Closing the Health Justice Gap: Access to Justice in Furtherance of Health Equity

Abstract

A massive civil “justice gap” plagues the United States. Every day, low-income Americans—and disproportionately people of color—go without the legal information and representation they need to enforce their rights. This can cost them their homes, jobs, food security, or children. But unmet civil legal needs in housing, employment, and public benefits, for example, are not simply injustices—they are well-documented drivers of poor health, or social determinants of health. Those marginalized by virtue of both race and socioeconomic status are particularly harmed by inaccessibility to justice and also by chronic health conditions and lower life expectancy. When a tenant walks into court alone for an eviction hearing and faces an experienced landlord’s attorney, the tenant is unlikely to prevail, and her eviction can lead to myriad poor health outcomes.

The health justice movement leverages law and policy to advance health equity. In recent years, it has gained tremendous traction, especially due to the COVID-19 pandemic’s spotlight on health disparities. In tandem, the access to justice movement is progressing with the advancement of major federal, state, and local legislation and initiatives. However, the movements have been running on parallel tracks, and their connections have been under-examined. This Article puts the two movements and bodies of scholarship squarely in dialogue with one another.

True access to justice cannot be attained without leveraging law and policy in pursuit of health equity. There can be no justice for those who lack an equal opportunity to achieve health and well-being. This Article offers a new model for access to justice interventions defined by adherence to three core principles of health justice. To further health equity, access to justice strategies must (1) facilitate enforcement of extant laws; (2) elevate the power of affected individuals and communities; and (3) advance structural law and policy reform. Informed by the health justice framework, this model will allow the access to justice movement to realize its ultimate aspiration of social equality and provide for a healthier nation.

Keywords: health justice, access to justice, poverty, health disparities, civil rights, housing

JEL Classification: K00