Stopping the Vicious Cycle: Equitable Enforcement Strategies to Achieve Safe, Stable, and Accessible Housing for People with Disabilities.

Policy Points People 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.

SARS-CoV-2 transmission: a sociological review.

The current pandemic is defined by the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that can lead to coronavirus disease 2019 (COVID-19). How is SARS-CoV-2 transmitted? In this review, we use a global lens to examine the sociological contexts that are potentially and systematically involved in high rates of SARS-CoV-2 transmission, including lack of personal protective equipment, population density and confinement. Altogether, this review provides an in-depth conspectus of the current literature regarding how SARS-CoV-2 disproportionately impacts many minority communities. By contextualising and disambiguating transmission risks that are particularly prominent for disadvantaged populations, this review can assist public health efforts throughout and beyond the COVID-19 pandemic.

Intimate Partner Violence, Firearm Injuries and Homicides: A Health Justice Approach to Two Intersecting Public Health Crises.

More than half of all intimate partner homicides involve a firearm and firearms are frequently used by perpetrators of intimate partner violence (IPV) to injure and threaten victims and survivors. Recent court decisions undermine important legal restrictions on firearm possession by IPV perpetrators, thus jeopardizing the safety of victims and survivors. This article reviews the history and recent developments in the law at the intersection of IPV and firearm violence and proposes a way forward through a health justice framework.

Abortion Rights and the Child Welfare System: How Dobbs Exacerbates Existing Racial Inequities and Further Traumatizes Black Families.

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

The ACGME's New Paid Family and Medical Leave Policy: Just the Beginning.

The COVID-19 pandemic has laid bare a problem that many people have managed behind the scenes for years: how to balance work and family caregiving responsibilities. For physicians, many of whom were already experiencing burnout prior to the pandemic, the extra burden of COVID-19-related work stress combined with fewer options for childcare and other support has made coping all but untenable. In early 2022, the Accreditation Council for Graduate Medical Education (ACGME) promulgated new paid family and medical leave policy for residents and fellows. This editorial considers the importance of this step by the ACGME as well as the remaining gaps in paid leave policy in medical education, graduate training, and practice.

Barriers to Disclosure of Intimate Partner Violence Among Undocumented Spanish-Speaking Immigrants in the United States.

Undocumented monolingual Spanish-speaking immigrants are one of the most vulnerable and marginalized groups to experience intimate partner violence (IPV) in the United States. This paper explores the barriers that prevent IPV disclosure in healthcare settings. Qualitative interviews (n = 14) were conducted with previously undocumented Spanish-speaking legal clients of a community domestic violence agency. The major barriers expressed by the interviewees regarding IPV screening and disclosure include limited opportunities for IPV screening, misinformation about legal rights from abusers, fear of deportation and separation from children, and lack of knowledge about resources.

Health Justice Partnerships: An International Comparison of Approaches to Employing Law to Promote Prevention and Health Equity.

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

A New Kind of Academic MLP: Addressing Clients' Criminal Legal Needs to Promote Health Justice and Reduce Mass Incarceration.

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.

On the Ethics of Mandatory Reporting of Positive Drug Tests in Newborns and Pregnant Parents at the Time of Delivery.

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.

Public Health, Firearms, and Domestic Violence in US v Rahimi.

This Viewpoint describes the implications of US v Rahimi for public health and safety of persons experiencing domestic violence.

Protecting Sexual and Reproductive Health Privacy Post-Dobbs.

This Viewpoint discusses the dangers to abortion providers and patients of law enforcement access to sexual and reproductive health information.

The Role of Advocacy in Public Health Law.

This article discusses how advocacy can be taught to both law and public health students, as well as the role that public health law faculty can play in advocating for public health. Despite the central role that advocacy plans in translating public health research into law, policy advocacy skills are rarely explicitly taught in either law schools or schools of public health, leaving those engaged in public health practice unclear about whether and how to advocate for effective policies. The article explains how courses in public health law and health justice provide ideal opportunities to teach advocacy skills, and it discusses the work of the George Consortium, which seeks to engage public health law faculty in advocacy efforts.

Medical-Legal Partnership in Primary Care: Moving Upstream in the Clinic.

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.

Addressing Global Human Rights Violations in Rhode Island: The Brown Human Rights Asylum Clinic.

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.

The Medical-Legal Partnership Approach to Teaching Social Determinants of Health and Structural Competency in Residency Programs.

Medical-legal partnerships (MLPs) embed civil legal services lawyers into health care settings and interprofessional health care teams delivering care to low-income or otherwise vulnerable patients and communities. MLPs present the opportunity to instill in residents a practical understanding of the social determinants of health and provide them with concrete tools to address them. MLP training helps residents develop structural competency and build the skills necessary to address barriers to health at the patient, institutional, and population levels. Through a case study, this Perspective explores how residents can address health-harming legal needs working in partnership with interprofessional health care teams that include lawyers, and illustrates how such MLP experiences can relate to competency-based Milestones that are applicable to training residents in all specialties.