Advancing Action on Health Equity Through a Sociolegal Model of Health

Abstract

Health actors can use the law more strategically in the pursuit of health and equity by addressing governance challenges (e.g., fragmented and overlapping mandates between health and nonhealth institutions), employing a broader rights‐based discourse in the public health policy process, and collaborating with the access to justice movement. Health justice partnerships provide a road map for implementing a sociolegal model of health to reduce health inequities by strengthening legal capacities for health among the health workforce and patients. This in turn will enable them to resolve health issues with legal solutions, to dismantle service silos, and to drive systemic policy and law reform. Context In the field of public health, the law and legal systems remain a poorly understood and substantially underutilized tool to address unfair or unjust societal conditions underpinning health inequities. The aim of our article is to demonstrate the value of expanding from a social model of health to a sociolegal model of health and empowering health actors to use the law more strategically in the pursuit of health equity. Methods We propose a modified version of the framework for the social determinants of health (SDoH) equity developed by the 2008 World Health Organization Commission on the Social Determinants of Health by conceptually integrating the functions of the law as identified by the 2019 Lancet–O'Neill Institute Commission on Global Health and Law. Findings Access to justice provides a critical intersection between social models of public health and work in the justice fields. Addressing the inequities produced through the policies and institutions governing society unites the causes of those seeking to enhance access to justice and those seeking to reduce health inequities. Health justice partnerships (HJPs) are an example of a sociolegal model of health in action. Through the resolution of health issues with legal solutions at the individual level, the dismantling of service silos at the institutional level, and policy and law reform at the systemic level, HJPs demonstrate how the law can be used as a tool to reduce social and health inequities. Conclusions Greater attention to law as a tool for health creates space for increased collaboration among legal and health scholars, practitioners, and advocates, particularly those working in the areas of the social determinants of health and access to justice, and a promising avenue for reducing health inequities.

Identifying and responding to family adversity in Australian community and primary health settings: a multi-site cross sectional study

“…“Practical problems” (e.g., fines, housing notices, etc) often go unaddressed and so can dominate clinical encounters, lead to missed appointments, disrupt the practitioner-client relationship and worsen health outcomes ( 30 ). Health-justice partnerships have the potential to link health consumers with legal assistance for these practical problems to mitigate the impact of societal adversities on family mental health and wellbeing ( 31 ).…”

Workforce diversity in specialist physicians: Implications of findings for religious affiliation in Anaesthesia & Intensive Care

“…Following Schram, Boyd-Caine [ 67 ] who argue for incorporating law into the understanding of the social determinants of health and addressing of health equity, this study argues for a comprehensive programme of research to study the influence of religion and religious representation in medical specialties on health equity. The findings in this study, along with concerns for adequate cultural competence and clinician-patient relationships to improve health outcomes, support the argument that religious diversity in Anaesthesia and Intensive Case specialty needs to be further evaluated.…”

Effect of a Legal Clinic Program Within an Urban Primary Health Care Center on Social Determinants of Health: A Program Evaluation

“… 2 Previous research has found that some of these challenges (eg, discrimination in accessing housing) could be improved through the support of legal services, but populations experiencing difficulties due to SDoH frequently do not have the financial means to access legal services. 3 - 5 …”

“…7 People living in poverty have higher burdens of health problems such as mental illnesses, chronic diseases, and multiple comorbidities, and have greater difficulties in navigating and paying for health and legal services. 2 , 4 , 5 , 8 Unmet legal needs are an SDoH that jeopardise basic human needs compounding poor health and health inequities. 4 , 5 , 8 Patients living in poverty often consult their primary care providers for health issues arising from unmet legal needs.…”

“… 2 , 4 , 5 , 8 Unmet legal needs are an SDoH that jeopardise basic human needs compounding poor health and health inequities. 4 , 5 , 8 Patients living in poverty often consult their primary care providers for health issues arising from unmet legal needs. 9 , 10 Primary care professionals recognize the association between poverty, health, and legal needs but may not be equipped to provide services other than healthcare.…”