Social Justice in the Rubric of Public Health Nursing: A Commentary

A vital sense of morality in attitude and policy sought within the realm of Public Health Nursing (PHN) Practice is referred to as social justice. An examination of social justice has nothing to do with criminal jurisprudence, but rather has to do with a sense of fairness in terms of healthcare delivery to the disadvantaged while raising nurse practitioner awareness. Also included in this discussion are brief summaries of several journal readings which include “Social Justice as a Framework for Professional Nursing,” “Reinvesting in Social Justice: A Capital Idea for Public Health Nursing?,” “Social Justice Issues Related to Uneven Distribution of Resources,” “What Does Social Justice Require for the Public's Health?,” and the Schim/Benkert article. The commentary then proceeds to make a statement reflecting upon the readings, voicing thoughts as they relate to PHN Practice and social justice.    

Social justice's meaning is generally understood within the context of public health nursing practice. However, perhaps best summed up by Gostin and Powers of Georgetown University Law Center (Gostin, & Powers, 2006), as they proclaim its fundamental meaning as a concept of “fairness,” or “reasonableness,” in meting out “the fair disbursement of common advantages and the sharing of common burdens” (p.1053, 1054). Many agree that public health holds a moral duty to implement health improvements for the most disadvantaged of society. 

Perhaps an adequate working definition of social justice would be as follows. The idea is to treat all people fairly in access to healthcare, administering health care needs equitably, without discrimination towards the poor, certain ethnic group members, homeless, or needy individuals who may be victims of (Gostin, & Powers, 2006) “substandard housing,” inadequate “education, unhygienic and polluted environments and social disintegration” (p.1054). The main idea, regarding social justice within the practice of public health's nursing contribution, is to alleviate harsh judgments in punishing or denying care to the less fortunate while instituting a policy to legally mitigate any disparities among the economically or socially disadvantaged. 

The first summary is of the journal article by Doris Boutain. Boutain (2005) in “Social Justice as a Framework for Professional Nursing,” discusses that a consistent ratio links health disparity and “societal inequality” (p.404). These two, inextricably converge together, making it necessary for nursing education to pro-actively focus an integrative structure of outlining course content to allow nurses to be able to level the playing field. An emphasis points out that nursing professionals need to be presented with the educational grounding in order to properly foster a sense of social justice. 

Boutain's observations are insightful. As (Boutain, 2005) furthermore described are ways in how such a course might be structured, suggesting topics to include both “history, legal” and ethical nursing concerns within the profession (p. 405). The article suggests curriculum must be infused with how social injustice issues affect nurses, that the literature addressing this situation is too scarce, and that social justice generally revolves around poverty, minority health, and other marginalized groups which comprise underserved populations. 

To summarize the article, “Reinvesting in Social Justice: A Capital Idea for Public Health Nursing?” professors posit that a new look in advocacy of social justice activities would actually be a key core to help boost economics. Drevdahl, Kneipp, Canales, and Dorcy (2001) do not suggest investing in so-called “social capital” as a panacea for all ills (p. 19). The article offers historical perspectives on public health with a mention of Florence Nightingale, the meaning of justice from Greek philosophical views of ethics, and the short-comings of an American market model of which some enjoy privatized health benefits which were once part of public programs and services. 

The Ervin and Bell article, “Social Justice Issues Related To Uneven Distribution Of Resources,” simply weighs unequal distribution of goods, services, food, and of course healthcare. The main premise in their argument announces that such uneven distribution is extremely detrimental to the “common good in the United States and [italics, mine] to the global community” (p. 8). The authors admit the situation to be a complex web through which to navigate. Authors Bell and Ervin (2004) discuss how twenty other nations have lower infant and maternal mortality rates as contrasted to the United States' figures. These are stunning statistics for a leading industrialized nation, and very surprising. 

The Gostin and Powers commentary in Health Affairs, “What Does Social Justice Require for the Public's Health?” is quite comprehensive. A summary of their commentary boils down to an examination of declaring a definition of social justice within a framework of public healthcare, in which they think of social justice as a “crisis” of “personal responsibility” (p. 1054). In arguing that national, state, and public policy must be adamant in the dispersal of such social justice among the needy is the primary gist and passion of the article.   

In Public Health Nursing, Schim, Benkert, Bell, Walker, and Danford place an eye towards breaking down a general metaparadigm of urban health nursing into the four basic conceptual traditions. To summarize, the goal is to integrate into a model for urban nursing with social justice, “person, environment, health, and nursing” (p. 73). Overall the article centralizes its discussion on a working theme of leveling the playing field, to equalize gaps in political and economic situations, and to address the issue of private and public healthcare. 

Finally, in reflection upon all thoughts about the readings, it is believed that a firm commitment, newly re-affirmed sense of humanity, political will, education, and significant policy implementations may help address issues of social justice in the sphere of public health nursing. There is no doubt that everyone is on this planet together. It makes obvious sense that nursing professionals, educators, theorists, and practitioners should lead the way in the pursuit of qualifying a working definition of social justice and implement any practical, legal, or otherwise solutions to bettering conditions for disadvantaged persons seeking healthcare.    

References

Boutain, D. (2005). Social justice as a framework for professional nursing. Journal of Nursing Education, 44, 404-407.

Drevdahl, D., Kneipp, S., Canales, M. K., & Dorcy, K. S. (2001). Reinvesting in social justice: A capital idea for public health nursing?. Advances In Nursing Science, 24(2), 19-31.

Ervin, N. E., & Bell, S. E. (2004). Social justice issues related to uneven distribution of resources,(Spring/Summer issue), 8-13.

Gostin, L. O., & Powers, M. (2006). What does social justice require for the public's health? Public ethics and policy imperatives – social justice demands more than fair distribution of resources in extreme public health emergencies. Health Affairs, 25, 1053-1060.

Schim, S. M., Benkert, R., Bell, S. E., Walker, D. S., & Danford, C. A. (2006). Social justice: Added metaparadigm concept for urban health nursing. Public Health Nursing, 24(1), 73-80.