Preventive law becomes preventive medicine

In a commentary to appear in the Oct. 22 issue of the journal Pediatrics, Barry Zuckerman, MD, the Joel and Barbara Alpert Professor of Pediatrics at Boston University School of Medicine, discusses how by working together, lawyers and physicians potentially can close the gap in health disparities that persist even in universal health care coverage.

While the relationship between poverty and poor health is complex, access to basic needs like adequate housing and nutrition, appropriate education and personal safety is well documented to improve health trajectories.

According to Zuckerman the article by Beck, et al in Pediatrics represents a special example of how a multidisciplinary approach to social determinants of health initiated from a primary care setting can address poor housing conditions and reduce risk for asthma for individual patients and for a population. "When families do not receive the benefits or protections of certain laws, their health can be undermined. The consequences can be treated medically, but their upstream causes are social and are more effectively addressed using legal strategies," said Zuckerman.

A recent report estimates that 50 to 85 percent of health center users – between 10 and 17 million people – experience unmet legal needs, many of which impact their health. Most at-risk individuals may not know that their problems have legal solutions. Medical-Legal Partnerships, founded by Zuckerman at Boston Medical Center in 1993 for children, helps parents navigate the complex government and legal systems that often hold solutions for many social determinants of poor health.

"The team's role is to identify early unmet legal needs that cause or exacerbate child health problems. Once identified, lawyers bring critical skills to complement the expertise of the health care team," explained Zuckerman.

By reducing the impact of legal determinants that affect health, this creative partnership in clinical settings will compliment increased access to health care provided by recent health care reforms.

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