# Securing Health Equity: Philosophical Foundations for Equality and Social Justice in Public Health and Health Care

> **NIH NIH G13** · UNIVERSITY OF WASHINGTON · 2024 · $47,535

## Abstract

Project Summary/ Abstract
Social justice is the primary ethical value underlying health equity. The public health
literature, due to its disciplinary limitations, does not “secure” conceptions of health
equity to an in-depth theory of social justice. Political philosophy offers several theories
of social justice. Which of these are best suited to health equity? The objective of this
solo-authored book project is to answer this question.
 The book has three specific aims: To identify and critically assess (1) the implicit
ethical goals that underlie much public health research, education, and policy on health
equity; (2) the dominant theories of social justice that are frequently applied to public
health and healthcare ethics; and (3) alternative theories of social justice that could be
applied to health and healthcare.
 As the book will be a work in normative bioethics and its primary methodology is
philosophical analysis and critical assessment of concepts and arguments, it does not
have a hypothesis per se but rather a central claim to be explained and defended. The
central claim is that we need to develop and apply the political philosophical theory of
“relational egalitarianism” to health equity. Relational egalitarianism is a theory
committed to elucidating and defending relational equality. According to this form of
equality, foremost, social justice means that people must be able to stand in front of
each other as equals. Health inequity, according to this theory, occurs primarily when
health disparities are caused by or lead to relational inequalities, or both. The innovation
of the project is that it will (1) develop relational egalitarianism to apply to health equity
as an alternative to dominant analytic theories of social justice, and (2) it will engage in
literature from analytic political philosophy along with theories of structural and
interactional racism, sexism, transoppression and ableism from the critical theory
literature. Its significance is that it will demonstrate how relational egalitarianism can
help guide choices about how health equity should be understood, measured, and
represented in the health sciences, policy, and education. As the reduction of health
inequities, which will improve the health of marginalized groups, is frequently cited as a
primary goal of public health, the book is of clear

## Key facts

- **NIH application ID:** 10794134
- **Project number:** 1G13LM014426-01
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Carina Fourie
- **Activity code:** G13 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $47,535
- **Award type:** 1
- **Project period:** 2024-08-15 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10794134

## Citation

> US National Institutes of Health, RePORTER application 10794134, Securing Health Equity: Philosophical Foundations for Equality and Social Justice in Public Health and Health Care (1G13LM014426-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10794134. Licensed CC0.

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