Accountability as Self-Determination: Abolitionist conceptions of health, wellbeing, and safety

Soc Sci Med. 2026 Jan 14;392:118970. doi: 10.1016/j.socscimed.2026.118970. Online ahead of print.

ABSTRACT

Carceral paradigms and practices of punishment are widely understood to have devastating consequences for individual and community health. In response, abolitionist practitioners, organizers, and scholars have conceptualized forms of non-punitive accountability as a remedy to harm and violence, primarily through the practices and politics of restorative and transformative justice. Despite clear evidence punishment harms health and wellbeing, virtually no research has explored if and how accountability-based approaches may impact health and wellbeing for people who have caused harm. This conceptual article examines and theorizes accountability as one basis of how abolitionist politics and practice function as an affirmative social determinant of health. We argue that non-punitive accountability – understood through the theoretical, political and practice frameworks of abolition, and restorative and transformative justice – has the potential to positively impact health and wellbeing. Specifically, we assert that accountability practices adopted by groups and communities grounded in abolitionist politics and guided by principles of agency and self-determination, and commitments to challenging both state and interpersonal violence, can act as affirmative social determinants of health. Abolitionist frameworks for considering health and wellbeing are explored followed by a critical analysis of how agency in restorative justice and self-determination in transformative justice function both theoretically and practically – not only as key distinctions between accountability and punishment, but as foundational elements for improved health and wellbeing. We then analyze existing practice-based research that suggests a positive correlation between accountability and health and conclude with implications for practice, discourse, and future research.

PMID:41547055 | DOI:10.1016/j.socscimed.2026.118970