Published In

American Journal of Law and Medicine

Document Type

Article

Publication Date

2003

Subjects

Medical law; Social aspects; Equal protection; Health aspects

Abstract

This article explores the promise and limits of law in addressing disparities in health. Part II summarizes the research detailing disparities in treatment, outcomes, and health status associated with gender, ethnicity/race, and socioeconomics. Part III evaluates the proper scope of public health interventions to reduce disparities in health status. Most health law scholars have focused on the problem of access to health care. Yet, access to care accounts for a relatively small percentage of a population’s health. Part III considers the utility of law in addressing determinants of health status in two general areas derived from the Healthy People 2010 framework: “behavioral” health risks and socioeconomic status. Legal approaches to behavioral health risks such as those involving tobacco, HIV, and obesity are controversial. Using law to address socioeconomic disparities would be an even more radical approach in the United States. Part IV concludes that there are great risks to retaining a narrow definition of public health and public health interventions. A narrow conception of public health restricts society’s ability to address serious problems that have a major impact on health status. The article concludes that there is little public or governmental support for a more expansive conception of public health. Interventions into behavioral risk factors for poor health status often are stymied by the competing paradigm of personal responsibility. Socioeconomic factors are even less likely to be considered the proper domain of regulation. Health status disparities thus are likely to remain a wrong in search of a right.

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