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Public Health Health and Human Rights
by
Jonathan Todres

Introduction

The fields of health and human rights intersect in important ways. Both aim to advance human well-being. Health status has implications for an individual’s capacity to realize his or her rights across many issues. For example, poor health can impair a child’s capacity to realize her right to education. Similarly, health policies and programs can implicate a range of human rights in their design and implementation. The connections operate in the other direction as well. The realization or violation of other rights—such as the right to birth registration, the right to education, or the right to access information—can affect an individual’s ability to access the care and information necessary to maintain good health. Other human rights violations—such as torture; cruel, inhuman, and degrading treatment; or violations of labor rights—have clear adverse consequences for the health status of targeted individuals. In short, health and human rights are deeply intertwined in ways that are fundamental to human well-being. In recent years, health and human rights has emerged as a field of study encompassing a very broad range of issues, including access to care, health promotion, trade law and public health, HIV/AIDS, reproductive rights, the role of medical professionals in the treatment of prisoners during armed conflicts, medical experimentation involving human subjects, and many more. The result is a vast and fairly disparate literature. This article focuses on health and human rights literature in the public health context, while also providing some foundational scholarship on health and human rights theory and practice. Thus, for the most part, it does not include literature on human rights issues that arise in the context of the medical treatment of individuals, which historically has been seen primarily as the purview of medicine, not public health. The first part of the article includes general sources followed by two sections on progress in the field. The remainder of the article is organized by substantive issue and specific population. Due to space considerations, this article cannot include every issue with health and human rights implications, but instead highlights prominent health and human rights issues that have significant implications across the spectrum of public health. The final section of the article focuses on specific populations that confront special health and human rights challenges. The substantive issues highlighted in this article impact many, if not all, of the specific populations, so readers interested in the impact of a particular issue on one of the special populations, such as the impact of obesity on children, are encouraged to review the relevant issue and population specific sections as well as the anthologies in the early sections the article.

General Overviews

Though a relatively young field, health and human rights now has a robust body of scholarly literature, research reports, and other valuable resources. Mann 1997, written by a pioneer in the field, provides an early argument for recognizing the linkages between health and human rights. Mann, et al. 1999 is the seminal volume on health and human rights, providing a broad introduction to various aspects of the field. Clapham and Robinson 2009 is a similarly structured volume. Both sources provide discussion of foundational concepts as well as a focused study of specific issues within the field, and they thus serve as excellent overviews of the field. Hunt 2006 offers a concise summary of the right to the highest attainable standard of health, for readers looking for a short explanation of the right to health and its components. United Nations 2000 is one of the most influential articulations of the normative content of the right to health, and a must-read for anyone working on these issues. A much more detailed analysis of the right to health under law is found in Tobin 2012, which offers an excellent introduction for those individuals particularly interested in the legal aspects of health and human rights. Finally, Harrington and Stuttaford 2010 is a more recent foundational work that examines both theoretical and practical aspects of health and human rights.

  • Clapham, Andrew, and Mary Robinson, eds. 2009. Realizing the right to health. Swiss Human Rights Book 3. Zurich, Switzerland: Rüffer & Rub.

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    In this volume, leading experts in health and human rights address a range of issues, including the social determinants of health, HIV/AIDS, trade and health, SARS and malaria, and health and human rights challenges in migration, prisons, and other settings. A chapter by Eibe Riedel on the conceptual foundations of health and human rights by provides a valuable examination of relevant international law in health and human rights.

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  • Harrington, John, and Maria Stuttaford, eds. 2010. Global health and human rights: Legal and philosophical perspectives. London: Routledge.

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    This volume outlines the theoretical and practical underpinnings of rights-based approaches to health. It also includes discussion of emerging systems of governance, and it addresses relevant substantive issues, including health sector corruption, children’s right to health in the courts, and the impact of patent rights and privatization of health care on health rights.

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  • Hunt, Paul. 2006. The human right to the highest attainable standard of health: New opportunities and challenges. Transactions of the Royal Society of Tropical Medicine and Hygiene 100:603–607.

    DOI: 10.1016/j.trstmh.2006.03.001Save Citation »Export Citation »E-mail Citation »

    This brief article defines the right to health, discusses its underlying components, provides an introduction to the role of the Special Rapporteur on the Right to Health, and presents three examples of health rights in practice: Niger’s Poverty Reduction Strategy, Uganda’s “neglected” diseases, and US-Peru trade negotiations.

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  • Mann, Jonathan M. 1997. Medicine and public health, ethics and human rights. Hastings Center Report 27.3: 6–13.

    DOI: 10.2307/3528660Save Citation »Export Citation »E-mail Citation »

    Early article discussing the connections between human rights and public health and medicine. Explores the ethical imperative for recognizing linkages between health and human rights.

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  • Mann, Jonathan M., Sofia Gruskin, Michael A. Grodin, and George J. Annas, eds. 1999. Health and human rights: A reader. New York: Routledge.

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    Seminal volume providing an introduction to health and human rights concepts and practice. It covers human rights in the context of both public health and medicine and includes important chapters on the impact of health policies (e.g., AIDS and TB control) on human rights. Chapter 1, “Health and Human Rights,” by Jonathan Mann, et al., provides an excellent overview of the linkages between health and human rights.

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  • Tobin, John. 2012. The right to health in international law. New York: Oxford Univ. Press.

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    A detailed examination of the right to health in international law that will be valuable to readers seeking an in-depth examination of relevant law. Tobin charts the history, conceptual foundations and methodology of the right to health, and he analyzes both the general and specific obligations of nations and the global community.

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  • United Nations Committee on Economic, Social and Cultural Rights. 2000. General comment 14: The right to the highest attainable standard of health. UN Doc. E/C.12/2000/4.

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    This highly influential UN committee interpretation of the “right to the highest attainable standard of health” discusses normative content of the right—including the key elements of availability, accessibility, acceptability, and quality—and details specific obligations of states under international law.

