The United States prides itself on the notion of “liberty and justice for all.” The reality is that people, including children, navigate the legal system alone. Unrepresented people have to be their own advocates in a daunting system. The implications of self-representation involve negative repercussions for a person’s — and their community’s — well-being.
Low-income Americans cannot afford legal assistance. Vulnerable populations such as women, people of color, and the elderly are more likely to be low-income. In 2017, the Legal Services Corporation, the largest funder of legal aid in the United States, found that 1.1 million people eligible for legal assistance were rejected or their needs were insufficiently met. By one estimate, 80 percent of the civil legal needs of the poor and 50 percent of the civil legal needs of middle-income people are not met. Ultimately, these severe disparities ensue in what many call the civil “justice gap.”
The public defender system (granted it is not a perfect system) does not extend to civil issues, which include matters pertaining to and impacting people’s health. Given the importance of these issues to people’s livelihood, a lack of legal assistance is a critical public health issue.
An example: housing issues
To illustrate, poor upkeep of affordable housing complexes may result in the growth of mold and other contaminants that directly impact the health of the tenants. Without legal assistance, tenants of these buildings are often unable to navigate the legal process to ensure that their right to adequate housing is met. Affordable housing does not and should not equate to substandard living conditions for people. Communities living in poverty, or communities living off of very few dollars, bear the burden of defending their wellness by seeking legal assistance in response to poor social conditions. Because of the uncertainty of their situation, they may face increased levels of stress, fear, and anxiety that contributes to isolation from seeking out legal remedies.
Affordable housing is only one example of where unmet legal needs and poor social services are a disservice to the most vulnerable. This is similarly seen in the maintenance of the roads in impoverished communities, access to reliable and safe transportation, and availability of fresh and affordable produce, among many others.
In an effort to mitigate this crisis, physicians and lawyers have aligned to use their combined resources to help their clients more appropriately and efficiently. The emergence of medical-legal partnerships stems originally from a 1975 California case banning the use of short-handled hoes by farm workers because it resulted in crippling back injuries due to the constant bending over. Following this, medical-legal partnerships across the nation have advanced public health in ways that have created legal outlets to ensure and protect people’s health. Mitchell | Hamline School of Law’s Health Institute and St. Paul’s Family Tree Clinic are just a couple of examples of these partnerships in Minnesota.
Trying to address the justice gap
To specifically address the lack of legal representation, the Minnesota State Bar Association (MSBA) formed the Alternative Legal Models Task Force. The report outlined multiple avenues for the MSBA to pursue in order to address the justice gap in Minnesota through licensing paraprofessionals to provide legal services independently like in Washington and Utah. Unfortunately, the report’s recommendations were voted against. Thinking along these lines of innovation, medical-legal partnerships should develop integrated professionals that address public health issues that can be remedied through legal avenues. Innovation is key because access to legal services should not only exist as a reaction to injustice for vulnerable communities.
This one solution cannot conclusively address all the implications of health disparities, the justice gap, and the impacts of poverty. We aim to help direct the discussion toward greater collaboration between professions. We need to frame public health and the justice gap as interconnected rather than entirely distinct from each other. Transforming legal services to integrate comprehensive definitions and concepts of health will not only benefit the most marginalized communities, but the health and well-being of the greater society.
Minnesota, and the nation more broadly, need to further integrate public health and legal service delivery to help enrich and sustain communities. Ultimately, we need to create conditions for communities to define and protect their health for there truly to be justice for all.
Conner Suddick is a Hamline University student studying legal studies and social justice who is dedicated to addressing the structural barriers of accessing the legal system; he was recognized as a 2018 Truman Scholar for his community involvement. Raie Gessesse is a student at Hamline studying public health and public service who is deeply passionate about the advancement of health equity through public policy and legal advocacy.
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