The World Health Organization declares health as a fundamental human right, and universal healthcare is a requisite if individuals and societies are to realize this claim. However, progress toward the realization of this right is increasingly threatened with the global economic downturn. Spiraling healthcare costs and the rise in complex bio-psychosocial morbidities particularly threaten the most vulnerable among us. Whether it is the international distribution of antiviral medications, the national availability of health insurance, or the individualized chronic disease care management programs, the allocation of finite resources in a socially just manner has served as the central ethic of healthcare.
Social justice refers to the equitable reaping of benefits and bearing of burdens across individuals and societies. Regardless of the desired economic, political, or cultural objectives of socially just endeavors, good health is fundamental to advancing human rights and societal well-being. When health is considered from this vantage point, the primary focus of healthcare must be the promotion of quality obtainable health outcomes, not merely on resource allocation.
However, as health researchers, there is a more critical aspect to this global problem. A logical correlate to quality health outcomes is the allocation of resources directed toward health research. Despite the disproportionate amount of healthcare research monies spent on investigating the biologic basis of disease, very few biomedical research discoveries have resulted in cure. Moreover, in today's society, the majority of poor health concerns are socially and environmentally mediated-obesity and the epidemic of violence are two profound examples. The National Institutes of Health's Roadmap for Medical Research and other international research programs are tackling the disconnect between biomedical research priorities and health outcomes by spearheading a variety of translational initiatives designed to transcend disciplinary boundaries. However, do the current paradigms for translational research capture the complexities of the social determinants known to impede health attainment? Because university education serves as the crucible for student formation and scientific inquiry, expanding and perhaps shifting the research training paradigm for all disciplines would improve the health of the most vulnerable, thus advancing the most fundamental goal of social justice.
Although the concept of social justice has been embedded in nursing practice since the advent of modern nursing, the role that research plays in advancing human rights is not routinely overtly explicated in nursing education or research training, regardless of academic level. For baccalaureate nursing students, nurturing student ideals while providing ample opportunities to study social determinants of health from an evidence-based practice approach will encourage them to think scientifically about how to surmount barriers faced by vulnerable populations. For graduate nursing students, emphasis must be placed on the importance of contextually relevant, methodologically rigorous research designed to promote clinically efficacious health outcomes. As many schools of nursing grapple to define the complementary roles of research and professional doctoral education, the concept of social justice can serve as a template for developing a cadre of scholars whose integrated scholarship activities will advance health outcomes. As nurses, we can do nothing less.
Judith A. Vessey, PhD, MBA, FAAN
Lelia Holden Carroll Professor of Nursing
School of Nursing, Boston College, Chestnut Hill, MA
[email protected]