Search

The article focuses on the heightened risks for women's health following the Supreme Court's overturning of Roe v. Wade. Topics include the increased prevalence of rape-related pregnancies and intimate partner violence (IPV) leading to higher homicide rates in states with abortion bans, the overall higher rate of violence against women in the U.S. compared to other countries, and the connection between reproductive coercion and restricted access to abortion services.

Policy PointsPeople with disabilities experience a vicious cycle of poverty, poor health, and marginalization partly because of the inequitable implementation and enforcement of laws, including underenforcement of civil rights and housing laws and overenforcement of punitive nuisance and criminal laws.Inequitable enforcement reflects policy choices that prioritize powerful entities (e.g., landlords, developers) to the detriment of people who experience intersectional structural discrimination based on, for example, race, disability, and income.Equitable enforcement, a process of ensuring compliance with the law while considering and minimizing harms to marginalized people, can promote health and disability justice by increasing access to safe, stable, and accessible housing. [ABSTRACT FROM AUTHOR]

This article describes a new type of medical-legal partnership (MLP) that targets the health and justice concerns of people enmeshed in the U.S criminal justice system: a partnership between clinicians who care for people with criminal system involvement and public defenders. This partnership offers an opportunity to not only improve patient health outcomes but also to facilitate less punitive court dispositions, such as jointly advocating for community-based rehabilitation and treatment rather than incarceration. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and growing political polarization have activated parental grievance against the government in recent years. Politicians have capitalized on this grievance by campaigning on, proposing, and passing legislation providing greater protections for parental rights in decision-making about health care and public education. This Article tracks the history of how courts have sought to balance parental rights with the public interest, and then explores contemporary controversies surrounding parental rights, including healthcare decision-making, public health mandates, public education, and the child welfare system. These controversies illuminate the incoherence in courts', policymakers', and the general public's framing of parental rights and demonstrates the need to identify shared values and promote equity in order to effectively balance individual rights with the common good. [ABSTRACT FROM AUTHOR]

This article explores how abortion bans in states with large Black populations will exacerbate existing racial inequities in those states' child welfare systems. [ABSTRACT FROM AUTHOR]

This article traces the development and growth of health justice partnerships (HJPs) in three countries: the United States, Australia and the United Kingdom. [ABSTRACT FROM AUTHOR]

This article explores how abortion bans in states with large Black populations will exacerbate existing racial inequities in those states’ child welfare systems. [ABSTRACT FROM AUTHOR]

The article underscores the significance of postpartum mental health conditions, particularly the impact on mothers and families, and highlights the role of the maternal health workforce, home visit programs, and birth-setting options in addressing these conditions. Topics include the need for a more diverse maternal health workforce, the expansion of home visit services, and the importance of birthing centers in promoting postpartum mental health equity.

Black maternal health disparities have existed for decades. But with America's recent "racial reckoning," the public health and medical communities are increasingly focused on understanding the pathways that lead to higher rates of Black maternal morbidity and mortality, and policymakers are exploring legal and policy approaches to reducing inequities. While most of the attention is on reducing racial disparities in mortality during pregnancy, childbirth and postpartum, this article investigates the problem from a life course perspective. Applying public health and medical literature that details the role of allostatic load and weathering in adult and maternal health, this article examines how multiple compounding and intersecting social, political, and legal structures drive poor health outcomes for Black mothers. These structures include the particular social status of Black mothers in American history and society, the political disempowerment and scapegoating of Black mothers that has shaped harmful public policies, and the poorly designed and enforced laws and systems that not only fail to protect Black mothers from discrimination but, at times, exacerbate it. This article reviews and assesses current state and federal proposals for legal and policy reform aimed at addressing the Black maternal health crisis and subsequently proposes the need for a comprehensive multisectoral approach. [ABSTRACT FROM AUTHOR]

The article discusses Supreme Court's recent decision in Dobbs v. jackson Women's Health Organization, which allows states to ban or restrict access to abortion, will have many implications for the health, economic stability, and equal opportunity of people who can become pregnant. Topics include studies show that abortion access plays an important role in reducing IPV; analysis of data from the Turnaway Study.

