Locating Disability Within a Health Justice Framework.

This Article explores the connections between disability and health justice in service of further tethering the two theories and practices. The author contends that disability should shift from marker of health inequity alone to critical demographic in the analytical and practical application of health justice. This theoretical move creates a more robust understanding of the harms of health injustice, its complexities, and, remedially, reveals underexplored legal and policy pathways to promote health justice.

Food Oppression in a Pandemic.

COVID-related racial disparities represent a spectrum of injustices and inequalities. Focusing on food oppression, this essay argues that racism infuses food law and policy in ways that contribute to racially disparate COVID deaths and severe illnesses. USDA nutrition program participants were at a nutritional disadvantage when COVID hit. Yet, government responses focused on food insecurity, not nutritional quality. Racism against a predominantly Black and brown labor force of essential food workers - from fields to meat plants to grocery stores - created tolerance for the administration's failure to protect or compensate some of the country's most vulnerable workers. When COVID-driven supply issues threatened to narrow white people's activities and choices, the favored response was to keep their options open by sacrificing Black and brown workers. A food oppression lens - understanding how corporate interests drive food policy - is necessary to achieve food equality in this pandemic and beyond.

Cooperative Ownership as a Health Justice Intervention: A Promising Strategy to Advance Health Equity Through the U.S. Childcare System.

In their article "The Civil Rights of Health," Harris and Pamukcu offer a framework connecting civil rights law to unjust health disparities with the aims of creating broader awareness of subordination as a root cause of health inequities and inviting policymakers to create new legal tools for dismantling it. They close with a call to action. Here, we take up their call and propose cooperative enterprises as a health justice intervention. To illustrate this conceptualization, we focus on childcare as a system with robust connections to social, economic, and health equity for children, workers, and families.

We Charge Vaccine Apartheid?

Vaccine apartheid is creating conditions that make for premature death, poverty, and disease in racialized ways. Invoking vaccine apartheid as opposed to euphemisms like vaccine nationalism, is necessary to highlight the racialized distributional consequences of vaccine inequities witnessed with COVID-19. This commentary clarifies the concept of vaccine apartheid against the historical and legal usage of apartheid. It reflects on the connections and important disjunctions between the two. It places the intellectual property regime under heightened scrutiny for reform and transformation. This commentary finds that drawing on the intersections between a human rights and health justice approach can provide creative and novel approaches for anti-subordination. It concludes that acknowledging and naming the structural injustice of vaccine apartheid is only the first step towards providing redress.

Translational Science 22 conference proceedings.

The Translational Science TS22 conference in Chicago in April 2022 was the first time post-pandemic that members of the Association of Clinical and Translational Science were able to meet up in person to share scientific advances. Given the remaining level of risk due to COVID-19, the meeting was designed as hybrid allowing virtual participation to some of the presentations. Prior to the meeting, JCTS Junior Editors were invited to report on the plenary sessions of the meeting. The present perspective constitutes a summary of three plenary sessions.

‘An incorporeal disease': COVID-19, social trauma and health injustice in four Colombian Indigenous communities

Worldwide, medical doctors and lawyers cooperate in health justice projects. These professionals pursue the ideal that, one day, every individual on Earth will be equally protected from the hazards that impair health. The main hindrances to health justice are discrimination, poverty and segregation, but we know that beyond concrete, quantifiable barriers, symbolic elements such as beliefs and fears also play a significant role in perpetuating health injustice. So, between March 2020, when the World Health Organization declared COVID-19 a global pandemic, and June 2021, when vaccines against the virus were globally available, we collected original information about the ways in which four Colombian Indigenous communities confronted COVID-19. Knowing that Colombian Indigenous communities often face health injustices, our goal was to understand the role of symbolic elements in the situation. Our main insight is that historical genocidal processes, in which the powerful have betrayed the trust of Indigenous communities, have created a trauma in the latter, resulting in reluctance and suspicion regarding the acceptance of ‘gifts' from external sources, including potentially beneficial health treatments. © The Author(s) 2022.