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Reference Works

Marks 2004 is an indispensable collection of the relevant documents and provisions in international law that cover the right to health and related rights implicating heath status. The Global Health and Human Rights Database is an online searchable collection of health and human rights cases and relevant national and international instruments. Bell, et al. 2009 provides a detailed online resource guide to health and human rights law and research related to HIV/AIDS. Cook and Ngwena 2007 is a collection of articles that offer foundational insights into health disparities, determinants of health, and human rights–based responses. Asher 2010 is a valuable resource for nongovernmental organizations, professional associations, and advocates seeking to understand and employ a human rights framework to address health issues.

  • Asher, Judith. 2010. The right to health: A resource manual for NGOs. 2d ed. Boston: Martinus Nijhoff.

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    This manual outlines ways health professionals, associations, and advocates can identify right to health violations, as well as promote and protect individuals’ right to health. It includes an overview of the legal framework, human rights monitoring systems, and states’ obligations under international human rights law. It also details strategies and tools for monitoring and advocacy, and highlights case studies of entities successful in monitoring and promoting the right to health.

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  • Bell, Emily, Helena Choi, Delme Cupido, Ralf Jürgens, Rick Lines, and Richard Pearshouse. 2009. HIV/AIDS and human rights. In Health and human rights: A resource guide. 4th ed. Compiled and edited by Jonathan Cohen, Tamar Ezer, Paul McAdams, and Minda Miloff. New York: Open Society Institute.

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    Valuable online resource on the linkages between human rights and HIV/AIDS. It includes a compilation of relevant international human rights law organized by right, case studies of effective use of human rights principles in the HIV/AIDS context, and a bibliography on the topic.

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  • Cook, Rebecca J., and Charles G. Ngwena, eds. 2007. Health and Human Rights. Aldershot, UK: Ashgate.

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    A collection of thirty-two previously published journal articles that provide analysis of the determinants of health and the utility of a human rights–based approach to health.

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  • Global Health and Human Rights Database. O’Neil Institute for National and Global Health Law, Georgetown University, and Lawyers Collective.

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    Open-access database of health and human rights court judgments, national constitutions, and international and regional instruments. A valuable source for both health and human rights research and advocacy.

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  • Marks, Stephen P., ed. 2004. Health and human rights: Basic international documents. Cambridge, MA: Harvard Univ. Press.

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    Foundational compilation of relevant international and regional treaties, declarations, and others instruments that form the body of international law on health and human rights. Includes documents related to public health and medicine.

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Journals and Reports

This section includes valuable references that produce health and human rights resources on an ongoing basis. Health and Human Rights: An International Journal is arguably the leading journal in the field covering all regions of the globe. BMC International Health and Human Rights covers similar issues with a focus on developing countries. Both are open-access sources. The Lancet also has occasional articles on health and human rights issues in its Health and Human Rights Paper Series. The website of the Special Rapporteur on Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health publishes periodic reports on health and human rights issues that can be either issue- or country-specific. Human Rights Watch periodically publishes in-depth field investigations that examine challenges with on-the-ground implementation of health-related rights.

Assessing Progress

Evaluation is recognized as an essential component of any public health program. The field of human rights has focused on evaluation and assessment only more recently. This section includes a sample of evaluation efforts. Three articles are included—Backman, et al. 2008; MacLachlan, et al. 2012; and Singh, et al. 2007—that offer empirical assessments of the effectiveness of human rights law in improving health status in various countries. De Vos, et al. 2006 offers a comparative analysis of a market-based approach to health with the right to health approach to health-care delivery. Gostin and Mann 1999 is an article that sets out a framework for assessing the human rights impact of health policies that has been utilized by a number of other researchers. Gruskin, et al. 2005 and Beyrer and Pizer 2007 are two anthologies that dedicate a number of chapters to methodologies for measuring progress on health and human rights issues. While these two books are valuable sources as a whole and provide important coverage of other aspects of health and human rights, their sections on measuring progress are highlighted here. Finally, MacDonald 2007 examines progress toward the Millennium Development Goals, offering a broader critique of global policies and their impact on health and well-being.

  • Backman, Gunilla, Paul Hunt, Rajat Khosla, et al. 2008. Health systems and the right to health: An assessment of 194 Countries. The Lancet 372:2047–2085.

    DOI: 10.1016/S0140-6736(08)61781-XSave Citation »Export Citation »E-mail Citation »

    Exploring the universal progress in the creation of equitable health systems, the authors identify 72 right-to-health indicators and evaluate 194 countries. Based on their findings, the authors make recommendations for governments, international bodies, civil society organizations, and other institutions for the monitoring of health systems and the progressive realization of the right to health.

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  • Beyrer, Chris, and H. F. Pizer, eds. 2007. Public health and human rights: Evidence-based approaches. Baltimore: Johns Hopkins Univ. Press.

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    This volume examines health and human rights issues in some of the most challenging settings, including conflict zones in Burma, Congo, Darfur, and Sierra Leone. Part II consists of seven chapters that focus on methodologies for examining health and human rights interactions. Other sections of the volume also provide insightful analysis of policy and case studies.

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  • De Vos, Pol, Wim De Ceukelaire, and Patrick Van der Stuyft. 2006. Colombia and Cuba: Contrasting models in Latin America’s health sector reform. Tropical Medicine & International Health 11.10: 1604–1612.

    DOI: 10.1111/j.1365-3156.2006.01702.xSave Citation »Export Citation »E-mail Citation »

    Compares Colombia’s largely market-based health sector reforms with Cuba’s reliance on the public sector for health care delivery and its recognition of health care as a public good. The article finds that Cuba’s recognition of health as a human right has led to better outcomes.

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  • Gostin, Lawrence, and Jonathan Mann. 1999. Toward the development of a human rights impact assessment for the formulation and evaluation of public health policies. In Health and human rights: A reader. Edited by Jonathan Mann, Sofia Gruskin, Michael A. Grodin, and George J. Annas, 54–71. New York: Routledge.

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    The chapter provides a seven-step framework for assessing the human rights impact of public health policies. The framework is designed to help in the design and development of policies that balance public health benefits and potential human rights burdens. It has be utilized widely and built upon by other researchers in subsequent publications.

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  • Gruskin, Sofia, Michael A. Grodin, George J. Annas, and Stephen P. Marks, eds. 2005. Perspectives on health and human rights. New York: Routledge.

