Taking an Anti–Health Inequity Approach to Counter the Unfair Burden of Poor Health

In the 1990s Margaret Whitehead defined health inequities-often referred to in the United States as "health disparities"-as health differences that are avoidable, unnecessary, and unjust.1 More recent work (e.g., by Braveman2) has done much to sharpen our understanding of why we need specific efforts to counter fundamental inequities if we are to achieve health equality. After the George Floyd national reckoning with racial inequities, the concept of antiracism-deliberate efforts tocountersystemicand historical forces that discriminate against particular racial groups-has entered the public conversation, elevating the visibility of one particular dimension of efforts that can help push us toward equity.3 This evolving thinking has made it ever more clear that addressing long-standing inequalities that stem from unjust conditions requires deliberate action to counter that injustice. This perspective, which we should perhaps call an "anti-health inequity" approach, makes clear that the work of public health is inextricable from the work of social justice, simplybecause equality of health outcomes is unachievable without deliberateactiontotackletheforcesthat create the inequity in the first place. Informed by this thinking, recent work has suggested, for example, that Black-White health disparities, resting astheyoften doon long-standingwealth disparities, may be unattainable without reparations for the Black population to contribute to narrowing Black-White wealth gaps.4These concepts are, at this point, becomingembedded inthe mainstream of public health thinking56 and are likely not particularly new to readers of this journal. They do remain, however, far from the broader cultural mainstream. Three articles in this issue of AJPH illustrate well the persistence of health inequities and point to the need for specific efforts that are anti-inequity to mitigate the unjust burden of poor health.