Breaking barriers to equity: A conversation with Dr. Julia Iyasere

I was honored to have the opportunity to talk to someone I've been fortunate to meet in the past few months and who has taught me incredible things about the topic of equity in healthcare and even more so the idea of health justice, Dr. Julia Iyasere, Executive Director of the NewYork-Presbyterian Dalio Center for Health Justice. As a physician, an educator, a researcher, and I suggest an evidence-based social activist, Dr. Iyasere has led the establishment and growth of the Dalio Center in just the over 9 months since its launch. But the ideas she champions in her work come from deep in her personal story, inspired by the path she has chosen and catalyzed by the moment in which we found ourselves over the last year and a half. Dr. Iyasere underlines how the realities of a world faced with COVID unearthed long established and deeply rooted issues not only in healthcare, but in society in general. © The Author(s), 2021.

The Peruvian COVID-19 vaccine scandal and re-thinking the path to public trust.

In February 2021, the Peruvian 'vaccinegate' scandal broke when the media reported that nearly 500 experimental doses of an ongoing COVID-19 trial were given to key individuals not enrolled in the trial. Indeed, vaccine doses were administered to leading politicians, such as the former President and his wife, and other high-level health officials and academic leaders at the universities overseeing ethical compliance and administration of the trial. The 'vaccinegate' scandal in Peru is but one example of how the lack of a coordinated global response to COVID-19 has allowed countries to act in the best interest of some, ultimately, failing to secure a democratic approach to the right to health for all during a global pandemic. While Peruvian vaccinegate is an example of the egregious use of power to further cronyism amid fear and mounting COVID-19 related death, unfortunately, it is not an anomaly. We argue that the sensationalisation of the event has distracted from the existing precarious health system in Peru and the ways in which long-existing abuses of power evident prior to the pandemic limit a just response to it.

Advocacy for Health Justice: An Innovative Pilot Course for MD and Master of Public Policy Students.

Problem: U.S. medical schools are searching for ways to address issues of health justice in undergraduate medical education. Physicians have not typically received training in how to be effective advocates for systemic change and individuals in policy fields are not usually equipped to understand the complex issues of health science and their intersection with the health system and society. To address this gap, medical school faculty partnered with school of public policy faculty on a collaborative learning model that engaged MD and Master of Public Policy students together to strengthen their collective knowledge of the healthcare landscape, and to build skills to work for health justice. Intervention: We hypothesized that pairing medical students with public policy students to learn about the intersections of health justice and advocacy could enhance the efficacy of each group and provide a new model of collaboration between medical and policy professionals. The students collaborated on a health justice advocacy project through which they provided consultation to an established community organization. Context: The 8-week course took place in the spring of 2021 in Los Angeles, California. Due to Covid-19 the course was taught online and included asynchronous learning modules and live Zoom sessions. The project also served as a pilot for the post-clerkship phase of a new longitudinal health justice curriculum for MD students that launched in August 2021. Impact: Analysis of student work products, course evaluations, partner interviews, and student focus groups showed that students valued learning through their interdisciplinary collaborative work which gave them new perspectives on health justice issues. The community partners indicated that the students consultative work products were useful for their initiatives, and that they found working with MD and MPP students to be a valuable way to think about how to build stronger and more inclusive coalitions to advocate for health justice. This project has the potential for national impact as it aligns with the Association of American Medical Colleges' renewed focus on the responsibility of academic medicine to partner with communities for health justice. The project also contributed to the national conversation on how to align health systems science education with the aims of health justice through our participation in the American Medical Association Accelerating Change in Medical Education Consortium. Lessons Learned: Leveraging faculty relationships with community partners was crucial for developing meaningful projects for students. Cultivating and expanding community partner networks is necessary to sustain and scale up this type of intervention. Centering the needs of communities and supporting their on-going work for health justice is essential for becoming an effective advocate. Learning communities that bring interdisciplinary students, healthcare providers, policy professionals, and community partners together to learn from one another can create key opportunities for ameliorating health inequities.

COVID-19 violence and the structural determinants of death: Canada's seasonal agricultural worker programme.

The Seasonal Agricultural Worker Program (SAWP) is a managed migration programme that aims to fill labour shortages in Canada's agricultural industry with Black and Brown workers from the global South. For decades, migrant workers, scholars, and advocate groups have called for fundamental changes to address power imbalances produced by the design of the SAWP. The continued operation of the SAWP during the COVID-19 pandemic has intensified the underlying structural violence that migrant labourers experience. Analysing the SAWP as a case study in how globalised labour processes dehumanise and make workers disposable, we argue that it is one component in a web of social and structural factors rooted in colonialism and racial capitalism, constituting the structural determinants of death. Whereas the structural determinants of health point to health 'inequities' and 'disparities', we advance the concept of structural determinants of death to politicise the numerous and multidimensional forms of violence embedded within state policy and to shed light on their beneficiaries. In doing so, we detail how policies can diminish the agency necessary to avoid death in deadly conditions and, specifically, draw attention to the preventable suffering and death perpetuated by the SAWP.