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    Follow-up publication to the seminal work Mann, et al. 1999 (cited under General Overviews). It includes a valuable section on methodologies for measuring progress on health and human rights issues and assessing compliance with international law. Other chapters explore health and human rights issues in specific contexts, including development, emerging technologies, sexual and reproductive health, and violence.

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  • MacDonald, Theodore H. 2007. The global human right to health: Dream or impossibility? Oxford: Radcliffe.

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    A critique of the impact of globalization and neoliberal economic policies on health and human rights. Focusing on the UN Millennium Development Goals, the author assesses a broad range of themes relevant to health and human rights, including the UN’s role, the impact of transnational corporations; inequalities in wealth distribution, access to safe water, and health care; children’s rights; gender equality; infectious diseases, including malaria and HIV/AIDS; and environmental sustainability.

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  • MacLachlan, Malcom, Mutamed Amin, Hasheem Mannan, et al. 2012. Inclusion and human rights in health policies: Comparative and benchmarking analysis of 51 policies from Malawi, Sudan, South Africa and Namibia. PLoS ONE 7.5: e35864.

    DOI: 10.1371/journal.pone.0035864Save Citation »Export Citation »E-mail Citation »

    Empirical study of fifty-one health policies in Namibia, Malawi, South Africa, and Sudan, looking at whether their policies advance core concepts of human rights in health care, particularly among vulnerable groups. Using Equiframe, an analytical measurement tool developed by the authors, the article assesses whether countries’ health policies promote equitable, accessible, and inclusive health services. The authors further highlight policy strengths, significant shortcomings, as well as country-specific patterns.

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  • Singh, Jerome Amir, Michelle Govender, and Edward J. Mills. 2007. Do human rights matter to health? The Lancet 370:521–527.

    DOI: 10.1016/S0140-6736(07)61236-7Save Citation »Export Citation »E-mail Citation »

    This article analyzes how legal measures have been utilized to advance the right to health in select countries. It covers significant legal developments in India, South Africa, Argentina, and Ecuador, showing the value of litigation aimed at enforcing the right to health.

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Progress through Litigation

Litigation has been a significant component of efforts to enforce human rights in a number of countries. This section looks at significant cases and assessments of litigation as a tool for advancing the right to health. Annas 2003 is a commentary on the Minister of Health v. TAC case, an early landmark health and human rights case from South Africa. The article includes discussion of the limits of litigation as a strategy. Yamin and Parra-Vera 2010 examines a groundbreaking case in Colombia. Yamin and Gloppen 2011 provides a more detailed critique and assessment of litigation as a tool for enforcing health rights. Gloppen 2008 is included for those looking for an examination of key aspects of each stage of the litigation process. Cabal and Todd-Gher 2009; Hogerzeil, et al. 2004; and Hogerzeil, et al. 2006 are valuable compilations of right-to-health cases in numerous countries, providing important insights into what makes for successful litigation on health issues. Keener and Vasquez 2009 provides analysis of health and human rights litigation at the international level, examining significant cases in the Inter-American Court of Human Rights. Finally, UN Committee on the Elimination of Discrimination against Women 2011 deals with a case that provides an example of enforcement of the right to health through the individual complaints mechanism of a treaty body.

Infectious Diseases, Including HIV/AIDS

Research and scholarship on HIV/AIDS dominate this area of health and human rights. In many respects the human rights issues surrounding HIV/AIDS were pivotal to the development of health and human rights as a distinct discipline. Four sources are included on health and human rights responses to HIV/AIDS: Bell, et al. 2009 offers a comprehensive reference source; Gostin 1997 is an early foundational work; and Breyer, et al. 2009 and Stemple 2008 provide critical assessments of the health and human rights framework. Todres 2007, a fifth HIV/AIDS-related source, looks at the secondary effects of the disease on health and other rights. Two other articles focus on human rights issues that arise in the context of other infectious disease: Boggio, et al. 2008 focuses on tuberculosis, while Jacobs 2007 focuses on SARS. Finally, Fidler 2004 examines governance issues and the impact of the SARS outbreak.

  • Bell, Emily, Helena Choi, Delme Cupido, Ralf Jürgens, Rick Lines, and Richard Pearshouse. 2009. HIV/AIDS and human rights. In Health and human rights: A resource guide. 4th ed. Compiled and edited by Jonathan Cohen, Tamar Ezer, Paul McAdams, and Minda Miloff. New York: Open Society Institute.

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    Valuable online resource on the linkages between human rights and HIV/AIDS. It includes a compilation of relevant international human rights law organized by right, case studies of effective use of human rights principles in the HIV/AIDS context, and a bibliography on the topic.

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  • Boggio, Andrea, Matteo Zignol, Ernesto Jaramillo, Paul Nunn, Geneviève Pinet, and Mario Raviglione. 2008. Limitations on human rights: Are they justifiable to reduce the burden of TB in the era of MDR- and XDR-TB?. Health and Human Rights 10.2: 121–126.

    DOI: 10.2307/20460107Save Citation »Export Citation »E-mail Citation »

    Using tuberculosis as a case study, this article explores a central tension in public health law—the balance between the government’s responsibility to protect the public and the individual’s right to privacy, freedom of movement, and freedom from cruel, inhuman, or degrading treatment. Explores the circumstances under which human rights can be limited to protect the public’s health, addressing issues of involuntary confinement, diagnosis, and treatment.

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  • Breyer, Chris, Susan G. Sherman, and Stefan Baral. 2009. Harm reduction, human rights and public health. In HIV prevention: A comprehensive approach. Edited by Kenneth H. Mayer and Hank F. Pizer, 501–523. London: Elsevier.

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    This chapter includes a discussion of the linkages between human rights and public health. It focuses on HIV prevention in a number of at-risk populations. It also explores the tensions between a human rights approach and a public health–oriented harm reduction model.

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  • Fidler, David P. 2004. Germs, governance, and global public health in the wake of SARS. Journal of Clinical Investigation 113:799–804.

    DOI: 10.1172/JCI200421328Save Citation »Export Citation »E-mail Citation »

    A critical analysis of pre- and post-SARS trends in the governance of infectious disease containment. This article tracks the vertical and human rights–based strategies of infectious disease governance that gained prominence largely because of the HIV/AIDS pandemic, and it explores the growing importance of addressing public health issues as part of good governance.

