 Public health professionals and policymakers are well aware, however, of concerns that the health maximizing approach to public health can often perpetuate and even exacerbate existing injustices in health and human well-being. At least since the 1990s, ethics scholars have challenged public health to look beyond efficiency to address other, generally egalitarian concerns of justice. Activists concerned about racial, gender and other social group injustices also frequently call on public health institutions to pursue health equity, particularly by reducing what are viewed as unjust health disparities.