This article develops a comprehensive and theoretically integrated account of equality, justice, reciprocity, and their consequences for social life, organizational structures, and human health. Drawing strictly on the provided philosophical, sociological, and organizational health psychology literature, the paper brings into dialogue normative political philosophy with empirical research on organizational justice and effort–reward imbalance. The central argument is that equality is not merely a distributive ideal but a relational and institutional achievement that shapes moral standing, epistemic recognition, social cooperation, and embodied well-being. Beginning with philosophical debates on equality, responsibility, moral harm, and the non-identity problem, the article situates justice as a condition of social relations rather than a purely outcome-based metric. It then examines migration, settler colonial expansion, and global labor mobility as structural contexts in which equality and injustice are historically produced and reproduced. The analysis proceeds to organizational life, where theories of reciprocity, equity, procedural justice, and relational justice are examined in depth and linked to robust evidence on cardiovascular disease, mental health outcomes, and mortality. By synthesizing these domains, the article demonstrates that injustice operates simultaneously at moral, social, epistemic, and physiological levels. The discussion highlights how organizational injustice and effort–reward imbalance function as complementary stressors rooted in violated norms of reciprocity and respect. The article concludes by arguing that policy responses must move beyond narrow economic incentives toward institutional designs that uphold dignity, voice, and fair recognition as prerequisites for both social equality and population health.

Organizational justice has emerged as one of the most powerful psychosocial predictors of employee health, wellbeing, and long term mortality. Across organizational psychology, occupational medicine, and social theory, evidence has accumulated that perceptions of fairness in decision making, interpersonal treatment, and reward allocation are not merely subjective evaluations but deeply embodied experiences that shape physiological, emotional, and moral responses. This article develops a comprehensive theoretical and empirical synthesis of organizational justice by integrating epidemiological research on work stress and health with philosophical accounts of moral recognition, reciprocity, and injustice. Drawing exclusively on foundational studies in organizational justice, effort reward imbalance, and psychosocial stress, as well as moral and political philosophy, the article argues that injustice at work constitutes a form of social harm that operates simultaneously at psychological, biological, and ethical levels.

Building on the pioneering work of Elovainio, Kivimaki, Vahtera, Ferrie, Siegrist, and their collaborators, the article shows how unfair treatment predicts cardiovascular disease, psychiatric morbidity, and mortality through mechanisms of chronic stress, neuroendocrine dysregulation, and erosion of social trust. At the same time, drawing on Fricker’s theory of epistemic injustice, Fanon’s analysis of structural oppression, and Strawson’s account of moral emotions, the article demonstrates that organizational injustice also undermines workers’ standing as knowers, moral agents, and socially recognized persons. These moral injuries intensify physiological stress responses by destabilizing expectations of reciprocity and dignity.

The article advances a multidimensional model in which distributive, procedural, and interactional justice function as institutionalized expressions of social reciprocity. When these are violated, workers experience not only material deprivation but also moral devaluation. This dual harm explains why injustice at work predicts health outcomes more strongly than many traditional biomedical risk factors. The article also critically examines debates about causation versus correlation, showing how longitudinal cohort studies, natural experiments, and theoretical integration support a causal interpretation of justice as a determinant of health.

By linking organizational justice research to broader debates in moral philosophy on harm, responsibility, and the non identity problem, the article situates workplace injustice within a wider ethical framework of social creation and institutional design. It concludes by arguing that promoting justice at work is not merely an organizational best practice but a public health and moral imperative. Future research directions are outlined, emphasizing the need for deeper integration of psychosocial epidemiology, ethical theory, and migration studies in a globalizing labor market.