice by examining our approach to health and what it means to be healthy, systemically and structurally.
Through recent events, the raw reality of health disparities and inequities have been exposed. These events are earmarked by COVID-19's decimating and disparate impacts on Black and Brown populations during one of the greatest social movements of our time to end racism. Since this very public explosion of intersecting forms of oppression and inequitable suffrage, many have clamored to make sense of it, to reframe our narratives toward action, and re-envision what progress and change could look like. This text is positioned as a tool to help professionals dismantle old ways of thinking while reconstructing new ones that can be more responsive in meeting the realities of today.
The author challenges the reader to think about public health more deeply and pragmatically as the space for reconciling solutions to these poignant health issues. This requires the exploration of an ideological shift in how we think of health, how we prepare healthcare providers outside of an antiquated sick care system, and how we prioritize the determinants of health across a re-imagined continuum of care. The scope of this book ranges from a historical and structural examination of our beliefs about health to perceiving a more just system of care where health is intentionally co-created toward this aim. It intentionally explores health along the lines of equity and through the broader lens of the social determinants of health to shed light on the opportunity in this moment that public health creates for health care.
Justice in Health is a timely and important resource for healthcare professionals (pre- and post-licensure) and healthcare decision-makers. The book also appeals more widely to instructors, academics, researchers, and students across disciplines of nursing, medicine, public heath, sociology, and social work.

Contents:

Chapter One: Collision of Contexts and ConscienceThis chapter provides an overview and global introduction to the content. In the introduction, understanding of core concepts of public health, equity, justice, and health is established. This chapter centers on unpacking the meaning of health, how health is understood and misunderstood, and most importantly how health is created. Its impact in producing outcomes across the determinants of health are examined across an ecological spectrum of the populations, communities, and the system of care. The conceptual exploration of just health and what the creation of a more just system of health means is introduced and situated in relation to our society and why health matters.

Chapter Two: Contextualizing and Situating Race and Health in the United States

This chapter explores the historical role of nursing within social justice movements. Key figures whose work formed the foundation of nursing practice in social justice and advocacy are accentuated. The roots of nursing practice are critically examined to shed light on where nursing practice is now and where it needs to be in the future. This discussion is contextualized within the current climate of health care, health needs, and governmental mandates that point to the future of health care. The role of the nurse in shaping the future of nursing and the future of health care is at the heart of this chapter's discussion. It pulls in current and relevant call-to-action reports such as the future of nursing, nursing 2020, and beyond; healthy people 2030; and the year of the nurse to inform the discussion. Specific conclusions about the role of the nurse, relevant competencies now and in the future are presented based on the culmination of these areas.

Chapter Three: Frameworks for Framing Justice in Health

This chapter is deeply philosophical and driven by the introduction and exploration of key theories most critical to meet the health and well-being challenges we face as a nation. Highlighted are discussions of critical theories and perspectives that include but are not limited to Feminist Theory and Intersectionality, Post-colonial and Emancipatory Inquiry, Social Justice, Structural Violence, and Structural Justice. Discussion about the social determinants of health is at the forefront to help introduce the reader to contextual causes that determine health guided by these various theoretical perspectives. This chapter serves to synthesize structural and root causes through exposing the hidden realities of power, privilege, and social identity.

Chapter Four: Health Equity and Critical Health Issues

This chapter dives into exposing critical root causes that perpetuate health disparities such as race, poverty, mass and youth incarceration, violence against women including intimate partner violence, and human trafficking. It also examines issues that determine health such as access to care, food, housing, transportation, and insurance. Beyond identification of these issues, this chapter makes the connection to earlier perspectives discussed in Chapter 3 to extend and situate health in relation to structural drivers and causes. It is connecting the dots beyond the healthcare system that lead to a deepening of understanding of how health happens across disparate populations and in aggregate populations. It also begins to frame what a health equity systems approach could look like and what must be considered.

Chapter Five: Culture of Health

This chapter starts to explore how to create a healthcare system without walls. This chapter reframes the current beliefs of what a healthcare system is toward what it can be within the concept of building a system of care without walls. A healthcare system without walls is discussed by identifying structural obstacles and gaps within the current structure including their impacts and introducing new ways to overcome and dismantle these challenges. A core pillar in this discussion is critical conversations about what it means to be a healthcare provider and how we can better prepare healthcare providers to meet the demands of a new re-imagined system. To this end, the chapter also introduces trauma-informed care as one of the key professional shifts required in the routine preparation of healthcare providers. As an overarching mechanism for facilitating healing, this chapter covers understanding trauma, its consequences, and its impacts at an individual and community level. It examines what a culture of healing looks like through a trauma-informed orientation and explores the healing of individuals and communities who have experienced trauma. The core elements of a trauma-informed approach and their application across this spectrum are included, and recommendations and useful approaches to implementing a culture of healing provided.

Chapter Six: Leading Through Just Action

This chapter introduce the readers to community engagement and partnerships as facilitators to rebuilding and co-creating a system of care. Understanding community partnership and their importance are discussed. Examining practice partnerships and best practice approaches for engaging with the community to meet their health needs where they are is a central component of this chapter. The chapter draws on community engagement and partnership exemplars from the field that have been used to demonstrate how communities can mobilize and transform health. It also discusses the use and power of platforms such as media for advocacy and use of data as tools for change. The chapter serves to help health providers, health researchers, and health educators consider non-traditional approaches to creatively find ways to exchange knowledge, skills, and expertise needed to reform and redress health disparities. It's a chapter to remind healthcare providers to act effectively to create and influence equitable health solutions.

Chapter Seven: Just Health

This chapter summarizes and synthesizes the important points, complexities, and concepts raised throughout the previous chapters. It culminates in a discussion that pays particular attention to upstream versus downstream public and population health approaches to make the case as to why the reconciliation of public health toward just health cannot wait. Just health is revisited against this backdrop and summarized at the praxis of theory, knowledge, and action toward achieving health justice. The chapter concludes with a call to action and suggested steps to address the urgent and emergent conditions that mitigate health outcomes and identify opportunities for change that can be leveraged now.