Abstract

Empirical research shows the significant negative effects inequality has on aspects such as public health, vulnerability to violence, and social trust. While the majority of researchers agree that there exist specific social determinants of health (SDH) as well as a distinct social gradient in health (SGH), there is wide disagreement both over what the exact causal relationship between social inequalities and health is, and what the adequate policy responses especially to the SGH are. For policy-oriented theorists, the question arises which (if any) normative implications these empirical findings offer for philosophers working on equality.

This paper argues that the first lesson philosophers should take away from the empirical literature is that the issue that needs to be addressed is harmful social inequality, rather than unequal material distributions, or unequal opportunities and starting gates as such. That is to say, inequality with respect to a specific feature X (such as material distributions, or opportunities) is not—in itself—the problem, but the problem are the negative effects of certain harmful forms of complex social inequalities. For our normative analysis this entails that we should focus on the conceptualization of the ideal of social equality, and the kinds of relationships and institutional arrangements compatible with it.

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