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  • Gostin, Lawrence O., and Zita Lazzarini. 1997. Human rights and public health in the AIDS pandemic. New York: Oxford Univ. Press.

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    Early health and human rights work that addresses the AIDS pandemic. Includes discussion of relevant international human rights law and the significant challenges to its effective enforcement, as well as the linkages between human rights and public health, and an assessment of AIDS law and policy from a human rights perspective.

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  • Jacobs, Lesley A. 2007. Rights and quarantine during the SARS global health crisis: Differentiated legal consciousness in Hong Kong, Shanghai, and Toronto. Law & Society Review 41.3 (September): 511–553.

    DOI: 10.1111/j.1540-5893.2007.00313.xSave Citation »Export Citation »E-mail Citation »

    Socio-legal study on legal consciousness among health-care professionals and patients in three locales during the SARS crisis. The study examines how rights concerns were balanced with the use of quarantine in Hong Kong, Shanghai, and Toronto.

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  • Stemple, Laura. 2008. Health and human rights in today’s fight against HIV/AIDS. AIDS 22 (Suppl. 2) (August): S113–S121.

    DOI: 10.1097/01.aids.0000327443.43785.a1Save Citation »Export Citation »E-mail Citation »

    This article explores the use of the health and human rights framework in the context of HIV/AIDS. It includes discussion of setbacks in the effort to combat HIV/AIDS. It also discusses a key weakness in the human rights framework: lack of accountability for states that fall short of meeting their obligations.

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  • Todres, Jonathan. 2007. Rights relationships and the experience of children orphaned by AIDS. UC Davis Law Review 41.2: 417–476.

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    Provides an example of the far-reaching human rights implications of health issues, examining the impact of AIDS on children who have been orphaned as a result of the disease. Its discussion of the interrelated and interdependent nature of rights is important to both the development of the normative content of specific rights, including the right to health, and to policies and programs aimed at ensuring rights, particularly of marginalized populations.

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Health Promotion

Health promotion issues are becoming increasingly important in the health and human rights context. As the impact of chronic diseases continues to grow, in both industrialized and developing countries, chronic diseases are garnering greater attention from human rights scholars. This section focuses on tobacco and obesity as examples of health promotion issues examined from a health and human rights perspective. Dresler and Marks 2006 and Crow 2004 provide an outline and discussion of the right to tobacco control. Meier 2005 is a critique of international law on tobacco. Bayer and Stuber 2006 addresses the issue of stigma in the tobacco context and explores its implications for other public health policies and programs. Although a significant amount of health and human rights scholarship focuses on law and policy, Reubi 2012 is an interesting look at the actors who pressed to have tobacco control recognized as a human right, offering insights into the process by which new rights are recognized. While the health and human rights literature on tobacco control is growing rapidly, much less has been written on obesity as a human right. Priest, et al. 2010 and Greenway 2008 offer two perspectives on the merits of approaching child obesity from a human rights perspective.

  • Bayer, Ronald, and Jennifer Stuber. 2006. Tobacco control, stigma, and public health: Rethinking the relations. American Journal of Public Health 96:47–50.

    DOI: 10.2105/AJPH.2005.071886Save Citation »Export Citation »E-mail Citation »

    Commentary on the role of stigma in responses to public health issues. Reflecting on lessons from early responses to HIV/AIDS, which found that stigmatization had adverse human rights implications and subverted HIV identification and prevention efforts, the authors examine the use of stigma in anti-tobacco responses. They identify how stigma is actively used in current campaigns to curb tobacco use, and discuss the broader implications of this strategy for public health.

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  • Crow, Melissa E. 2004. Smokescreens and state responsibility: Using human rights strategies to promote global tobacco control. Yale Journal of International Law 29:209–250.

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    Presents a comprehensive review of the origins and obstacles of the WHO’s Framework Convention on Tobacco Control (FCTC), and elaborates on the human rights dimensions of tobacco control. Discusses the potential role of international human rights treaty bodies and regional human rights systems as vehicles for human rights litigation aimed at securing remedies for tobacco-related harms.

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  • Dresler, Carolyn, and Stephen Marks. 2006. The emerging human right to tobacco control. Human Rights Quarterly 28:599–651.

    DOI: 10.1353/hrq.2006.0032Save Citation »Export Citation »E-mail Citation »

    This article examines the potential application of a human rights framework to responses to tobacco-related disease, especially among impoverished populations. It reviews the impact of tobacco on public health; discusses relevant international human rights law, focusing on women’s and children’s rights; and concludes with an assessment of the prospects for implementing the “right to tobacco control” under various international and regional legal mechanisms.

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  • Greenway, Julie. 2008. Childhood obesity: Bringing children’s rights discourse to public health policy. Community Practitioner 81.5 (May): 17–21.

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    This concise article advocates for articulating childhood obesity as a rights issue rather than a public health issue in order to prevent implementation of fragmented approaches by various stakeholders and counteract commercial influences. The author identifies relevant articles of the UN Convention on the Rights of the Child and specifically explores the treaty’s potential to facilitate effective policy pertaining to childhood obesity.

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  • Meier, Benjamin Mason. 2005. Breathing life into the Framework Convention on Tobacco Control: Smoking cessation and the right to health. Yale Journal of Health Policy, Law & Ethics 5:137–192.

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    A critique of the failure of the Framework Convention on Tobacco Control (FCTC) to adequately address the subject of smoking cessation. It argues that the FCTC’s neglect of nicotine addiction violates the right to health, particularly in regards to state’s affirmative obligations to curb smoking and prevent disease. It concludes by exploring options that states may employ to revitalize the right.

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  • Priest, Naomi, Boyd Swinburn, and Elizabeth Waters. 2010. A human rights approach to childhood obesity prevention. In Preventing childhood obesity: Evidence, policy and practice. Edited by Elizabeth Waters, Boyd A. Swinburn, Jacob C. Seidell, and Ricardo Uauy, 40–45. Oxford: Wiley-Blackwell.

    DOI: 10.1002/9781444318517Save Citation »Export Citation »E-mail Citation »

    Discusses relevant sources of law—the right to health, right to adequate food, right to development, and right to be protected from harm and exploitation—and outlines a human rights approach to childhood obesity.