(Re)Designing Technical Documentation About COVID-19 with and for Indigenous Communities in Gainesville, Florida, Oaxaca de Juárez, Mexico, and Quetzaltenango, Guatemala

Background: In this article, we document how our team of translators, interpreters, technical communicators, and health justice workers is collaborating to (re)design COVID-19-related technical documentation for and with Indigenous language speakers in Gainesville, FL, USA;Oaxaca de Juarez, Mexico;and Quetzaltenango, Guatemala. Literature review: Although (mis)representations of Indigenous communities have been an ongoing issue in and beyond technical communication, the COVID-19 pandemic has brought added attention to how government institutions and other agencies fail to consider the cultural values, languages, and communication practices of Indigenous communities when writing, designing, and sharing technical information. Research questions: 1. How can technical communicators work toward social justice in health through collaborative design with Indigenous language speakers?2. How can technical documentation about COVID-19 be (re)designed alongside members of vulnerable communities to redress oppressive representations while increasing access and usability?Methodology: Through interviews and other participatory design activities conducted with Indigenous language speakers in the US, Guatemala, and Mexico, we illustrate how Western approaches to creating technical documentation, particularly in health-related contexts such as the COVID-19 pandemic, put communities at risk by failing to localize health messaging for Indigenous audiences. We then document our work intended to collaboratively design and translate COVID-19-related technical information alongside those Indigenous language speakers to benefit Indigenous language speakers in Gainesville and other parts of North Central Florida. Results: Through this discussion, we highlight how technical communicators can collaborate with Indigenous language speakers to create, translate, and share multilingual technical documents that can contribute to social justice efforts by enhancing language access. Conclusion: Through collaborations with Indigenous language speakers, translators, and interpreters, social/health justice projects in technical communication can be combined, localized, and adapted to better serve and represent the diversity of people, languages, and cultures that continue to increase in our world. IEEE

Digital surveillance in a pandemic response: What bioethics ought to learn from Indigenous perspectives.

Our paper interrogates the ethics of digital pandemic surveillance from Indigenous perspectives. The COVID-19 pandemic has shown that Indigenous peoples are among the communities most negatively affected by pandemic infectious disease spread. Similarly to other racialized subpopulations, Indigenous people have faced strikingly high mortality rates from COVID-19 owing to structural marginalization and related comorbidities, and these high rates have been exacerbated by past and present colonial dominance. At the same time, digital pandemic surveillance technologies, which have been promoted as effective tools for mitigating a pandemic, carry risks for Indigenous subpopulations that warrant an urgent and thorough investigation. Building on decolonial scholarship and debates about Indigenous data sovereignty, we argue that should Indigenous communities wish to implement digital pandemic surveillance, then they must have ownership over these technologies, including agency over their own health data, how data are collected and stored, and who will have access to the data. Ideally, these tools should be designed by Indigenous peoples themselves to ensure compatibility with Indigenous cultures, ethics and languages and the protection of Indigenous lives, health and wellbeing.

Vaccines for all? A rapid scoping review of COVID-19 vaccine access for Venezuelan migrants in Latin America.

