Social and environmental factors impact health
First explored by the World Health Organization in the early 2000s, it is now well understood that social, economic, and environmental context matters for health. The CDC defines “social determinants of health” as “the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” Social determinants can have positive or negative health impacts, and include economic stability, access to education, access to health care, and positive community context and built environments.
Civil legal problems are common
An estimated 74% of low-income American households experienced at least one civil legal problem in 2021 – with many households dealing with multiple issues. Yet many low-income people do not know how to access legal assistance or do not understand their problem is legal in nature.
Civil legal problems impact health
Civil legal problems can cause or exacerbate drivers of poor health. 55% of low-income Americans who experienced a civil legal problem say they substantially impacted finances, mental health, physical health, safety, and relationships.
The law is complex and inaccessible
Laws and legal systems are complex, require interpretation, and constantly evolve. People who are not attorneys have historically not had access to legal information and problem-solving skills. Care teams who are faced with the legal problems of those they serve that seem to have no solutions can experience moral injury and fixing fatigue.
There is a scarcity of attorneys to address the civil legal problems of low-income people
There are 5.8 legal aid attorneys for every 10,000 Massachusetts low-income residents and 4 per every 10,000 Rhode Islanders. In 2024, fewer than 5% of tenants facing eviction in a Massachusetts court had legal representation (compared to more than 90% of landlords with legal counsel).
Ask yourself: Where along this spectrum was the last family that you supported?