title: Denaturalizing scarcity: a strategy of enquiry for public- health ethics.
abstract: Most scarcities that underpin health disparities within and among countries are not natural; rather, they result from policy choices and the operation of social institutions. Using examples from the United States of America: the Chicago heat wave and hurricane Katrina, this paper develops "denaturalizing scarcity" as a strategy for enquiry to inform public-health ethics in an interconnected world. It first describes some of the resource scarcities that are of greatest concern from a public-health perspective, and then outlines two (not mutually exclusive) lines of ethical reasoning that demonstrate their importance. One of these involves the multiple relationships that link rich and poor across national borders in today's interconnected world. The paper then briefly describes ways in which globalization and the associated institutions are linked to health-threatening scarcities. The paper concludes that denaturalizing scarcity represents a valuable alternative to mainstream health ethics, directing our attention instead to why some settings are "resource poor" and others are not.
authors.affiliation: University of Ottawa, Ottawa, ON, Canada. tschrecker@sympatico.ca).
authors.forename: Ted
authors.initials: T
authors.lastname: Schrecker
mesh_terms: D003906:Developing Countries / Q000191:economics; D014943:Global Health; D006292:Health Priorities; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities; D006801:Humans; D038622:Internationality; D011203:Poverty; D011204:Poverty Areas; D011634:Public Health / Q000941:ethics*; D040841:Resource Allocation / Q000941:ethics*; D012941:Social Responsibility; D026712:Value of Life
references.citation: Obes Rev. 2006 Feb;7(1):5-12
references.pmid: 16436098
references.citation: Lancet. 2005 Jun 25-Jul 1;365(9478):2193-200
references.pmid: 15978927
references.citation: PLoS Med. 2007 Oct;4(10):1561-6
references.pmid: 17958462
references.citation: J Epidemiol Community Health. 2006 Nov;60(11):998-1003
references.pmid: 17053290
references.citation: Lancet. 2007 Sep 29;370(9593):1153-63
references.pmid: 17905168
references.citation: Int J Health Serv. 2007;37(1):63-87
references.pmid: 17436986
references.citation: Global Health. 2007 Jun 19;3:6
references.pmid: 17578569
references.citation: Global Health. 2008 Mar 25;4:6
references.pmid: 18364048
references.citation: Environ Health Perspect. 2002 May;110(5):537-42
references.pmid: 12003760