Promoting social justice in the capitalist academy? Health equity and the Johns Hopkins University Michael Bloomberg School of Public Health

Stella Medvedyuk, Dennis Raphael
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Abstract

The past two decades have seen increasing mentions of health equity and the importance of addressing the social determinants of health in USA public health statements. Yet, there is little uptake of these concepts into USA public policy. We see this, in part, as being due to the unwillingness of the USA public health community – including its network of Masters of Public Health Programs – to address the fundamental cause of health inequities: the United States’ capitalist economic system which skews the distribution of the social determinants of health in favour of the wealthy and powerful. We illustrate this reluctance by examining how the Bloomberg School of Public Health of Johns Hopkins University conceptualises the promotion of health equity through its International Declaration of Health Rights. Nothing in the Declaration considers how the economic system threatens health yet it is presented as a model for public health education. We review its shortcomings and show how revision to it is unlikely since the School is endowed by its namesake billionaire Michael Bloomberg who has denounced any attempts at redistributing wealth and income in the service of public health. Evidence of how public health messaging is already shaped by powerful economic interests embedded within the United States’ capitalist system substantiates concerns that have been raised about such branding and its effects on public health discourse and action.
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在资本主义学院中促进社会公正?健康公平与约翰霍普金斯大学迈克尔-布隆伯格公共卫生学院
过去二十年来,美国公共卫生声明中越来越多地提及健康公平以及解决健康的社会决定因素的重要性。然而,美国的公共政策却很少采纳这些概念。我们认为,部分原因在于美国公共卫生界(包括其公共卫生硕士项目网络)不愿意解决健康不平等的根本原因:美国的资本主义经济体系使健康的社会决定因素的分布偏向于富人和权贵。我们通过考察约翰霍普金斯大学布隆伯格公共卫生学院如何通过其《国际健康权利宣言》将促进健康公平概念化来说明这种不情愿。宣言》中没有任何内容考虑到经济体系如何威胁健康,但却将其作为公共卫生教育的典范。我们回顾了《宣言》的不足之处,并说明对《宣言》进行修订是不太可能的,因为该学院是由以其命名的亿万富翁迈克尔-布隆伯格(Michael Bloomberg)捐赠的,而布隆伯格曾谴责任何为公共卫生服务而重新分配财富和收入的尝试。有证据表明,美国资本主义体系中的强大经济利益集团已经在塑造公共卫生信息,这也证实了人们对这种品牌及其对公共卫生言论和行动的影响的担忧。
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