Date of Graduation

Fall 12-14-2012

Document Type

Project

Degree Name

Master of Public Affairs (MoPA)

Department/Program

Leo T. McCarthy Center for Public Service and the Common Good

First Advisor

Corey Cook, PhD, Associate Professor, Department of Politics, USF

Second Advisor

Ronald R. Sundstrom, PhD, Associate Professor of Philosophy, USF

Third Advisor

Tomás J. Aragón, MD, DrPH, Health Officer, City and County of San Francisco

Abstract

Health equity is the social justice lens that public health institutions across the United States have increasingly embraced as a mandate, however there are few jurisdictions addressing how to prioritize funding toward that end. The practical translation of a social justice concept necessitates the creation of a budgetary tool and an implementation process that identifies those with the highest levels of health disparity and social disadvantage.

Using the San Francisco Department of Public Health (SFDPH) as its central case, this paper argues that for health delivery systems to be socially just and to achieve health equity, these systems must not only establish the principle that health equity is important, they must prioritize their funding to achieve it. The broad public health mission to protect and promote the health of all will create ethical and methodological challenges when it comes to prioritizing one group’s needs over others.

This paper addresses the first steps toward creating a budget prioritization method that is feasible for managers to administer while also being transparent to the public, summarizes lessons learned, and discusses ethical dilemmas that jurisdictions will face when implementing health equity into a budgetary process.

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