234324 Lawyers Helping Doctors? Medical-legal partnerships as a vehicle for social change

Monday, November 8, 2010

Ilene Albala , Socio-medical Science division of History and Ethics, Columbia University Mailman School of Public Health, New York, NY
The classic public health dilemma: a child with severe asthma is treated with medication, only to return home to an apartment full of cockroaches and mold. While physicians treat the child's asthma, he/she is seemingly powerless to improve the child's living conditions. Purpose: To highlight the “medical-legal partnership” (MLP) as a vehicle for social change. MLPs provide patients and physicians with the power to improve health outcomes by addressing the problem of access to resources.

Significance: Traditional models of public health prevention have focused on specific disease causalities, without addressing fundamental causes of disease, such as access to resources driven by poverty. The MLP model is an interdisciplinary approach to public health prevention which aims at targeting barriers to improved health, including lack of food, housing, and disability benefits. Lawyers in MLPs assist patients in resolving conflict with landlord-tenant disputes, social security disability, and Medicaid issues. Methods: New York Legal Assistance Group LegalHealth department (NYLAG) is one such model which serves a low-income, urban population in New York City. Founded in 2001 NYLAG LegalHealth assists clients at no fee in 17 hospitals and medical clinics throughout NYC. Results: The study of NYLAG has revealed that the program has improved health outcomes in children with asthma, has reduced stress in cancer survivors, and has created physician awareness about the importance of medical-legal collaborations.

Implications: Medical-legal partnerships such as NYLAG are a model for social change which addresses fundamental concerns of access to resources critical to public health.

Learning Areas:
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the history and concept of a “medical-legal partnership” as it relates to social justice for patients, especially low-income patients with little access to resources. Identify the role of the legal profession in public health as a means of advocating for the patient’s rights at a fundamental level. Demonstrate the importance of interdisciplinary collaborations between the legal profession and physicians and public health professionals as a way to bridge fundamental health disparities associated with low-income patients.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to give this presentation because I am currently developing new research projects at the Legal Health division of the New York Legal Assistance Group which is a medical/legal partnership for legal health advocacy.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.