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Let’s Talk: Ethical foundations of health equity

Cette ressource est également disponible en français.

The Let’s Talk document explores justice as the ethical basis of health equity. It expands upon this idea by exploring how public health practitioners can use this knowledge to guide work to address health equity.

Distributive justice

The authors discuss two broad dimensions of distributive justice: the currency of justice and the principles of justice.

The currency of justice is described as access to services, resources that promote health, opportunities to be healthy and health outcomes. The principles of justice guide the distribution of the currency of justice in public health interventions and include principles of equality, sufficiency, priority to the worse off and maximization of the currencies across the population.

The resource also provides examples to demonstrate how the principles intersect with the currencies of justice are provided, as well as how these intersections can guide public health decision-making and resulting population health outcomes. A specific example of how ethical judgements can affect the design of diabetes interventions is outlined as an example to guide application across public health program and topic areas.

Discussion questions

The document includes four discussion questions to encourage critical thinking and conversation about the ethical foundations of health equity and the selection of public health approaches to address it.

Use this resource to:

  • critically examine what you think makes a difference in health unjust and how this affects the strategies you propose to address health equity;
  • facilitate organizational and team discussions about the ethical foundations of health equity; and
  • incorporate ethical considerations into strategic directions and program plans to influence decision-making to address health inequities.


Related resources

Companion Document: Ethical foundations of health equity: A curated list (2020)

Learning from practice: Targeting within universalism (2014)

Proportionate universality (2015)

Public Health Speaks: Intersectoral action for health equity (2013)

Glossary of Essential Health Equity Terms


More from the Let's Talk Series


National Collaborating Centre for Determinants of Health. Let’s Talk: Ethical Foundations of Health Equity. (2020). Antigonish, NS: NCCDH, St. Francis Xavier University.

Tags: Key concepts, Document, Report / Document, Let's Talk