Primary author: Courtney Hamilton



Theory of Social Justice - Revised

Analysis of the theory of social justice must start with the definition of the ambiguous word - justice. Justice has different definitions based on who is giving the definition, as it means different things to different people. Gostin and Powers define (2006, p.1054) justice as “fairness or reasonableness, especially in the way people are treated, or decisions are made” while Drevdahl (2002) equates justice with liberty. While there are several different theories of social justice that debate the concept of justice itself, David Miller first presented his theory of social justice in 2003. Miller based his theory on public thoughts regarding the presence and nature of justice within society. He utilized public opinion polls and research as his basis of theory. Miller stated (2003, p.22) “ justice fundamentally requires us to treat people as equals; or we should understand justice as to what people would agree to in advance of knowing their own stake in the decision to be reached”. Miller further states that social justice includes not only what you are owed but what you owe others as well. He further elaborates that social justice does not mean that all people must agree on how the justice is achieved. He states that the majority of those will agree on the need for justice however. Miller describes three communities that are reflective of the three primary concepts of social justice; need, desert and equality. These communities are: solidaristic communities, instrumental associations, and citizenship (Miller, 2003).

Solidaristic communities share common needs and bonds, such as a family relationship. In these communities, everyone knows the others needs and contribute to alleviating those needs. The key concept within these communities is the concept of "need". The need concept refers to someone who is lacking essential or necessary provisions which are necessary for them to either survive or grow. Miller stresses the differences between needs and wants and focuses purely on the needs of the communities (Miller, 2003). Instrumental associations refer to more business type relationships in which each person enters the relationship with a particular skill set or service he/she is able to provide. Those involved combine their services in an attempt to meet a common goal. The key concept, therefore is the desert concept - as each person receives some type of benefit from the superior effort they bring to the relationship. The desert concept refers to someone who deserves some type of reward or award for something they have done well. It is important to note that the deserts are based on the participants performance and not on the talent they have (Miller, 2003). Citizenship is related to the equality concept. Citizenship refers to any member of a society. Miller states each member of that society is equally responsible for the rights of every other citizen. Each member of the society has equal rights and has the right of fair distribution and justice. (Miller, 2003). The equality concept refers to everyone being treated the same, without any focus on individual preferences or needs (Miller, 2003).


With this definition and key concepts in mind, it is clear that the role of social justice in intertwined within public health. As Drevdahl (2002) states, social justice is the basis of public health and the primary mission of public health is ”…to use exceptional measures to achieve social justice”(Drevdahl, 2002, p.162). Gostin & Powers (2006) also state that social justice is the core value behind public health. Central to the tenets of both social justice and public health is the idea of collectivism which states that what is best for the whole is better than what is best for the individual (Drevdahl, 2002). As the focus of public health is on the population as a whole, collectivism would certainly have an integral role in policy development as well as in developing interventions and programs within the community. Buchanan (2008) states that it is important for those involved in public health to work within the community to begin consensus building. It is imperative to work with community members to determine what they believe to be the most important needs and priorities within that community. Working to mobilize and improve communities is an example of the role of social justice within public health (Drevdahl, 2002), as is the focus on the disadvantaged members of society (Gostin & Powers, 2006). The goal of all public health interventions and policies should be to eliminate health disparities (Fahrenwald, Taylor, Kneipp, & Canales, 2007). The utilization of existing frameworks such as the Social Action Model help public health practioners work to bring social justice into the communities they are serving.

While Miller (2003) does not address public health programs and social justice theory, he does address health policies as well as other governmental programs aimed at addressing social inequalities. There are many public health programs that are based on social justice as it is considered by many to the foundation of public health. While the term social justice may not be used frequently when discussing public health, its tenets and practices are essential for providing a framework from which public health is derived. As public health officials work to alleviate health disparities, to improve the living conditions of the disadvantaged, and to implement policy changes, social justice is being applied.

References
Buchanan, D.R. (2008). Autonomy, paternalism and justice: Ethical priorities in public health. American Journal of Public Health. 98(1). 15-21.
Drevdahl, D. (2002). Social justice or market justice? The paradoxes of public health partnerships with managed care. Public Health Nursing. 19(3). 161-169.
Gostin, L.O. & Powers, M. (2002). What does social justice require for the public’s health? Public health ethics and policy imperatives. Health Affairs. 25(4). 1053-1060.
Fahrenwald, N.L., Taylor, J.Y., Kneipp, S.M, & Canales, M.K. (2007). Academic freedom and academic duty to teach social justice: A perspective and pedagogy for public health nursing faculty. Public Health Nursing. 24(2). 190-197.
Miller, D. (2003). Principles of social justice. Boston, MA: Harvard University Press