Document Type

Article

Publication Date

7-14-2020

Abstract

The health justice framework envisions the leveraging of law and policy to advance racial and socioeconomic health equity. Health justice scholars have examined structures in need of legislative and policy reforms, both within healthcare and with regards to the social determinants of health. My article argues that access to justice is an under-examined and critical component of health justice.

This country is plagued by a massive civil "justice gap," documented extensively by the American Bar Association and just recently in a report by the American Academy of Arts and Sciences, through which individuals marginalized by virtue of race and socioeconomic status, go without legal information and representation needed to protect and enforce their rights in areas of civil legal need. The resulting under-enforcement of those rights leaves those individuals not only without access to justice, but also vulnerable to poor health. Unmet civil legal needs in the areas of housing, employment, public benefits, education, immigration, and domestic violence, for example, are all connected to well-documented social determinants of health that drive disparities. Those double burdened by virtue of race and socioeconomic status are both particularly vulnerable to the harms of lack of access to justice and to the chronic health conditions and lower life expectancy associated with health-harming legal needs.

When a tenant walks into court for an eviction hearing alone and faces a landlord's attorney with years of experience, that tenant is unlikely to raise defenses such as unsafe conditions that violate the housing code or inadequate notice of the eviction. Without enforcement of her legal rights, the day that a marshal puts her furniture and her family out on the street, as health justice scholar Dayna Bowen Matthew has posited, the "law on the streets" does not reflect the "law on the books." There is growing recognition that this misalignment is bad for the family's health, as housing insecurity and homelessness are associated with poor health and mental health, and can drive health disparities, particularly for double-burdened low-income communities of color.

Just as the health justice movement is gaining momentum in the wake of a pandemic that laid bare racial and socioeconomic health disparities, the access to justice movement is advancing in its own right, with a wave of local and state right to counsel legislation, particularly in eviction cases, and access to justice federal efforts such as increased Legal Services Corporation funding and the recent restoration of the White House House Office of Legal Aid Interagency Roundtable and the U.S. Department of Justice Office for Access to Justice. I argue in this article that access to justice is a vehicle for health justice; similarly, access to justice efforts benefit from the health justice framework. Access to justice in furtherance of health justice should include the dissemination by lawyers of legal rights information to both affected communities and interprofessional collaborators, robust access to legal representation to enforce existing (and any newly gained) rights that implicate health, and collaboration by lawyers with affected communities to advance systemic reform efforts.

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