INTRODUCTION: The entangled health and economic crises fueled by COVID-19 have exacerbated the challenges facing Venezuelan migrants. There are more than 5.6 million Venezuelan migrants globally and almost 80% reside throughout Latin America. Given the growing number of Venezuelan migrants and COVID-19 vulnerability, this rapid scoping review examined how Venezuelan migrants are considered in Latin American COVID-19 vaccination strategies. MATERIAL AND METHODS: We conducted a three-phased rapid scoping review of documents published until June 18, 2021: Peer-reviewed literature search yielded 142 results and 13 articles included in analysis; Gray literature screen resulted in 68 publications for full-text review and 37 were included; and official Ministry of Health policies in Argentina, Brazil, Chile, Colombia, Ecuador, and Peru were reviewed. Guided by Latin American Social Medicine (LASM) approach, our analysis situates national COVID-19 vaccination policies within broader understandings of health and disease as affected by social and political conditions. RESULTS: Results revealed a heterogeneous and shifting policy landscape amid the COVID-19 pandemic which strongly juxtaposed calls to action evidenced in literature. Factors limiting COVID-19 vaccine access included: tensions around terminologies; ambiguous national and regional vaccine policies; and pervasive stigmatization of migrants. CONCLUSIONS: Findings presented underscore the extreme complexity and associated variability of providing access to COVID-19 vaccines for Venezuelan migrants across Latin America. By querying the timely question of how migrants and specifically Venezuelan migrants access vaccinations findings contribute to efforts to both more equitably respond to COVID-19 and prepare for future pandemics in the context of displaced populations. These are intersectional and evolving crises and attention must also be drawn to the magnitude of Venezuelan mass migration and the devastating impact of COVID-19 in the region. Integration of Venezuelan migrants into Latin American vaccination strategies is not only a matter of social justice, but also a pragmatic public health strategy necessary to stop COVID-19.

Global public health security and justice for vaccines and therapeutics in the COVID-19 pandemic.

A Lancet Commission for COVID-19 task force is shaping recommendations to achieve vaccine and therapeutics access, justice, and equity. This includes ensuring safety and effectiveness harmonized through robust systems of global pharmacovigilance and surveillance. Global production requires expanding support for development, manufacture, testing, and distribution of vaccines and therapeutics to low- and middle-income countries (LMICs). Global intellectual property rules must not stand in the way of research, production, technology transfer, or equitable access to essential health tools, and in context of pandemics to achieve increased manufacturing without discouraging innovation. Global governance around product quality requires channelling widely distributed vaccines through WHO prequalification (PQ)/emergency use listing (EUL) mechanisms and greater use of national regulatory authorities. A World Health Assembly (WHA) resolution would facilitate improvements and consistency in quality control and assurances. Global health systems require implementing steps to strengthen national systems for controlling COVID-19 and for influenza vaccinations for adults including pregnant and lactating women. A collaborative research network should strive to establish open access databases for bioinformatic analyses, together with programs directed at human capacity utilization and strengthening. Combating anti-science recognizes the urgency for countermeasures to address a global-wide disinformation movement dominating the internet and infiltrating parliaments and local governments.

Uneven power dynamics must be levelled in COVID-19 vaccines access and distribution.

COVID-19 is one of the major global health threats of the 21st century, causing unprecedented humanitarian crises worldwide. Despite concerted efforts to curb the spread of the disease, the pandemic continues to strain healthcare systems globally and a safe, highly effective, and globally acceptable and equitable vaccination program, together with pre-existing precautionary measures, is essential to effectively contain the outbreak. We commented on the need to level any uneven power dynamics in COVID-19 vaccines access and distribution. The COVID-19 vaccines distribution must not allow for sovereignty which is tightly linked to historical imbalances in power and resources to result into discrimination between rich and poor countries. Poor countries must be supported in ensuring access to COVID-19 vaccines by levelling the power dynamics that perpetuate inequality and fuel inequity. We must ensure equity, fairness and transparency in COVID-19 vaccines distribution and gain public trust in COVID-19 vaccines through participatory community engagement. COVID-19 vaccines distribution and access must be equitable and not politicized.

Eviction, Health Inequity, and the Spread of COVID-19: Housing Policy as a Primary Pandemic Mitigation Strategy.

The COVID-19 pandemic precipitated catastrophic job loss, unprecedented unemployment rates, and severe economic hardship in renter households. As a result, housing precarity and the risk of eviction increased and worsened during the pandemic, especially among people of color and low-income populations. This paper considers the implications of this eviction crisis for health and health inequity, and the need for eviction prevention policies during the pandemic. Eviction and housing displacement are particularly threatening to individual and public health during a pandemic. Eviction is likely to increase COVID-19 infection rates because it results in overcrowded living environments, doubling up, transiency, limited access to healthcare, and a decreased ability to comply with pandemic mitigation strategies (e.g., social distancing, self-quarantine, and hygiene practices). Indeed, recent studies suggest that eviction may increase the spread of COVID-19 and that the absence or lifting of eviction moratoria may be associated with an increased rate of COVID-19 infection and death. Eviction is also a driver of health inequity as historic trends, and recent data demonstrate that people of color are more likely to face eviction and associated comorbidities. Black people have had less confidence in their ability to pay rent and are dying at 2.1 times the rate of non-Hispanic Whites. Indigenous Americans and Hispanic/Latinx people face an infection rate almost 3 times the rate of non-Hispanic whites. Disproportionate rates of both COVID-19 and eviction in communities of color compound negative health effects make eviction prevention a critical intervention to address racial health inequity. In light of the undisputed connection between eviction and health outcomes, eviction prevention, through moratoria and other supportive measures, is a key component of pandemic control strategies to mitigate COVID-19 spread and death.

