The mutual influences of social epidemiology and ideas of justice, each on the other, have been seminal in the development of public health ethics and law over the past two decades, and to the prominence that these fields give to health inequalities and the social—including commercial, political, and legal—determinants of health. General and political recognition of injustices in systematised health inequalities have further increased given the crushingly unequal impacts of the COVID-19 pandemic; including impacts of the legal and policy responses to it. However, despite apparent attention from successive UK governments to injustices concerning avoidable inequalities in health opportunities and outcomes, significant challenges impede the creation of health laws and policy that are both effective and ethically rigorous. This article critically explores these points. It addresses deficiencies in a UK health law landscape where health care contexts and medico-ethical assumptions predominate, to the great exclusion of broader social and governmental influences on health. The article explains how a public health framing better serves analysis, and engages with a framework of justice-oriented questions that must be asked if we are to understand the proper place and roles of law and regulation for the public’s health.

中文翻译：

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健康（不）正义的法律决定因素

社会流行病学和正义观念相互影响，在过去二十年的公共卫生伦理和法律的发展中具有开创性意义，并且突出了这些领域对健康不平等和社会——包括商业、政治和法律——健康的决定因素。鉴于 COVID-19 大流行的严重不平等影响，对系统化健康不平等中的不公正现象的普遍和政治认识进一步增加；包括对其的法律和政策反应的影响。然而，尽管历届英国政府都明显关注与健康机会和结果中可避免的不平等有关的不公正现象，但重大挑战阻碍了制定既有效又符合道德规范的健康法律和政策。本文批判性地探讨了这些要点。它解决了英国卫生法领域的缺陷，其中医疗保健背景和医学伦理假设占主导地位，而排除了更广泛的社会和政府对健康的影响。这篇文章解释了公共卫生框架如何更好地服务于分析，并涉及一个以正义为导向的问题框架，如果我们要了解法律和法规对公众健康的适当地位和作用，就必须提出这些问题。