Litigating Health Risks: Assessing The Impact Of Legal Services To Combat Housing And Neighborhood-Related Health Risks

摘要

The present dissertation considers the interaction between housing and neighborhood challenges that trigger health risks and examines the effectiveness of legal services as a resource tool for at-risk families in improving child and family health. This dissertation offers a detailed analysis of the home and neighborhood contexts based on 72 ethnographic interviews with low-income mothers residing in an inner-city neighborhood- Dorchester, MA. This project is also nested within a larger program evaluation of the Medical Legal Partnership for Children (MLPC) program administered through Boston Medical Center and three community health centers in Dorchester, where respondents were recruited. In the MLPC program, physicians refer patients, when their health problems seem to be caused by something housing-related, to in-house legal services to help address the housing problem and which in due course reduce health risks present in the home environment via legal enforcement. The quasi-experimental design of this study compares 36 families who have used MLPC services to address housing-related legal problems, while the remaining 36 families had similar demographic characteristics (in that they were low-income Dorchester residents) and housing problems but did not have access to the MLPC program through the health center where their children received medical/health services. This dissertation consists of three substantive papers that highlight various aspects of the study findings. The first paper describes the potential of law to act as a mediator between poor housing and poor health. The second paper discusses the theoretical framework of legal consciousness as it relates to within group differences among marginalized group members. The third paper is an empirically grounded account that compares problem-solving strategies employed by low-income families to cope with and manage everyday problems, particularly those related to housing. In the overall conclusion, I discuss the relevance of this dissertation with respect to its scholarly contributions and offer several policy recommendations. As a whole, this dissertation contributes to a better understanding of how the deliberate use of legal services may provide an opportunity to enhance coping strategies that maximizes the resource capacity and improves the living conditions of poor families.