Medical–Legal Partnerships: How Legal Services can Dramatically Improve Health Outcomes, and the Missed Opportunity to Help Women Seeking Abortions

• Author: Rebecca Rubin
• DOI: http://doi.org/10.1111/fcre.12449
• Published date: 01 October 2019
• Date: 01 October 2019

FAMILY LAW WRITING COMPETITION WINNER

MEDICAL–LEGAL PARTNERSHIPS: HOW LEGAL SERVICES CAN

DRAMATICALLY IMPROVE HEALTH OUTCOMES, AND THE MISSED

OPPORTUNITY TO HELP WOMEN SEEKING ABORTIONS

Rebecca Rubin

There are significant health disparities in the United States, with low-income and minority Americans experiencing higher

rates of chronic disease and autoimmune disorders. Research has firmly established that social factors - such as malnutrition,

limited access to healthcare, and safe housing - play a critical role in these health disparities. Medical-Legal Partnerships are

a relatively new approach to improving the health of people living in poverty by addressing the root causes of these health-

harming social factors. This article discusses the benefits of Medical-Legal Partnerships and argues for continued expansion

of the model, particularly in pediatricians’offices, because parents are more likely to seek medical care for their children than

themselves. This article further discusses how legal constraints prevent federal funding for Medical-Legal Partnerships in

abortion clinics; this creates a missed opportunity to work with women who are seeking abortions, many of whom face con-

siderable social and economic challenges that could be addressed through legal assistance. This article digs into the legal

restrictions that create this missed opportunity and proposes potential solutions to better serve the vulnerable population of

abortion-seeking women.

Key Points for the Family Court Community:

Social factors create significant health disparities in the United States.

Medical–legal partnerships address health disparities by targeting the upstream legal causes of health-harming social

factors.

Legal constraints prevent federal funding for medical–legal partnerships in abortion clinics, which creates a missed

opportunity to work with a vulnerable population of women who often face considerable social and economic

challenges.

Medical providers and legal aid attorneys should push for the expansion of the medical–legal partnership model.

Federal funding restrictions should shift and medical providers should create private funding streams to increase the

presence of medical–legal partnerships in abortion clinics.

Keywords: Abortion; Health Disparities; Health-Harming Social Factors; Hyde Amendment; Medical–Legal Partnerships;

Poverty; and Social Determinants of Health.

Javana Bradford sat in the waiting room with her newborn baby, Augyst, trying to ignore the pit of

hunger in her stomach.

1

“Javana?”She stood and followed the pediatrician into a quiet room. Javana’s

pediatrician was part of a medical–legal partnership

2

(MLP)—a collaboration between a health care

facility and a legal services organization that integrates legal assistance into the health care process. In

this model, the pediatrician understood that treating Augyst effectively required a holistic assessment of

Augyst’s life. The pediat rician thus asked Javana if she envisioned any health complications for herself

over the next few months. Javana confided that she was not eating enough because she could not afford

sufficient food.

3

The MLP-trained pediatrician both recognized the relevance of this problem for Augyst

and also knew that Javana’s hunger could have a legal basis. The pediatrician referred Javana to the

MLP attorney working with the health care facility. The attorney helpedJ avana add Augyst to the family

allowance for food stamps, thus increasing the benefits and ensuring they had enough food to survive.

4

Corresponding: rrubin6@fordham.edu

FAMILY COURT REVIEW, Vol. 57 No. 4, October 2019 569–582

© 2019 Association of Family and Conciliation Courts