The challenges that patients and their families experience to access care for chronic health conditions often make the health professionals responsible for their care feel powerless. At times, it may be convenient to lay the blame for these challenges on a singular group, such as policymakers or the health insurance system. However, the true reasons such challenges exist are much more complex, multifactorial, and interrelated. A broader systemic analysis and broader vision is needed to integrate the sociocultural context and place a particular focus on vulnerable, underserved populations, including older adults, people living in densely populated areas, people with lower socioeconomic status, migrants, and minorities¹1 Shadmi E, Chen Y, Dourado I, Faran-Perach I, Furler J, Hangoma P, Hanvoravongchai P, Obando C, Petrosyan V, Rao KD, Ruano AL, Shi L, de Souza LE, Spitzer-Shohat S, Sturgiss E, Suphanchaimat R, Uribe MV, Willems S. Health equity and COVID-19: global perspectives. Int J Equity Health 2020; 19(1):104.. In this context, equity and social justice are constructs that may only feasible in a Utopia but are essential to effect change moving forward.

Social justice as a concept is quite appealing and should be fully embraced by all health care professions²2 Arena R, Laddu D, Severin R, Hall G, Bond S, HL-PIVOT Network. Healthy living and social justice: addressing the current syndemic in underserved communities. J Cardiopulm Rehabil Prev 2021; 41(3):E5-E6.. The concept professes that all people should have equal access to wealth, well-being, privilege, opportunity, and health regardless of legal, political, economic, or other circumstances³3 Braveman PA, Kumanyika S, Fielding J, Laveist T, Borrell LN., Manderscheid R, Troutman A. Health disparities and health equity: the issue is justice. Am J Public Health 2011, 101(Suppl. 1):S149-S155.. Moreover, this concept focuses on dimensions beyond civil or criminal law principles and the relationship between individuals and society to lead fulfilling lives. Therefore, social justice is relatable and universal for all regions in the world.

Latin America as a region hosts many countries that share numerous commonalities. Prior to the coronavirus disease 2019 (COVID-19) pandemic, there were significant health related challenges in Latin America, including prescription drug shortages, lack of access to healthy food or primary care for migrants, and homelessness. According to the GINI Index, Latin America is the most inequitable region globally; 185 million people’s income is below the poverty threshold, of whom 66 million live in extreme poverty⁴4 Garcia PJ, Alarcón A, Bayer A, Buss P, Guerra G, Ribeiro H, Rojas K, Saenz R, Salgado de Snyder N, Solimano G, Torres R, Tobar S, Tuesca R, Vargas G, Atun R. COVID-19 response in Latin America. Am J Trop Med Hyg 2020; 103(5): 1765.. While these underserved communities support each other to supplement these shortcomings by working with local movements, food banks, and religious organizations, significant challenges remain.

The current approach to health care in underrepresented individuals who live in underserved communities is no longer sustainable. The way forward must include healthy living medicine (HLM) as a foundation, at its core promoting physical activity, good nutrition, average body weight, and not smoking. On a systemic level, this cultural change refers to the establishment of policies and practices.

The promise or possibility of being is here in Latin America. This approach needs to embrace the concept of social justice so that all individuals in the population have similar opportunities to embrace a healthy lifestyle and minimize the deleterious effects of chronic disease.

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