According to Oxfam Australia (2024) social justice is broadly understood to mean the fair and equal treatment of everyone in society. Although the aim of all health promotion is to provide fair and equal treatment, often there are underlying inequalities that impact many groups throughout Australia including Indigenous people; people with a disability; lesbian, gay, bisexual, transgender, intersex, queer, asexual and other sexually or gender diverse individuals; culturally and linguistically diverse individuals; as well as some women.

The social justice principles seek to recognise and address both the health outcomes, such as incidence and prevalence of disease and death rates as well as the factors that influence health such as socioeconomic status, environment and cultural factors. The principles of social justice underscore much of health promotion since the Ottawa Charter in 1986.  

Health promotion should seek for everyone to have equal levels of good health, but what each person requires in order to be able to attain health will vary and needs to be addressed.

The social justice principles can be remembered using the acronym PEAR.

• Participation
• Equity
• Access
• Rights

Participation

This principle emphasises the importance of involving people groups in the decision-making processes affecting their lives. It recognises the value they have to offer and that their voices should be heard and valued.
For example, consulting with rural and remote communities when developing health promotion initiatives for people in those areas.

Equity

This principle acknowledges that everyone has different needs and therefore needs to be treated differently. It identifies that treating everyone equally will not result in the same health outcomes. Equity aims to ensure everyone has access to the resources they need to achieve their full potential, regardless of their background or circumstances. For example, people with lower income levels may need more financial assistance to pay for dental work than those with a higher income. Below is a classic image used to illustrate the difference between equity and equality.

Access

This principle emphasises the importance of ensuring all people have access to the resources and opportunities necessary for their wellbeing. This includes access to education, healthcare, housing, employment and other essential services. For example, many community health centres will have pamphlets available in different languages to allow different cultural backgrounds to access the same information.

Rights

In Australia, people have legal rights, such as the right to medical assistance which relates to and can impact health care and health promotion. Some human rights principles related to healthcare include the right to access adequate healthcare services without discrimination, the right to timely and appropriate healthcare and the right to privacy and confidentiality. Individual's also have the freedom to make decisions about their healthcare, must provide informed consent and are free from medical experimentation. 

The four social justice principles: participation, equity, access and human rights play a crucial role in both an individual's and a community's health status.

By participating in decision-making processes, individuals and communities feel more empowered and take control of their own health and wellbeing. For example, in the development of the Close the Gap Campaign (Closing the Gap) the Australian government consulted with both individual Indigenous people and specific Indigenous community groups to identify and address health issues that affect them. This includes meeting with specific communities when the initiative applies specifically to that community.

Establishing an active involvement for all parties to decide how to better their own health and those around them creates a strong sense of individual and community responsibility. This sense of autonomy and ownership promotes individual empowerment to make health-informed decisions; but in turn fosters a community that works towards a collaborative effort to promote better health and wellbeing.

When applying equity and access the aim is to ensure everyone has access to the resources they need to achieve good health, regardless of their background or circumstances. This can mean providing better tele-health services to rural areas, or ensuring a non-English speaking mother has access to a translator when seeking medical support for her pregnancy. Access can also relate to the speed of access to health care. This may mean more funding is provided to support the Rural Flying Doctors service to ensure similar health outcomes are achieved in rural areas compared to urban cities.

Addressing health disparities ensures that individuals and communities benefit from a fair healthcare system with better access to services. Reducing inequalities improves overall health and wellbeing, especially for those who need extra support to maintain or enhance their health.

Human rights foster safe, healthy environments free from discrimination, benefiting the mental health and wellbeing of individuals and communities. They ensure fair access to healthcare and respectful treatment, improving overall health. Additionally, human rights allow individuals to decline medical treatments that conflict with their cultural or religious beliefs, such as those religions that refuse blood transfusions or transplants.

These social justice principles have a positive impact on promoting the health status of all Australians and help to ensure everyone has equity of support and access so that they have equal opportunity to achieve good health outcomes. 

Human Rights in Australia

https://humanrights.gov.au/our-work/education/human-rights-australia 

Your Healthcare Rights  

https://www.healthdirect.gov.au/your-healthcare-rights 

Right to Health

https://www.ag.gov.au/rights-and-protections/human-rights-and-anti-discrimination/human-rights-scrutiny/public-sector-guidance-sheets/right-health