Civil Rights Laws as Tools to Advance Health in the Twenty-First Century

Abstract

To improve health in the twenty-first century, to promote both access to and quality of health care services and delivery, and to address significant health disparities, legal and policy approaches, specifically those focused on civil rights, could be used more intentionally and strategically. This review describes how civil rights laws, and their implementation and enforcement, help to encourage health in the United States, and it provides examples for peers around the world. The review uses a broad lens to define health for both classes of individuals and their communities-places where people live, learn, work, and play. Suggestions are offered for improving health and equity broadly, especially within societal groups and marginalized populations. These recommendations include multisectorial approaches that focus on the social determinants of health.

COVID‐19 Interconnectedness: Health Inequity, the Climate Crisis, and Collective Trauma

“…The low‐income communities, resulting from systemic colonization, reservations, and/or slavery, face severe public health and environmental risks. These risks include financially stressed public schools; a high presence of unhealthy food choices (e.g., fast foods) and low presence of supermarkets with fresh produce and other healthy foods for home‐based preparation; a high per capita number of liquor stores and other sources of alcohol (e.g., delis, bodegas) as compared to more privileged neighborhoods and suburban areas; violence (including intimate partner violence); and lack of spaces for physical activities (McGowan et al, 2016).…”

“…Housing and employment policies and practices often exclude inmates, depriving them of the ability to meet basic needs, including health. Black and Brown inmates, therefore, face health disparities and should be included in discussions of health equity (McGowan et al, 2016). The COVID-19 pandemic is also highlighting how incarceration has a significant impact on health.…”

Using concept mapping to develop a human rights based indicator framework to assess country efforts to strengthen rehabilitation provision and policy: the Rehabilitation System Diagnosis and Dialogue framework (RESYST)

“…legal commitments dictate the establishment of national priorities, optimal workforce planning drives better performance, effective coverage leads to enhanced utilization. Specifically, the Legal Commitments and Strategic Priorities cluster underlines the obligation of States to incorporate the key provisions of the CRPD in domestic legislation [ 73 ](Indicators #103, #20, #79, #14, #15, #56, #81) as a crucial means in realizing the right to health of persons with disabilities [ 74 ] and strengthening health systems [ 75 , 76 ] and suggests that national priorities in the context of SDGs (Indicators #17, #66, #39) be informed by the international human rights standards, a view that is shared widely among leading commentators and global health experts [ 77 – 79 ]. A similar interpretation can occur across other clusters of indicators allowing an in depth examination of systemic issues pertaining to rehabilitation service delivery, financing and workforce planning.…”

Using Concept Mapping to Develop a Human Rights Based Indicator Framework to Assess Country Efforts to Strengthen Rehabilitation Provision and Policy: The Rehabilitation System Diagnosis and Dialogue (RESYST) Framework

“…For example the relationship between "legal commitments" and "strategic priorities" is not simply linguistic but reflects the interaction among the elements of the framework within this cluster (indicators) -how one affects the others and is in turn affected by them, which is what converts these elements into a unified whole. [46] Specifically, the Legal Commitments and Strategic Priorities cluster underlines the obligation of States to incorporate the key provisions of the CRPD in domestic legislation [67] (Indicators #103, #20, #79, #14, #15, #56, #81) as a crucial means in realizing the right to health of PWD [68] and strengthening health systems [69,70] and suggests that national priorities in the context of SGDs (Indicators #17, #66, #39) be informed by the international human rights standards, a view that is shared widely among leading commentators and global health experts [71][72][73]. A similar interpretation can occur across other clusters of indicators allowing an in depth examination of systemic issues pertaining to rehabilitation service delivery, financing and workforce planning.…”