A Human Rights-Based and Relational Justice Approach to Assisted Reproduction in Spain.

Social inequities in health are a central topic of research and widely discussed across disciplines. In recent years, a wealth of studies has documented how systemic exclusion shapes access to care, opportunities, and resources, reinforcing disparities in health and health outcomes [, , , ]. Especially in the field of public health, dynamics of marginalization are increasingly recognized as key social determinants of health rather than consequences of inequities []. Social determinants of health, such as working conditions, healthcare accessibility, education, and discrimination, are known to critically shape inequities in access to health‐promoting resources [, , , ]. This includes policies that tie access to care to legal residency or employment [], neglect certain diseases [, ], or enact public health strategies that fail to account for the diversity of needs [, ]. As such, marginalization is an active process that systematically influences who has access to resources and opportunities, who is prioritized in receiving care, whose voices are heard, and whose needs remain overlooked. Recent contributions, such as a review by Baah and colleagues, analyze marginalization within the framework of social determinants of health, emphasizing social position as a key link between systemic exclusion and health inequities []. For years, institutions such as the World Health Organization (WHO) have also emphasized the importance of addressing social determinants of health and their effect on so‐called “marginalized groups” [, ]. Similarly, national institutions, such as Germany's Robert Koch‐Institute (RKI), have pointed to social inequalities in their publications [, ]. However, while such initiatives address barriers to healthcare access for certain groups, they often focus on the need for inclusion into existing structures rather than addressing how these structures themselves contribute to marginalization.