What is particularly serious as an injustice is the
lack of opportunity that some may have to achieve
good health because of inadequate social arrangements,
as opposed to, say, a personal decision not
to worry about health in particular. In this sense,
an illness that is unprevented and untreated for
social reasons (because of, say, poverty or the
overwhelming force of a community-based epidemic),
rather than out of personal choice (such as
smoking or other risky behaviour by adults), has a
particularly negative relevance to social justice.
This calls for the further distinction between
health achievement and the capability to achieve
good health (which may or may not be exercised).
This is, in some cases, an important distinction,
but in most situations, health achievement tends to
be a good guide to the underlying capabilities,
since we tend to give priority to good health when
we have the real opportunity to choose (indeed
even smoking and other addictive behaviour can
also be seen in terms of a generated ‘unfreedom’ to
conquer the habit, raising issues of psychological
influences on capability – a subject I shall not
address here).