Health as a Basic HumanRight
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In exploring the connection between health and human rights,we propose three relationships, each of which focuses on animportant aspect of this critical linkage.The
first relationship
, which can be diagrammed simply as
H
HR concerns the potential impacts of health policies,programs, and practices on human rights
.
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Recognition of the complementarily of public health goals andhuman rights norms can lead to more effective health policiesand programs.
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The challenge is to negotiate the optimal balance betweenpromoting and protecting public health and promoting andprotecting human rights.The
second relationship
, which can be diagrammed, equallysimply as
H
HR
,
expresses the idea that violations or lack of fulfillment of any and all human rights have negative effectson physical, mental, and social well-being (health).
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This is true in peacetime and of course in times of conflict andextreme political repression.The
third relationship
, which can be diagrammed as
H
HR
,
conveys the idea of inextricable connection.
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The central idea of the health and human rights movement isthat health and human rights act in synergy.
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Promoting and protecting health requires explicit and concreteefforts to promote and protect human rights and dignity, andgreater fulfillment of human rights necessitates soundattention to health and to its societal determinants.
The Public Health ––– Human Rights Dialogue
Public health and human rights can be considered as twodifferent, often complementary and occasionally conflicting ways of looking at the world. Even when they address similar or evenidentical problems, their language and underlying assumptionsmay differ.
Public health
is concerned with promoting and protectinghealth –– in other words, physical, mental, and social well-being –– and with preventing or reducing morbidity (illness, disability, or suffering) and premature mortality. A fundamental yet oftenunstated assumption is that public health seeks the greatest goodfor the greatest number.
Human rights
are concerned with promoting and protectingthe well-being of individuals by ensuring respect for individualrights and dignity. A central concern in human rights is the ethicalprinciple of autonomy. It is therefore inevitable that some tensionwill emerge between public health and human rights perspectivesand approaches to promoting human well-being
For example:
At times, an individual may be considered dangerous for the health of the larger group. (e.g. a person withtuberculosis can infect contacts; the intoxicated driver may cause automobile crashes that endanger others.)The public health response to these situations has oftenbeen to constrain the individual in order to protect thegroup.
Certain public health measures, proposed on the basisof excellent scientific data )e.g., adding iodine to tablesalt to prevent iodine efficiency and cretinism), may limitor eliminate individual choice and also have some sideeffects and costs.Human rights and public health have increasingly recognizedthe vital role of the societal environment to both health and therealization of human rights.Even while many individuals do what they can to be healthy(for example, eating well and avoiding tobacco smoking), their health will be strongly influenced by a polluted environment,dangerous work conditions or lack of safe drinking water. Similarly,the freedom to make one’s own decisions depends on conditionssuch as having sufficient income, a place to live, and good health.In turn, these factors are heavily influenced by whether or not anindividual belongs to a group that suffers discrimination. Thus, therelationship between the individual and the society is morecomplex than it may initially appear.
Human rights and public health are twocomplementary approaches
, and languages, to address andadvance human well – being.
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The human rights approach to seek to describe –– and thenpromote and protect –– the societal prerequisites for humanwell – being in which an individual can achieve his or her fullpotential.
Health
concerns are the physical, mental, and social well-being of individuals.
Public health
can be defined as “ensuring the conditions inwhich people can be healthy.” The core of public healthknowledge, based on research and experience, is that blends of individual and societal – level factors are involved in determininghealth status. For many, if not most people, the societal context isthe major determinant of vulnerability to preventable disease,disability, and premature death.The
Universal Declaration of Human Rights
–– thecornerstone document of modern human rights –– through itsfocus on the societal-level determinants of well-being addresses apanoply of public health issues and concerns, even though theword
health
itself appears only once in the document.
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The focus of the universal Declaration on these societal-levelhealth determinants provides public health with a framework,vocabulary, and guidance for analysis and direct responsethat may ultimately prove more useful to promote publichealth than frameworks inherited from biochemical and publichealth traditions.From a human rights perspective, interest in health hasprimarily focused on governmental actions taken in the name of public health and their impact on the rights enshrined ininternational human rights law. Most actions taken in the name of public health care are carried out under the aegis of governmentalauthority and responsibility. Most are actually performed bygovernmental agencies, and others are indirectly supported andorganized by governmental funding and regulation. Recognition of the dependency of fulfillment of human rights provides a new
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