Intersections of System Justification Theory and Public Health Liberation: Overcoming Barriers to Health Equity

Introduction

By Grok under the supervision of Dr. Christopher Williams

In the complex landscape of social, economic, and political systems, a persistent paradox emerges: individuals frequently express a desire for transformative change yet often fail to take action beyond their routine behaviors. This discrepancy between intention and action is particularly evident in public health, where systemic inequities—such as disparities in access to care or environmental health risks—persist despite widespread acknowledgment of the need for reform. System justification theory, developed by John Jost and Mahzarin Banaji, provides a psychological lens to understand this inertia, suggesting that people defend existing systems to fulfill needs for certainty, security, and social acceptance, even when those systems are disadvantageous. Concurrently, Public Health Liberation (PHL) theory, an emerging transdiscipline rooted in African American liberation philosophy, offers a transformative framework to accelerate health equity by challenging these systemic barriers through collective action and systemic reform. This essay explores the intersections between system justification theory and PHL, highlighting how PHL’s strategies align with and extend Jost’s conditions for social change to overcome psychological and structural obstacles to health equity.

System Justification Theory: Explaining Resistance to Change

System justification theory posits that individuals have a psychological need to defend and rationalize existing social, economic, and political systems, driven by epistemic (need for certainty), existential (need for security), and relational (need for social acceptance) motives (Jost & Banaji, 1994). This need leads people, including those disadvantaged by the system, to perceive the status quo as fair and legitimate, reducing their motivation to challenge it. For example, research indicates that low-income minority groups may attribute health disparities to personal failings rather than systemic issues, thereby perpetuating inequity (PMC). In public health, this manifests as acceptance of inadequate healthcare systems or environmental injustices, such as the lead-contaminated water crises in Flint, Michigan, and Washington, DC, where initial community inaction may reflect system-justifying beliefs.

Jost’s work also identifies conditions that facilitate social change, offering pathways to overcome these psychological barriers (Interview with Prof. John T. Jost). These include:

• Articulated Alternatives: Providing clear, detailed plans for change reduces uncertainty and makes new systems imaginable.

• Real-World Examples: Observing successful changes elsewhere, such as the Arab Spring or Eastern European transitions, inspires action by demonstrating feasibility.

• Tipping Points: When movements gain critical mass, change becomes perceived as inevitable, shifting psychological support toward new systems.

• Framing Effects: Presenting change in ways that align with existing values, such as framing climate action as preserving national identity, reduces resistance, particularly among high system justifiers like conservatives.

These strategies address the psychological needs that underpin system justification, making change more palatable and actionable.

Public Health Liberation Theory: A Framework for Equity

Public Health Liberation (PHL) theory is an innovative transdiscipline aimed at accelerating health equity by reconceptualizing public health through the lens of the “public health economy”—the interplay of economic, political, and social forces that shape health outcomes (Williams et al., 2022). Rooted in African American liberation philosophy, PHL integrates diverse traditions, including sociology, women’s studies, and anti-racism, to address structural violence and historical trauma. It introduces novel constructs such as the “Gaze of the Enslaved” (an ethical research standard), the “Morality Principle” (obligating immediate intervention), “liberation” (emancipation from constraints), and “illiberation” (self-oppression or immobility), which collectively challenge systemic inequities.

PHL is structured around five interconnected components:

• Philosophy: Grounds actions in values of fairness and liberation, drawing from emancipatory traditions.

• Theories: Includes the Theory of Health Inequity Reproduction (THIR), which posits that health equity requires social mobilization, constraints on harmful conduct, and economic incentives, acknowledging the need for systemic reform.

• Praxis: Emphasizes actionable strategies like community organizing, legal action, and policy advocacy to effect change.

• Research: Advocates for agile, community-responsive research to critique power structures and support equity goals.

• Training: Equips communities with skills in law, lobbying, and media to influence the public health economy.

PHL’s focus on collective action and cultural relevance makes it a powerful tool to challenge the status quo, particularly in contexts like Flint and Washington, DC, where systemic failures have disproportionately harmed marginalized communities.

