The Law of Health Equity

Since 2025, health equity has faced increasing hostility from federal courts, agencies, and the executive branch. Yet health equity’s promise— to narrow stark health gaps along racial, economic, and other lines— remains urgent and widely endorsed by states, localities, and nongovernmental actors. Evaluating how health equity efforts might falter under or surmount these challenges requires understanding their legal underpinnings: the law of health equity. This Article is the first in legal scholarship to comprehensively examine federal, state, and private sector health equity commitments. It reveals sustained societal recognition of health equity’s importance, while highlighting the need for more precise and actionable definitions. To do so, it critically analyzes equity definitions adopted by agencies and programs at the core of American health care. It then presents a fifty-state survey of health equity definitions, finding that the vast majority of states define equity, and identifies an empirical correlation between stronger state definitions and superior performance on equity metrics. In addition to states, major metropolitan areas, large health systems, and insurers have also defined and pursued health equity. In addition to legal endorsement of equity goals, achieving health equity requires consistently and precisely defining health inequities. This Article proposes reframing the law of health equity to focus on mitigating health shortfalls that arise from social disadvantage. Existing health equity approaches that rely on universal definitions (e.g., “the attainment of the highest level of health for all people”) or group definitions (e.g., “the absence of preventable differences in health among population groups”) struggle to provide a clear and ethically compelling delineation of which shortfalls constitute inequities.