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  • Reubi, David. 2012. Making a human right to tobacco control: Expert and advocacy networks, framing and the right to health. Global Public Health 7 (Suppl. 2) (December): S176–S190.

    DOI: 10.1080/17441692.2012.73394Save Citation »Export Citation »E-mail Citation »

    A case study on the effort to frame tobacco control as a human right. The article focuses on the actors that constitute the drivers behind this movement, and their motivations. It finds that one of the primary benefits of framing this issue as a human rights problem is greater access to potentially powerful legal and quasi-legal tools that can advance health.

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Business, Trade, and Health

Trade and economic issues have a significant impact on the health status and human rights of individuals in all countries. Often the effect is most pronounced in resource-constrained environments. Forman and Kohler 2012 discusses the competing tensions between business and social responsibilities of pharmaceutical corporations. Hernandez-Truyol and Powell 2009 examines the intersections between trade and human rights across a range of issues affecting health. Hestermeyer 2007 offers analysis of the WTO framework and includes a valuable compilation of relevant law and notable cases. Joseph 2003 presents a concise summary of the arguments in favor of patents and human rights respectively. Kinney 2010 addresses the important and under-analyzed question of how to ensure the right to health in for-profit health-care delivery systems. MacDonald 2006 is a critique of the global financial system, arguing that the current economic system exacerbates inequality. World Health Organization and World Trade Organization 2002 is an accessible publication that summarizes relevant WTO agreements and policies across a number of health-related issues.

  • Forman, Lisa, and Jillian Clare Kohler, eds. 2012. Access to medicines as a human right: Implications for pharmaceutical industry responsibility. Toronto: Univ. of Toronto Press.

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    Discusses the nature and extent of corporate duties regarding access to essential medicines as part of efforts to improve public health outcomes in low- and middle- income countries. It explores the tension between pharmaceutical companies’ social and business responsibilities, and includes interesting case studies and a useful annex, which includes the UN Special Rapporteur’s guidelines for pharmaceutical companies in relation to access to medicine.

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  • Hernandez-Truyol, Berta Esperanza, and Stephen J. Powell. 2009. Just trade: A New covenant linking trade and human rights. New York: New York Univ. Press.

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    This book comprehensively analyzes the intersections of trade and human rights. In addition to providing the foundational concepts of international law, the authors examine, in depth, human rights and free trade policies affecting labor, the environment, trafficking and bondage, indigenous populations, gender equality, poverty, and sustainable development.

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  • Hestermeyer, Holger. 2007. Human rights and the WTO: The case of patents and access to medicine. Oxford: Oxford Univ. Press.

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    A comprehensive text analyzing access to medicine as a human right and conflict between the right to health and patent rights. It provides detailed discussion of the WTO framework and enforcement mechanisms relevant to the right to access essential drugs. The book also includes a useful table of select of case law organized by jurisdiction, and important international laws and treaties relevant to the debate.

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  • Joseph, Sarah. 2003. Pharmaceutical corporations and access to drugs: The “fourth wave” of corporate human rights scrutiny. Human Rights Quarterly 25 (May): 425–452.

    DOI: 10.1353/hrq.2003.0018Save Citation »Export Citation »E-mail Citation »

    A clear summary of the debate over access to pharmaceuticals, particularly in the developing world, with HIV/AIDS drugs as the example. It analyzes arguments in favor of patents, the respective human rights duties of pharmaceutical companies and governments regarding access to drugs and patent protection, relevant WTO initiatives and global intellectual property agreements, as well as the interrelationship among patent protection, R&D, and global pricing models.

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  • Kinney, Eleanor D. 2010. Realizing the international human right to health: The challenge of for-profit health care. West Virginia Law Review 113 (Fall): 49–66.

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    An article exploring how to reconcile the economic reality of providing health-care goods and services through private, for-profit enterprise—an increasingly prominent model—with the right to health. Includes an outline of major international human rights treaties and UN bodies relevant to the recognition and enforcement of the right to health, and a critique of the role of free trade agreements in the realization of the international human right to health.

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  • MacDonald, Theodore H. 2006. Health, trade and human rights. Oxford: Radcliffe.

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    A detailed analysis and critique of the global financial system, arguing that the current system and its trade agreements sustain significant and increasing inequalities in health and other human rights violations. Particular attention is given to environmental “unsustainability,” the market forces behind powdered milk, and the HIV/AIDS epidemic as critical issues in the health, trade, and human rights debate.

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  • World Health Organization, and World Trade Organization. 2002. WTO agreements and public health: A joint study by the WHO and the WTO Secretariat. Geneva, Switzerland: World Health Organization/World Trade Organization.

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    A joint study by the WHO and the WTO Secretariat, presenting a systematic review of WTO agreements and policies relevant to health generally and specifically, including in the areas of infectious disease control, food safety, tobacco control, environment, access to drugs and vaccines, health services, food security and nutrition, and biotechnology.

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Environment

Environmental issues are having a growing impact on human populations and human health. They also have consequences for the rights of individuals, particularly among marginalized populations. Three articles are included that address select aspects of environmental impact on health: Atapattu 2004 examines issues related to climate change, including the right to a healthy environment; Barnett and Adger 2007 explores climate change’s impact on human security; and Schwartz, et al. 2006 examines the role of health professionals in responding to climate change challenges.

  • Atapattu, Sumudu. 2004. The public health impact of global environmental problems and the role of international law. American Journal of Law & Medicine 30:283–304.

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    This article highlights the significant public health implications of environmental issues and links environmental health issues to human rights discourse. It includes a detailed survey of international instruments relevant to the environment and public health. It also examines the relevant right-to-health instruments and discusses the right to a healthy environment, explaining the potential value of both procedural and substantive elements of the right.

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  • Barnett, Jon, and W. Neil Adger. 2007. Climate change, human security and violent conflict. Political Geography 26:639–655.

    DOI: 10.1016/j.polgeo.2007.03.003Save Citation »Export Citation »E-mail Citation »

    This article addresses climate change as a potential human security problem that may increase the risk of violent conflict. The article highlights the challenges of researching the ways that climate change can affect human security, and it examines research on the links between climate change and human insecurity, and between human insecurity and conflict. The article outlines a research agenda for improving the understanding of climate change’s impact on populations’ vulnerability and well-being.

