Victor W. Sidel, M.D., APHA President, 1985

Social Justice at Home and Abroad

Worldwide, there are an estimated 1.3 billion people who live in absolute poverty – one-fifth of the human population. In the United States, sociologist Ruth Sidel teaches that, despite gains that Bill Clinton has boasted about for the past year, the gap between the richest and the poorest people in our society has grown even wider. In the United States today, half of all black children live in poverty. So long as these and other disparities continue, there cannot be an adequate level of health for all our people.

As Bill Foege has repeatedly said, “Public health is social justice.” Unless we keep our eyes on that prize, we cannot succeed as health workers. Each day as I drive to my office in the Bronx, I pass the Bronx County Courthouse, which was built in 1935 during the administration of Franklin Roosevelt. On that building a frieze states, “Government is a contrivance of human wisdom to provide for human wants. Men have a right that those wants should be provided for by this wisdom.” That was a time when it was clear that the vast gaps in our society were not due to laziness or to evil in individual people, but were due to our economic system. Attacks on governments that seek social justice protect that system and are anti-health.

In the world today, vast gaps in income and in life chances are increasingly due to a work economic system that includes globalization, structural adjustment, and the transfer of wealth from poor nations to rich nations. These are all changes that individual people can’t control. Therefore, to move forward with social justice, we are going to have to work to convince people that such changes must be societal. In the United States, we pay among the lowest rates of taxes of any industrialized country, and the United States spends the lowest percentage of gross domestic product on economic development aid for poor countries. We cannot live that way in a world seeking health and social justice. If we do continue in our present course, we will not achieve any of the public health goals we are discussing here.

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