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Towards Justice in Health

Our current featured article is by one of nursing’s prominent scholars advocating for social justice in nursing and health care – Adeline Falk-Rafael, PhD, RN, FAAN.  For this article, she and her colleague Patricia A Bradley, PhD, MEd,RN report a critical contextual analysis of 6 issues of a magazine published by “Nurses for Social Responsibility” between 1992 and 1995.  In the article, titled “Towards Justice in Health.”An Exemplar of Speaking Truth to Power, Drs. Falk-Rafael and Bradley bear witness to a voice that has been largely absent in the nursing literature, as well as providing evidence of a significant grassroots effort to seek social justice in nursing and health care.  Visit the ANS web site today to download your no-cost copy of this article, and return here to add your comments, questions and responses to their article!

Dr. Falk-Rafael and Dr. Bradley have shared their perspectives on this work, and have also invited two of the nurses responsible for the magazine to also speak here to ANS readers! 

From Adeline Falk-Rafael:

I had become aware of a group of nurses calling themselves the Nurses for Social Responsibility (NSR) in Toronto, Ontario in the mid-1990s while working on my doctoral dissertation. I had known some of the nurses both professionally and by reputation as their

Adeline Falk=Rafael

Adeline Falk=Rafael

advocacy activities for homeless persons often were reported in the media. Both Cathy Crowe

and Kathy Hardill have been guest speakers in my community health nursing course at York University and on one occasion several years ago, Cathy shared the 6 issues of the magazine this group had produced in the early 1990s, Toward Justice in Health (TJH). Her hope and mine was that they would serve as the focus for a textual or content analysis as a graduate student project. Although I was never able to interest a graduate student in this research, the opportunity finally presented itself for me to begin such an analysis. As I began the process, I realized that I needed a colleague with expertise first in selecting the most appropriate methodology for such a textual analysis and secondly in conducting the analysis. I am so grateful that Pat Bradley agreed to work on this project with me.

From the initial reading of the magazines, through the analysis and writing of the findings, I never cease to be amazed at the foresight and courage that a small group of nurses with a passion for social justice of which Florence Nightingale, Lillian Wald, Lavinia Dock, and other early nursing leaders would be proud. My hope is that this effort to make visible their efforts will inspire others similarly to advocate for transformative societal changes and reverse social injustices that result from public policies and social norms that privilege a few and disenfranchise so many.

From Patricia Bradley

I was not living in Ontario during the mid-1990s and was not aware of the Nurses for Social Responsibility (NSR). I was introduced to their history when Adeline Falk-Rafael graciously

Patricia Bradley

Patricia Bradley

invited me to be part of the analysis of the magazines. Through the process, and meaningful dialogue with Adeline, there was an opportunity to uncover the power and strength that resided in these nurses and to reveal the subsequent realm of possibilities when nurses gather together for a cause. The journey towards change is not always easy or easy to maintain. I wonder how many other silent nursing histories exist and what they can teach us about change and the momentum of change for social justice. These invisible nursing histories need to be brought into the light so we can all learn and be inspired.


We’ve invited 2 of the original founders of TJH –Cathy Crowe and Kathy Hardill – to reflect on their experiences more than 20 years ago and add their recollections of the challenges and successes of producing TJH:

From Cathy Crowe  

I’m so proud that a period of Canadian nursing feminism and activism is now recorded for

Cathy Crowe

Cathy Crowe

future generations to learn from. At the time, It seemed incongruous to have ‘peace, shelter, social justice, etc. as prerequisites for health’ drilled into us in nursing school (Ottawa Charter for Health Promotion, the Alma-Ata Declaration), while at the same time the same schools neglected to teach even a basic Economics 101 or Politics 101 to teach about the role globalization or militarization play in diverting resources away from healthy public policies such as daycare, affordable housing or decent welfare rates. I can only call it intentional neglect. So at NSR we taught ourselves, the whole while sharing our learnings with the public and other nurses in some of the most creative means I have ever seen.

"Justice In Health" (white cover)

“Justice In Health” (white cover)

This is a picture I took of our magazine on display with other prominent feminist publications in the window of the  ‘This Ain’t the Rosedale Library’ bookstore in Toronto.

From Kathy Hardill

Reading the analysis of “Towards Justice in Health” brought me back to a time that was “heady” with promise and potential for nurse activism. It was a tumultuous time on the planet

Kathy Hardill

Kathy Hardill

and, looking back, so much has changed. I find myself having to explain the nuclear arms race to younger people, not to mention the Cold War and the Berlin wall. I was recently reminded of a meeting I and others attended with representatives from the Registered Nurses Association of Ontario (RNAO) in about 1990 where we argued that organized nursing ought to speak out about homelessness. The nurses across the table from us blinked a few times and said “But what has homelessness got to do with nursing?”

For sure, times have changed! RNAO understands homelessness and many other upstream issues and has become outspoken on these issues within the parameters of its role. Although the language of TJH may at times have been “provocative, strident, and outrageous,” when I listen for the voices of progressive, radical nurses now, I strain to hear anything at all. The most progressive anti-poverty health care voices in Ontario at the moment are from medicine. Progressive nursing needs a radical rebirth in the 21st century!

6 Comments Post a comment
  1. Dorothea Fox Jakob #

    The article documents the strength, courage, sensitivity and boldness that NSR offered to nurses in Toronto, Ontario, Canada. Thank you, Adeline and Patricia for analyzing the 6 issues of Justice in Health. Thank you to NSR.
    Many of the NSR members also were participants in the early Street Nurses Network in Toronto. They served as models for social action for the group. It was the work of NSR that encouraged members of the Street Nurses Network to make a submission on September 30, 1998 to the U.N. Committee on Economic, Social and Cultural Rights regarding Canada’s Implementation of the International Covenant on Economic, Social and Cultural Rights. Within the conclusion of the document is the following statement: “It is difficult to avoid concluding that the Canadian State has grossly violated the Articles of the International Covenant aforementioned.” Not much has changed to the better for the most vulnerable people in Canada by 2014.

    August 20, 2014
  2. Dorothea Fox Jakob #

    For readers who would like a sense of 2014 Canadian poverty demographics, you can review the following:
    “Social Determinants of Health: The Canadian Facts” by Juha Mikkonen and Dennis Raphael;
    “An Alternative Federal Budget: Striking a Better Balance” by The Canadian Centre for Policy Alternatives; and
    Campaign 2000, the “August 6, 2014 Submission to Federal Pre-budget Consultation” by Laurel Rothman.

    August 21, 2014
  3. Thank you for this blogpost and the article it is based from. A group of us Nursing teachers discussed this issue of ANS in Auckland New Zealand this morning – we were all inspired and challenged by the passion of our colleagues as they grapple with making nursing more humane and committed to social justice.

    December 10, 2014
    • Thank you so much for this feedback!! It is great to hear from you!

      December 11, 2014

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