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What's Wrong with Health Inequalities?
NICHOLAS B. KING
Assistant Professor of Bioethics and History
Case Western Reserve University
Nicholas B. King is an assistant professor in the Departments of Bioethics and History at Case Western Reserve University. He holds a Ph.D. in the History of Science and an M.A. in Medical Anthropology from Harvard University; and from 2003-2005 he was a Robert Wood Johnson Health and Society Scholar in the Department of Epidemiology at the University of Michigan. At Case, he directs the program in public health genetics, and co-directs the first block of the medical education curriculum. Dr. King’s research focuses on public health ethics and policy, including health inequalities, biodefense, surveillance, and emerging infectious diseases. He has published essays in the journals Bioethics, Journal of the History of Medicine and the Allied Sciences, Social Studies of Science, The American Journal of Bioethics, and the American Journal of Public Health.
What's Wrong with Health Inequalities?
While public health researchers and health policymakers have long been interested in health inequalities, ethicists have only recently begun devoting attention to this issue. Most agree that health inequalities are morally wrong; but few have provided explicit guidance on precisely which inequalities are wrong, why, and what to do about them. This is partially due to the fact that health inequalities present a special case for bioethics, because their ethical evaluation is inextricably entangled with their technical measurement. Using examples drawn from epidemiologic, demographic, and historical literature, this paper examines the moral complexity of measuring health inequalities, focusing on two major questions: Can we compare and rank different kinds of health inequalities? Can we identify numerical thresholds at which specific inequalities demand social amelioration?