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  • Schwartz, Brian S., Cindy Parker, Thomas A. Glass, and Howard Hu. 2006. Global environmental change: What can health care providers and the environmental health community do about it now? Environmental Health Perspectives 114.12: 1807–1812.

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    This commentary discusses the population health implications of climate change and the role health-care professionals can play in responses to these issue. The authors explore steps that clinical practitioners, public health professionals, and government can take to forge a robust response from the health community.

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Poverty and Development

Poverty and development overlap significantly with health and human rights issues. They implicate a broad range of rights, including but not limited to the right to survival, the right to development, the right to an adequate standard of living, the right to food, and the right to water. The articles cited here address different aspects of this topic. Marks 2005 addresses health and human rights in development. Chapman 2009 explores the interplay between human rights and the social determinants of health. Schuftan, et al. 2009 also addresses the social determinants of health, presenting a case study on advocating for broader recognition and implementation of the right to health. Braveman and Gruskin 2003 discusses health and human rights strategies for addressing poverty. Two sources—United Nations 2003 and NYU School of Law, et al. 2008—address the right to water, which has garnered increasing attention as a critical right for survival. Finally, Chilton and Rose 2009 looks at the issue of food insecurity.

Violence

Violence is a pressing issue for which both human rights and public health have developed responses. Krug, et al. 2002 is a good starting point for an overview on the issue, and it is widely cited. Mercy, et al. 1993 is the foundational public health article outlining the value of a public health response to violence. A 2003 special issue of the journal Health and Human Rights explores many aspects of health and human rights perspectives on violence, with a special emphasis on the right to safety. Pinheiro 2006 is a detailed catalog of types of harms suffered by children and the human rights law relevant in each setting. Carrillo 2002 is a good starting point for readings on violence against women. Finally, Richters 2004 provides a perspective from anthropology that highlights important issues that frequently do not receive significant attention from public health or human rights.

  • Carrillo, Roxanna. 2002. Overview of international human rights standards and other agreements and responses of the judicial system to violence against women. International Journal of Gynecology & Obstetrics 78 (Suppl. 1): S15–S20.

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    This article provides a historical overview of how violence against women came to be recognized in the international arena as a human rights issue, and how, in turn, that influenced legislative developments and judicial decisions at the national level.

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  • Gruskin, Sofia, and Alexander Butchart, eds. 2003. Special issue: Violence, health, and human rights. Health and Human Rights 6.2.

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    A collection of essays on violence from both public health and human rights perspectives, as well as integrated approaches. Issues covered include homicide, violence against women, child maltreatment, suicide, and the right to safety.

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  • Krug, Etienne G., Linda L. Dahlberg, James A. Mercy, Anthony B. Zwi, and Rafael Lozano, eds. 2002. World report on violence and health. Geneva, Switzerland: World Health Organization.

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    Seminal report on violence as a global public health issue. It discusses the nature and extent of violence globally, examining intra-family and community-based violence, violence against individuals, and collective violence. Though not a health and human rights perspective, numerous health and human rights articles on violence cite it, making this a foundational resource in this area.

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  • Mercy, James A., Mark L. Rosenberg, Kenneth E. Powell, Claire V. Broome, and William L. Roper. 1993. Public health policy for preventing violence. Health Affairs 12.4: 7–29.

    DOI: 10.1377/hlthaff.12.4.7Save Citation »Export Citation »E-mail Citation »

    Foundational article articulating the value of a public health approach to violence. The article explores the ways in which a public health approach to violence can help prevent harm from occurring.

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  • Pinheiro, Paulo Sérgio. 2006. World report on violence against children. Geneva, Switzerland: United Nations Secretary-General’s Study on Violence against Children.

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    A comprehensive report that came out of the UN Study on Violence against Children. It is an excellent source for discussion of issues of violence affecting children in the home, schools, care and justice institutions, workplace, and community, and the human rights law relevant to the violence experience by children in each setting.

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  • Richters, Annemiek. 2004. Violence, health and human rights: Challenges for medical anthropology. Medische Antropologie 16.1: 157–181.

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    This article explores violence as a health and human rights issue from an anthropological perspective. The article explores themes such as social suffering, justice, memory, and healing, and it offers anthropology case studies to illuminate the value of medical anthropologists engaging in public health and human rights issues.

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Mental Health

International human rights law states that the right to the highest attainable standard of health includes both physical and mental health. Burns 2009 is a discussion of human rights law relevant to mental health and a critique of health and human rights policies that have given short shrift to mental health issues. Dudley, et al. 2012 is a very detailed volume that offers a comprehensive source as a starting point for discussion of human rights and mental health. Drew, et al. 2011 is both a literature review and an empirical examination of mental health issues in developing countries. Gostin and Gable 2004 is an in-depth examination of relevant human rights laws and mechanisms, including a valuable discussion of regional human rights systems. Hunt and Mesquita 2006 offers a framework for recognizing and addressing mental health issues as part of the right to the highest attainable standard of health. Finally, Sarina, et al. 2011 offers a more focused study on mental health consequences of human rights violations, examining suicidal ideation in injecting drug users in India.

  • Burns, Jonathan Kenneth. 2009. Mental health and inequity: a human rights approach to inequality, discrimination, and mental disability. Health and Human Rights 11.2: 19–31.

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    This article critiques health and human rights discourses for insufficient attention to mental health issues. It analyzes the various ways discrimination on the basis of mental health manifests, reviews relevant international human rights law, and measures needed to remedy inequalities that persist related to persons with mental disabilities.

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  • Drew, Natalie, Michelle Funk, Stephen Tang, et al. 2011. Human rights violations of people with mental and psychosocial disabilities: An unresolved global crisis. The Lancet 378:1664–1675.

    DOI: 10.1016/S0140-6736(11)61458-XSave Citation »Export Citation »E-mail Citation »

    This empirical study examines and identifies the types of human rights violations experienced by people with mental and psychosocial disabilities in developing countries. The study also reviews relevant UN publications, NGO reports, and academic literature. The authors then develop evidence-based strategies to prevent these violations and to promote human rights in line with the UN Convention on the Rights of Persons with Disabilities (CRPD).

