Aligning Public Health, Health Care, Law and Policy: Medical-Legal Partnership as a Multilevel Response to the Social Determinants of Health

Abstract

In the wake of the Affordable Care Act (ACA), health law scholars as well as the Institute of Medicine have argued for better integration between medicine and public health goals to advance prevention and reduce health disparities. This article explores current health care, public health, legal and public policy responses to the major driver of health disparities – the social determinants of health (SDH) – and the potential for the ACA to provide mechanisms for reducing health disparities through addressing SDH. It then argues that medical-legal partnerships, which incorporate screening for unmet legal needs and the enforcement of legal rights on behalf of individual patients, families and communities into the health care setting, serve to integrate medicine and public health. Furthermore, by incorporating legal intervention into health care, medical-legal partnerships create an effective community-level mechanism for identifying and addressing systemic and policy issues which impact the health of vulnerable populations.