Resisting the problematisation of fatness in COVID-19: In pursuit of health justice.

The purpose of this paper is to explore the problematisation of fatness in contemporary responses to the COVID-19 pandemic. This paper draws from the catalogue of reports from journalists informed largely by an array of non-peer reviewed scientific literature documenting the relationship between fatness and COVID-19. Our method of enquiry is to examine fatness and COVID-19 through a problematisation lens that enables us to interrogate the scientific, political, and economic processes implicated in the production of fat bodies as problems. Fatness has been problematised in the COVID-19 pandemic. This has diverted responsibility for preparedness and well-being away from health systems and governments and onto the back of fat people and communities. This is unjust and unethical. In juxtaposition, fat activists around the world have challenged the problematisation of fatness and its effects, finding ways for fat people to subvert fat phobic institutions in the midst of the COVID-19 pandemic by collectively organising to support one another. The ways in which fatness is being taken up in current COVID-19 pandemic responses diverts responsibility for health system preparedness and community resiliency to fat individuals. This is both unjust and also obstructs meaningful action to address the health inequities laid bare by COVID-19. This paper is believed to be the first to analyse the problematisation of fatness in COVID-19, highlighting that lessons can be learned about health justice in disasters from the work of fat activists during this COVID-19 pandemic.

Toward an Intersectional Approach to Health Justice.

Despite unprecedented global wealth creation, health inequity-the unjust health inequality between classes and groups among and within countries-persists, reviving the relevance of social justice as a lens to understand and as an instrument to intervene in these issues. However, the theoretical aspects and polysemous character of social justice as applied in the field of public health are often assumed rather than explicitly explained. An intersectional justice approach to understanding health inequality, inequity, and injustice might be useful. It argues that preexisting class-, race/ethnicity-, and gender-based health injustice and the socially differentiated impacts of the COVID-19 pandemic are shaped, interconnectedly, by economic maldistribution, cultural misrecognition, and political misrepresentation. Pursuing health justice requires analyses, strategies, and interventions that integrate the economic, cultural, and political spheres of redistribution, recognition, and representation, respectively. Such an intersectional approach to health justice is even more relevant and compelling in light of the COVID-19 pandemic. This article is broadly about class, race/ethnicity, and gender political economy of public health-but with a narrower focus on maldistribution, misrecognition, and misrepresentation, shaping social and health injustices.

A Global Ecological Ethic for Human Health Resources.

COVID 19 has highlighted with lethal force the need to re-imagine and re-design the provisioning of human resources for health, starting from the reality of our radical interdependence and concern for global health and justice. Starting from the structured health injustice suffered by migrant workers during the pandemic and its impact on the health of others in both destination and source countries, I argue here for re-structuring the system for educating and distributing care workers around what I call a global ecological ethic. Rather than rely on a system that privileges nationalism, that is unjust, and that sustains and even worsens injustice, including health injustice, and that has profound consequences for global health, a global ecological ethic would have us see health as interdependent and aim at "ethical place-making" across health ecosystems to enable people everywhere to have the capability to be healthy.

Implementation Science to Address Health Disparities During the Coronavirus Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic is disproportionally affecting racial and ethnic minorities. In the United States, data show African American, Hispanic, and Native American populations are overrepresented among COVID-19 cases and deaths. As we speed through the discovery and translation of approaches to fight COVID-19, these disparities are likely to increase. Implementation science can help address disparities by guiding the equitable development and deployment of preventive interventions, testing, and, eventually, treatment and vaccines. In this study, we discuss three ways in which implementation science can inform these efforts: (1) quantify and understand disparities; (2) design equitable interventions; and (3) test, refine, and retest interventions.