Works in Progress Group #14 Racial Justice & Health Law

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Centering Critical Perspectives in Medical-Legal Partnerships

Numerous studies have documented that racism is a social determinant of health (SDoH) that contributes to racial health disparities. Medical-Legal Partnership (MLP) is a model of collaboration between lawyers and healthcare providers who seek to improve social conditions that affect health and well-being. MLPs aim to address SDoH on three levels: direct representation, institutional change, and systemic advocacy. They typically employ legal interventions to ensure that people’s basic needs, such as food, health care, and housing, are met. Improving access to such resources is an important way of engaging with the work of health equity.

While some MLPs incorporate a racial justice lens in their work, many do not. MLPs are generally more oriented toward addressing the effects of racism as a SDoH, rather than as the cause of poor health. But considering the cross-cutting nature of racism as a SDoH, MLPs can and should address it directly. Professor Makhlouf's article draws on Critical Race Theory (CRT) to reconceptualize the ways in which MLPs can address racism as a SDoH. Specifically, it highlights the unique role that MLPs can play in (1) educating lawyers and healthcare providers about inequitable power formations that cause racial health disparities, (2) sensitizing participants to the influence of intersectional discrimination through direct advocacy with and for BIPOC, (3) documenting the inadequacy of underenforced laws, and (4) including multidisciplinary approaches to understanding racial health disparities. The article concludes with a call to action for MLP participants to adopt CRT as a framework for engaging in anti-racist action.

Is a Federal Public Health Rights Act Necessary to Advance Equity in Light of Covid-19’s Disproportionate Impact on Black and Brown Communities?

Even before COVID-19 entered the global lexicon, Black and Brown communities in the United States fared far worse on various health measures than Whites. Some may write off health disparities as merely a result of personal lifestyle choices or inherent biological differences among racial and ethnic groups. However, analyzing this data through a historical context yields a fuller explanation. In fact, government-sponsored redlining policies enacted 90 years ago fostered modern-day health disparities.

Redlining adversely affected generations of Black and Brown communities. Though redlining was banned in 1968, Black and Brown redlined neighborhoods still suffer the most from poverty, lower life expectancy, chronic diseases, and poorer outcomes from COVID-19.

Studies point to a direct connection between specific health conditions and the neighborhoods adversely impacted by redlining policies. A recent report documented health disparities between two neighboring communities in Richmond, VA– one benefitted from redlining policies and the other was systemically harmed by it. The latter community was 99% non-White, had s a 21-year lower life expectancy, and a higher prevalence of the diseases that are top risk factors for Sars-COV-2. This is not an anomaly.

This pandemic has illuminated existing health disparities and widened the divide in achieving health equity. It behooves us to consider whether federal legislation should address health disparities. Given the federal government’s role in creating policies that facilitated unequal access to quality healthcare in many of the communities hit hardest by the virus, it must also bear responsibility for achieving health equity. Professor Watson's article discusses this.