Class 1: What are Justice and Health Partnerships?

1. What are Justice & Health Partnerships (JHPs)?

JHPs are innovative collaborations between healthcare providers and legal professionals that help individuals and communities to resolve legal problems impacting their health.

These collaborations have other names in other places. In the United States they’re known as medical legal partnerships, or MLPs. One of the best known MLPs started in Boston, when a medical centre saw paediatric asthma patients going frequently to the emergency department. The asthma was exacerbated by the children’s living conditions - damp and moldy apartments. The medical center got help from a pro bono legal service to force the landlords to make repairs. Once the housing problems were resolved, the children started to get better.

2. How do JHPs work?

First, we have to understand that legal problems and social determinants problems are often two sides of the same coin- as in the example above, where the damp and moldy apartments are simultaneously a health and legal issue.

When these problems are framed as social determinants of health problems, finding effective interventions can be challenging. Social determinants of health problems seem complex, sticky, and difficult to grapple with or resolve. But when framed as legal problems instead, we see that solutions can be found in the law. Although the law cannot resolve every social determinant of health problem, many areas of law do overlap with social determinants, including housing, government benefits, employment, human rights, contracts and debt, criminal and family law, and wills and incapacity.

JHPs work by leveraging the best from law and health to find solutions to difficult problems.

3. How can JHPs help patients?

There is a significant body of evidence that JHPs work to build legal awareness and literacy, increase timely access to legal services, improve health equity, and improve health outcomes. Studies have shown that when legal services are used to address social needs:

• People with chronic illness are healthier and get admitted to the hospital less
• People take their medications as prescribed, and engage more with preventive care services like smoking cessation
• People are more stably housed, and less likely to have their utilities shut off, and
• People have access to greater financial resources.

4. Where are there JHPs now?

There are now hundreds of these partnerships in the United States. They have started to catch on here in Ontario, where they are chiefly supported by our community legal clinics. Although new, the partnerships in Ontario have already helped thousands of people to resolve their legal issue by:

• Streamlining referral processes to make it easy for healthcare providers to make referrals or get consultations for patients
• Providing free legal advice and representation for patients
• Providing education and training for healthcare providers - like this course! - on the importance of prescribing legal health.