Medical-legal partnerships and the future of health care

Medical legal partnerships (MLPs) are interprofessional collaborations between medical and legal professionals designed with the goal of identifying patients’ health-harming legal and social needs. The pressing need for such collaborative endeavors is highlighted by the broader pattern of health status in the United States. According to some estimates, access to health care services accounts for 10% to 20% of modifiable health outcomes. As is now well-known, health status is influenced by broader social and economic factors—the so-called structural determinants of health (SDoH)—apart from individual behavioral or genetic risk factors. Indeed, physicians now increasingly insist upon the social nature of disease, such that those seeking to systematically understand the drivers of poor health are expected to account for the fact that “disease is always generated, experienced, defined, and ameliorated within a social world.” Of course, SDoH matter because they adversely impact not only our health, but also genuine human flourishing in a variety of ways. As Michael Marmot has written: “so intimate is the connection between our set of social arrangements and health that we can use the degree of health inequalities to tell us about social progress in meeting basic human needs.” While this close connection between health and human flourishing is now widely understood, an important tension remains: how to balance health care provision with prevention and with broader goals of social justice.