Does Population Health Have an Intrinsically Distributional Dimension?

作者：Reid Lynette^*

来源：Public Health Ethics, 2016, 9(1): 24-36.

DOI：10.1093/phe/phv022

Verweij and Dawson claim that population health has a distributive dimension; Coggon argues that this presupposes a normative commitment to equity in the very definition of population health, which should, rather, be neutral. I describe possible sources of the distributive view, several of which do not presuppose egalitarian commitments. Two relate to the nature of health as a property of individuals (it cannot be aggregated and exploited like wealth; its absence is more significant than its surplus); two relate to the epistemology and pragmatics of public and population health (social justice is an inherent value of public health practice; public health science and intervention rest on the clustering to identify causal factors). A fifth source of the distributive view is a critical stance on the concept of population health; I contrast this with Coggon's account of the public as a shared political imaginary. None of these views is 'neutral': they exhibit several different kinds of normativity and quasi-normativity, but this is not problematic. I argue that the critical stance appropriately distinguishes and relates social justice and public health.

• 出版日期2016-4