Medical-legal partnership (MLP) is a health care delivery innovation that embeds civil legal aid expertise into the health care team to address health-harming legal needs for vulnerable populations at risk for poor health. The MLP approach focuses on prevention by addressing upstream structural and systemic social and legal problems that affect patient and population health. Because many unmet legal needs affect health (such as residing in substandard housing; wrongful denial of government income supports, health insurance, or food assistance; family violence; and barriers to care based on immigration status), lawyers are important members of the health care team. This review describes the MLP approach to addressing the social determinants of health, examines its benefits for improving the delivery of primary care for vulnerable patients and populations, and explores new opportunities for MLP in primary care with the advent of systems reforms driven by the Affordable Care Act. [ABSTRACT FROM AUTHOR]

Some provisions of the Patient Protection and Affordable Care Act of 2010 (ACA) as well as regulatory policies under the Obama administration reflected the overwhelming evidence that to reduce health care costs, and to improve quality of care and population health, the social determinants of health (SDOH) must be addressed. These policies included funding for partnerships between public health agencies, community organizations, and health care institutions, promotion of value-based payment models that incentivize integrated health and social care delivery, and supportfor Medicaid program innovations that directly address social needs as part of health care. The Trump administration, through a series of legislative and regulatory changes, has undermined many of these efforts, reversing the momentum toward a more preventive and integrated health care system. This article traces how the Trump administration'spolicy approach to investments in value-based and integrated care models, state Medicaid waivers, and funding of the safely net backtrack from Obama administration evidence-based reforms that acknowledged the large role that SDOH play in health inequity, worsening population health outcomes in the U.S., and out of control health care costs. [ABSTRACT FROM AUTHOR]

The article discusses U.S. Internal Revenue Service (IRS) regulations under the U.S. Affordable Care Act requiring nonprofit hospitals seeking tax exemption to regularly conduct community health needs assessments (CHNA) and respond to community health needs. Topics covered include ways in which unmet legal needs function as health determinants, the participation of hospitals in medical-legal partnerships (MLP), and the role of legal barriers in community health.

The article introduces various topics covered in the issue including Rhode Island's State Innovation Model test grant and its Medicaid Accountable Entity program, the Rhode Island Patient Navigator Partnership's role in reducing income gap, and integration between medical and social care.

The opioid epidemic has renewed debate about how to structure laws, agency policies and hospital protocols for mandatory reporting of illicit substances during pregnancy. This paper analyzes the ethics of Rhode Island's approach to mandatory reporting - in particular, reporting of positive maternal and newborn drug tests at time of delivery. Given that state intervention is generally perceived by pregnant people as punitive and threatening to their family, we consider how four elements often used to justify punitive action by the state - retribution, deterrence, rehabilitation, and incapacitation (societal protection) - apply to Rhode Island's policy and approach to prenatal substance use. In addition, the paper considers the equity implications of Rhode Island's approach. It concludes that, given the potential for the policy to do more harm than good, investment of resources would be better spent on clinical and community services that support substance using parents and their newborns. [ABSTRACT FROM AUTHOR]

The Brown Human Rights Asylum Clinic (BHRAC) is a medical student-led organization affiliated with Physicians for Human Rights that collaborates with medical and mental health clinicians, lawyers, and community organizations to provide pro bono medical affidavits to undocumented individuals seeking legal status in the United States. Affidavits can document and corroborate the physical and psychological evidence of trauma alleged by asylum seekers, leading to better legal outcomes. This article describes our innovative program, partnerships, and workflow, as well as demographics and statistics from our past seven years of operation. Since its founding in 2013, BHRAC has conducted 55 medical evaluations, the majority involving Spanish-speaking female- identifying individuals from Guatemala, El Salvador, and the Dominican Republic. Thirteen individuals have been granted legal status, one individual was denied status, and the rest of the cases are pending. BHRAC has experienced a marked increase in affidavit requests. This paper serves as a call to action for medical professionals to become involved in this work. [ABSTRACT FROM AUTHOR]

As the United States embarks on health care reform through the Affordable Care Act (ACA), the knowledge, skills and attitudes necessary to practice medicine will change. Education centered on health disparities and social determinants of health will become increasingly more important as 32 million Americans receive coverage through the ACA. In this paper, we describe future initiatives at the Warren Alpert Medical School of Brown University in training medical students on health disparities and social determinants of health through mechanisms such as the Primary Care-Population Medicine Program, the Rhode Island Area Health Education Center, the Scholarly Concentration program and other mechanisms. [ABSTRACT FROM AUTHOR]

Much of the discussion about "health as a human right" has centered on global health initiatives, largely ignoring the application of human rights principles to the significant socioeconomic and racial health disparities in the United States. Given the persistent gaps in insurance coverage and access to quality preventive care in the US, the health and human rights movement has primarily focused its efforts on achieving universal health care coverage. However, this focus has left unaddressed how a human rights strategy might also address the social determinants of health. As Americans' health continues to worsen-the US Institute of Medicine recently reported that the US now fares worse in nine areas of health than 16 peer high-income democracies--a broader social determinants approach is warranted. This article explores the application of international human rights principles, including a "right to health" to the US context, and analyzes how existing domestic law may be used to advance health as a human right for America's most vulnerable populations. It demonstrates that an effective health and human rights strategy must build partnerships among health care providers, public health professionals, and lawyers to identify rights violations, hold officials and systems accountable, and mobilize communities to advocate for systems and policy change., (Copyright © 2013 Tobin Tyler. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.)