Power, Political Economy, and Health Justice

Since its emergence in the legal literature a decade ago, the Health Justice Framework has developed into a robust account of how law and policy can be transformed from a negative social determinant of health to a positive force for achieving health equity. However, the Framework has not sufficiently engaged with class relations within racial capitalism, a fundamental cause of health disparities. Such engagement is critical, because the goals of health justice will require a mass movement of the multiracial working class. This article situates the Health Justice Framework within the broader political economy of health, a field of inquiry and critique with a deep history. Since public health’s origins in the nineteenth century, the political economy of health has competed with mainstream public health theory, which reduces questions of health to individual bodies and behaviors, removing them from their social and structural context. Health justice, and the broader resurgent political economy of health, can push back against the commodification of health under neoliberal racial capitalism, but only by building the power of the multiracial working class. To build power, the Health Justice Framework has acknowledged the often-tense relationships between lawyers and organizers. By eschewing the expert advocacy and shallow organizing tactics that have predominated modern social change efforts and instead focus on deep organizing that centers the agency of ordinary people, health justice can chart a path forward during the challenges ahead in the Second Trump Administration. This path will require a focus on both policy and power, a balancing act that has become known as “non-reformist reforms.” The reemergent tenant movement, being organized locally in cities across the country, is both a prime example and a necessary component of health justice. Tenant organizing improves access to justice in a way that builds power through critiquing the insufficiency of existing tenant rights and the capitalist housing system. Tenant organizing also broadens the struggle for housing and connects it to other struggles. Tenant organizing as connects people, building community in the place of growing isolation.