Intersections: Overcoming System Justification with PHL

The intersection of system justification theory and PHL theory lies in their shared focus on understanding and dismantling systemic barriers, particularly in public health. System justification theory explains why individuals, including those in marginalized communities, may accept health disparities as inevitable, thus hindering efforts to achieve equity. PHL, with its emphasis on liberation and empowerment, provides a counterforce by aligning its strategies with Jost’s conditions for social change and directly addressing the psychological and structural mechanisms of system justification.

Aligning PHL with Jost’s Conditions for Change

1. Articulated Alternatives: PHL’s theoretical frameworks, such as THIR, provide clear alternatives to the current public health system. THIR suggests that health equity requires social mobilization, policy reform, and economic incentives, offering a roadmap that reduces the uncertainty associated with change. By articulating these alternatives, PHL addresses the epistemic need for certainty, countering the tendency to justify existing systems.

2. Real-World Examples: PHL’s praxis component involves community-led initiatives that create tangible successes, such as advocacy campaigns addressing environmental injustices. These examples demonstrate that change is feasible, reducing existential fears and inspiring further action. For instance, community organizing in response to the Flint water crisis can serve as a model for other communities, aligning with Jost’s emphasis on observable successes.

3. Tipping Points: PHL’s focus on collective action fosters the momentum needed to reach tipping points where systemic change becomes inevitable. By building community capacity and solidarity, PHL creates environments where individuals feel supported in challenging the status quo, shifting psychological support toward new systems.

4. Framing Effects: PHL’s culturally relevant approach ensures that health equity initiatives resonate with communities’ values and experiences. For example, framing health interventions as part of a broader struggle for justice and liberation appeals to marginalized groups’ sense of identity, making change more compelling and reducing resistance among system justifiers.

PHL Concepts Countering System Justification

PHL’s novel constructs directly challenge the mechanisms of system justification:

• Liberation vs. Illiberation: The concept of “illiberation” mirrors the immobilization caused by system justification, where individuals accept their disadvantaged status. PHL’s goal of “liberation” empowers communities to break free from this self-oppression, encouraging critical awareness and action against unjust systems.

• Public Health Realism: PHL’s recognition of the public health economy as anarchic, with competing self-interests, aligns with system justification’s view of power dynamics maintaining the status quo. By strategizing to navigate these dynamics, PHL disrupts entrenched interests that perpetuate inequities.

• Hegemonic Theory: PHL’s focus on countering dominant powers that exploit vulnerable communities directly addresses how system justification serves as a tool of hegemony, where the oppressed internalize and justify their oppression.

Empirical Insights and Applications

Research supports the relevance of system justification in public health contexts. For instance, a study found that system justification mediates the persistence of toxic work environments in healthcare, where employees justify dysfunctional systems, perpetuating bullying and compromising patient safety (PubMed). PHL’s creation of “liberation safe spaces” can counteract this by fostering environments where critical reflection and collective action are encouraged, reducing the social costs of challenging the system.

Case studies like the Flint and Washington, DC, water crises illustrate how system justification may initially delay community action, as residents accept assurances from authorities. PHL’s praxis, such as community organizing and legal advocacy, empowers residents to challenge these failures, aligning with Jost’s strategies for change. By generating evidence through community-responsive research, PHL further challenges system-justifying narratives, making disparities visible and actionable.

Challenges and Considerations

While PHL offers a robust framework, challenges remain. System justification is deeply ingrained, particularly in contexts with strong historical trust in institutions. PHL’s effectiveness may vary depending on community readiness and resource availability. Additionally, the transdisciplinary nature of PHL requires coordination across diverse fields, which can be resource-intensive. Future research should explore how PHL’s strategies can be scaled and adapted to different cultural and historical contexts to maximize impact.

Conclusion

The synthesis of system justification theory and Public Health Liberation theory provides a powerful framework for understanding and addressing barriers to health equity. System justification theory illuminates why individuals resist change, even when it benefits them, due to psychological needs for certainty, security, and social acceptance. PHL counters these barriers by offering articulated alternatives, fostering collective action, generating evidence, and framing change in culturally relevant ways. By aligning with Jost’s conditions for social change and introducing concepts like liberation and public health realism, PHL empowers communities to challenge systemic inequities and transform the public health landscape. As public health continues to evolve, integrating psychological insights with innovative frameworks like PHL will be essential for creating lasting, equitable change.