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  • Dudley, Michael, Fran Gale, and Derrick Silove. 2012. Mental health and human rights: Vision, praxis, and courage. Oxford: Oxford Univ. Press.

    DOI: 10.1093/med/9780199213962.001.0001Save Citation »Export Citation »E-mail Citation »

    A large volume in size and scope, with contributions from nearly one hundred of the field’s leading scholars and practitioners. The text surveys the overarching conceptual issues linking mental health and human rights; the interrelationship among human rights abuses, psychiatry, and markets; issues among vulnerable groups; current protections of mental health; and barriers and opportunities for the future—with particular focus on first-person narratives of mental health consumers and their caregivers.

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  • Gostin, Lawrence O., and Lance Gable. 2004. The human rights of persons with mental disabilities: A global perspective on the application of human rights principles to mental health. Maryland Law Review 63:20–121.

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    In-depth examination of the rights of persons with mental health disabilities. Includes an examination of the UN instruments and systems as well as the often overlooked regional human rights systems in Africa, the Americas, and Europe. Particular attention is given to reviewing developments in the European human rights system.

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  • Hunt, Paul, and Judith Mesquita. 2006. Mental disabilities and the human right to the highest attainable standard of health. Human Rights Quarterly 28:332–356.

    DOI: 10.1353/hrq.2006.0019Save Citation »Export Citation »E-mail Citation »

    This article explores the right to health as it relates to persons with mental disabilities. It examines relevant international and regional human rights instruments and case law on the right to health for persons with mental disabilities. The authors then propose an analytical framework rooted in the right to health for evaluating policies and programs that address or affect persons with mental disabilities.

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  • Sarina, Enisha, Luke Samson, Michael Sweat, and Chris Beyrer. 2011. Human rights abuses and suicidal ideation among male injecting drug users in Delhi, India. International Journal of Drug Policy 22:161–166.

    DOI: 10.1016/j.drugpo.2010.09.011Save Citation »Export Citation »E-mail Citation »

    Examines the human rights abuses that injecting drug users experience in India, finding that suicidal ideation, a significant predictor of suicide, is associated with a history of human rights abuses.

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Other Public Health Issues

Given the broad reach of health and human rights as a field, this section briefly highlights other important issues not covered in prior sections. Farmer 2003 is an excellent discussion of the links between health and human rights and social justice, authored by one of the leading figures in the field. It provides insights into grassroots efforts to advance a health and human rights framework. Friedman and Gostin 2012 introduces readers to the proposed Framework Convention on Global Health, highlighting its potential for advancing health-related rights. Meier and Mori 2005 offers a collective rights perspective on health and human rights, in contrast to most of the literature, which focuses on individual rights.

  • Farmer, Paul. 2003. Pathologies of power: Health human rights, and the new war on the poor. Berkeley: Univ. of California Press.

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    Drawing on extensive fieldwork experience in several countries, Farmer confronts the structural violence and other social justice issues that have adverse consequences for health and human rights. He argues for a human rights approach to health that truly addresses the needs of the poor. Highlighted are field experiences working on HIV/AIDS in Haiti, tuberculosis in Russian prisons, and poverty and health among the Chiapas in Mexico.

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  • Friedman, Eric A., and Lawrence O. Gostin. 2012. Pillars for progress on the right to health: Harnessing the potential of human rights through a framework convention on global health. Health and Human Rights 14.1: 4–19.

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    A discussion of the proposed Framework Convention on Global Health and its capacity for advancing a human rights–based approach to health. Provides useful strategies for advancing health and human rights as momentum builds for an international treaty on global health. Also contains a valuable table on human rights impact assessment toolkits.

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  • Meier, Benjamin Mason, and Larisa M. Mori. 2005. The highest attainable standard: Advancing a collective human right to public health. Columbia Human Rights Law Review 37 (Fall): 101–147.

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    Emphasizing the challenges that globalization presents for disease prevention and health promotion—particularly individuals’ diminishing control over their health status and the magnification of the societal determinants of health—the article advocates for a global public health framework utilizing international law. Notably, it argues for a conception of the right to health that includes a collective right to public health.

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Women

Cook 1995 is a foundational health and human rights article on gender discrimination and its impact of women. Cook, et al. 2003 is an important multidisciplinary analysis of reproductive health and human rights with useful case studies. Fried, et al. 2012 and Yamin and Maine 2005 are two studies on maternal mortality as a health and human rights issue. Krieger and Gruskin 2001 offers a brief comparison between human rights and public health approaches to women’s health. Roseman 2009 includes a valuable comparison between a model based on the Millennium Development Goals and a model based on a human rights approach. Finally, Murthy and Smith 2010 is a sweeping anthology that encompasses an extensive number of human rights issues affecting women.

  • Cook, Rebecca J. 1995. Gender, health and human rights. Health and Human Rights 1.4: 350–366.

    DOI: 10.2307/4065247Save Citation »Export Citation »E-mail Citation »

    Foundational article examining the impact that gender stereotyping has on women’s health and status. It discusses the value of having health-care professionals pay greater attention to the links between women’s health status and structural factors that entrench or reflect gender stereotypes. It explores the role of human rights law in addressing these challenges and improving the health status of women. Part of a theme issue on women’s health and human rights.

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  • Cook, Rebecca J., Bernard A. Dickens, and Mahmoud F. Fathalla. 2003. Reproductive health and human rights: Integrating medicine, ethics and law. New York: Oxford Univ. Press.

    DOI: 10.1093/acprof:oso/9780199241323.001.0001Save Citation »Export Citation »E-mail Citation »

    Drawing on perspectives from reproductive medicine, human rights, medical law, and bioethics, this edited volume provides a comprehensive introduction to reproductive and sexual health principles. It contains fifteen case studies and an extensive data and sources section that is a valuable starting point for further research on women’s health and human rights.

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  • Fried, Susana, Brianna Harrison, Kelly Starcevich, Corinne Whitaker, and Tiana O’Konek. 2012. Integrating interventions on maternal mortality and morbidity and HIV: A human rights–based framework and approach. Health and Human Rights 14.2: 21–33.

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    An application of a health and human rights framework to two issues having a significant impact on women’s health: maternal mortality and morbidity, and HIV/AIDS. It identifies the common structural drivers of these adverse health consequences and details how a human rights framework can shape effective responses. An important look at structural factors that shape public health issues.

