Socio-economic health inequalities through the lens of social justice theory, an innovative perspective.

Background: Socioeconomic health inequalities, characterized by avoidable, systematic, and unfair differences in health between social groups based on socioeconomic disparities, persist in Western countries despite extensive efforts. This situation prompts a critical examination of current public health interventions. While individual-focused approaches emphasize behavioral strategies to address avoidable factors, and systems approaches target systematic causes, there remains a significant gap in addressing one crucial aspect of health inequalities: their inherent unfairness. Study design: In this contribution, we conduct a theoretical exemplification. Methods: Distributive, procedural, and recognitive justice theory has been employed as critical lens to analyze public health interventions and policies. Results: Distributive justice focuses on the fairness of outcomes and is recognizable in the (re)distribution of resources such as food aid. However, if redistribution comes with stigma attached, it still fails to address fairness in full, which can hamper uptake. Procedural justice focuses on the fairness of the process leading up to certain outcomes. Stakeholder engagement in policy development is an example, but avoiding tokenism is key for truly reducing unfairness. Finally, recognitive justice emphasizes recognition, human dignity and equal social participation. It might be most elusive to 'catch' in policy but is also most crucial to address unfairness completely. Conclusions: Integrating social justice theory into public health strategies promotes fairness and contributes to of the reduction of health inequalities.