Relational Equality and Health

IV through VII consider various ways in which questions concerning health and healthcare resources could be addressed within a relational framework.Here, we discuss possible implications of the relational approach for health care, inequalities in health, and health policy.As we suggest, while there are some important considerations about health that a relational perspective can add to current debates (particularly when it comes to health policy and the kinds of strategies we pursue to improve population health and/or reduce health inequalities), many of the more specific implications of the relational perspective for health remain unclear.Section VIII concludes. II. RELATIONAL EQUALITYThe family of views we refer to as "relational" has, to a large extent, been developed in opposition to a growing literature that regards questions of equality as concerned with the fairness of distributions of one or more relevant goods in a certain population.On such accounts, the aim is to determine the conditions under which a distribution -of income, resources, well-being, or some other "currency" of justicecan be considered fair or unfair. 5Relational theories, on the other hand, view equality as a social and political value and are primarily concerned with "egalitarian social relations." 6This approach has been developed in two different directions.On the first, the primary concern is that individuals (or citizens) should relate to one another as equals; different versions of this social objective have been referred to as "equality of status," 7 "social equality," 8 or "democratic equality." 9While these approaches differ in various respects, they all single out phenomena such as oppression and status hierarchies as problematic.The phrase "a society of equals" 10 is often used to characterize the ideal of society these views envisage.The second family of relational approaches focuses on how institutions treat, and the attitudes they express toward, individuals. 11For such approaches, neglectful, disrespectful, or intentionally harmful treatment by institutions toward citizens is considered to be the primary target of egalitarian concern.It is important to understand the precise disagreement between relational and distributive perspectives, not least because there is significant overlap in the kinds of scenarios each of these two accounts identifies as problematic.On the one hand, distributive egalitarians can acknowledge that the issues of central importance to the relational egalitarian -i.e., the quality of social relations -matter, but believe that they can be captured within a distributive framework.For example, relational "goods" could to some extent be accounted for within a distributive conception of equality by including "status" or "respect" as one of the things that ought to be distributed in a particular way. 12Accounts that view distributive equality as the sole requirement of justice are also consistent with the view that justice requirements must be weighed against relational considerations (which would then be described as non-justice requirements).For example, in G. A. Cohen's account, the value of "community," which captures considerations similar to those that lie at the heart of relational accounts, seems to compete with the pursuit of justice (understood as distributive equality) in this manner. 13lational egalitarians, on the other hand, often allow that their approach has distributive implications.In particular, at least some relational egalitarians argue that limits must be placed on permissible levels of income inequality.Thus, relational