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  • Krieger, Nancy, and Sofia Gruskin. 2001. Frameworks matter: Ecosocial and health and human rights perspectives on disparities in women’s health—The case of tuberculosis. Journal of the American Medical Women’s Association 56.4: 137–142.

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    Provides a case study on how a health and human rights framework might be applied to a public health issue to ensure women’s health status and rights. Includes a set of questions that a health and human rights framework would prompt. Compares the health and human rights framework to the ecosocial model.

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  • Murthy, Padmini, and Clyde Lanford Smith. 2010. Women’s global health and human rights. Sudbury, MA: Jones & Bartlett.

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    A comprehensive volume covering a very broad range of issues implicating women’s health and human rights. The volume includes chapters on gender-based violence, armed conflict, economic policies, AIDS and other diseases, cultural practices harmful to women and girls, the environment, and many other issues that affect both women’s health status and the fulfillment of their rights.

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  • Roseman, Mindy Jane. 2009. Bearing human rights: Maternal health and the promise of ICPD. In Reproductive health and human rights: The way forward. Edited by Laura Reichenbach and Mindy Jane Roseman, 91–109. Philadelphia: Univ. of Pennsylvania Press.

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    This essay critically analyzes approaches adopted by the global community to reduce maternal mortality and morbidity, with particular focus on the merits of a “human rights and empowerment approach” versus a narrow, targeted focus on achieving Millennium Development Goal 5, improving maternal health, with or without regard to rights.

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  • Yamin, Alicia E., and Deborah P. Maine. 2005. Maternal mortality as a human rights issue: Measuring compliance with international treaty obligations. In Perspectives on health and human rights. Edited by Sofia Gruskin, Michael A. Grodin, George J. Annas, and Stephen P. Marks, 427–467. New York: Routledge.

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    This article examines maternal mortality, a significant women’s rights issue. It provides considered discussion of the obligation on states under international human rights law in light of the principle of progressive realization that applies to economic, social, and cultural rights, including the right to health.

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Children

As children constitute approximately one-third of the global population, they merit particular attention in the health and human rights context. Eide and Eide 2006 is a detailed discussion of the right to health as applied to children, focusing on the meaning of the right to health under the UN Convention on the Rights of the Child. Pinheiro 2006 is a comprehensive discussion of violence issues and related human rights law. Reading, et al. 2009 is an important article on child maltreatment from a human rights perspective. Priest, et al. 2010 looks at an increasingly significant issue for children—obesity—and assesses the value of a human rights approach. Todres 2011 offers a human rights–based approach to pressing issues facing children, including violence, obesity, and substance use, highlighting the limits of relying solely on a medical model. Finally, Westra 2006 is an examination of the impact of environmental degradation on children’s health, exploring the impact on both current and future generations of children.

  • Eide, Asbjørn, and Wenche Barth Eide. 2006. Article 24: The right to health. In A commentary on the United Nations Convention on the Rights of the Child. Edited by A. Alen, J. Vande Lanotte, E. Verhellen, F. Ang, E. Berghmans, and M. Verheyde. Leiden, The Netherlands: Martinus Nijhoff.

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    A short but detailed analysis of the right to health in the UN Convention on the Rights of Child, incorporating analysis from the drafting history, general comments, and other key sources, to elucidate the content of the right.

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  • Pinheiro, Paulo Sérgio. 2006. World report on violence against children. Geneva, Switzerland: United Nations Secretary-General’s Study on Violence against Children.

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    A comprehensive report that came out of the UN Study on Violence against Children. It is an excellent source for discussion of issues of violence affecting children in the home, schools, care and justice institutions, workplace, and community, and the human rights law relevant to the violence experience by children in each setting.

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  • Priest, Naomi, Boyd Swinburn, and Elizabeth Waters. 2010. A human rights approach to childhood obesity prevention. In Preventing childhood obesity: Evidence, policy and practice. Edited by Elizabeth Waters, Boyd A. Swinburn, Jacob C. Seidell, and Ricardo Uauy, 40–45. Oxford: Wiley-Blackwell.

    DOI: 10.1002/9781444318517Save Citation »Export Citation »E-mail Citation »

    Discusses relevant sources of law—the right to health, right to adequate food, right to development, and right to be protected from harm and exploitation—and outlines a human rights approach to childhood obesity.

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  • Reading, Richard, Susan Bissell, Jeffrey Goldhagen, et al. 2009. Promotion of children’s rights and prevention of child maltreatment. The Lancet 373:332–343.

    DOI: 10.1016/S0140-6736(08)61709-2Save Citation »Export Citation »E-mail Citation »

    An assessment of the utility of a children’s rights approach to child maltreatment. It examines public health and children’s rights approaches side by side, identifying areas of common ground and potential tensions between the two approaches, ultimately concluding that the two approaches are complementary.

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  • Todres, Jonathan. 2011. Beyond the bedside: A human rights approach to adolescent health. Journal of Law and Policy 20:191–229.

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    The article examines select issues affecting adolescent health today in the United States, including violence, substance use, and obesity. It then discusses the limits of a medical model and the value of a human rights approach to these issues.

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  • Westra, Laura. 2006. Environmental justice and the rights of unborn and future generations: Law, environmental harm and the right to health. London: Earthscan.

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    This book examines the relationship between the environment and children’s health (both present and future generations). It explores the impact of consumerism and “ecocrimes” on children’s health rights, development, and well-being.

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Other Special Populations

Certain populations face unique challenges with respect to health status and the realization of their rights. This section includes resources on select populations to highlight the specific challenges confronting these populations and the complexities of implementing health and human rights policies across different target populations. Kinney 2011, Pace 2009, and World Health Organization 2003 focus on migrant populations who are vulnerable to various adverse health outcomes. Elliott, et al. 2005; Jürgens, et al. 2010; and Transform Drug Policy Foundation 2011 focus on human rights violations of, and adverse health consequences for, drug users. Weller 2010 discusses persons with disabilities, and Lines 2008 focuses on prisoners.

LAST MODIFIED: 01/30/2014

DOI: 10.1093/OBO/9780199756797-0084

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