Category Archives: Health

New Issue: Georgetown Journal on Poverty Law and Policy.

New Issue: Georgetown Journal on Poverty Law and Policy Volume 30, Issue 3 (Spring 2023).

Samantha M. Rudelich and Megan C. Kilduff, Letters from the Editors, 30(3) Geo. J. on Poverty L. & Pol’y (2023).

Jon DeCarmine and Joseph S. Jackson, A Tale of Two Ten Cities: The Critical Role of Housing Engagement in Addressing Homeless Encampments, 30(3) Geo. J. on Poverty L. & Pol’y (2023).

Rebecca Horwitz-Willis and Leanna Katz, The Interdependence of Family, State, and Market: Childcare in the Shifting Landscape of the COVID-19 Pandemic, 30(3) Geo. J. on Poverty L. & Pol’y (2023).

Pamela A. Izvănariu, Contesting Racial Wages, 30(3) Geo. J. on Poverty L. & Pol’y (2023).

Katherine L.W. Norton, Accessing Justice in Hybrid Courts: Addressing the Needs of Low-Income Litigants in Blended in-Person and Virtual Proceedings, 30(3) Geo. J. on Poverty L. & Pol’y (2023).

Lauren Sudeall, Elora Lee Raymond, and Phillip M.E. Garboden, Disaster Discordance: Local Court Implementation of State and Federal Eviction Prevention Policies During the COVID-19 Pandemic, 30(3) Geo. J. on Poverty L. & Pol’y (2023).

New Article: The Abolition of Food Oppression

Etienne C. Toussaint, The Abolition of Good Oppression, 111 Geo. L. J. 5 (2023). Abstract Below.

Public health experts trace the heightened risk of mortality from COVID-19 among historically marginalized populations to their high rates of diabetes, asthma, and hypertension, among other diet-related comorbidities. However, food justice activists call attention to structural oppression in global food systems, perhaps best illuminated by the prevalence of unhealthy fast-food restaurants (and the lack of healthy alternatives) in low- income Black and Hispanic/Latinx neighborhoods nationwide. In response, local governments have begun to prioritize local food production to reduce food insecurity. Yet, even well-intentioned food justice initiatives, such as urban farming programs, can perpetuate structural inequities by glorifying entrepreneurialism or privatization as effective solutions to poverty. Further still, when lawmakers propose targeted relief programs for food insecure communities, such as the Biden Administration’s federal debt relief program for socially disadvantaged farmers, they are routinely challenged on constitutional grounds for preferencing non-White racial and ethnic groups. Thus, food insecurity in the urban ghettos and rural towns of America persists.

To defeat this impasse, this Article advocates an abolition constitutionalist framing of food insecurity in the United States. Specifically, it argues that framing the problem of food insecurity in historically marginalized communities as a badge of the antebellum system of chattel slavery invokes the legislative potential of the Thirteenth Amendment’s Enforcement Clause. Although the Supreme Court has empowered Congress to pass laws necessary for abolishing all badges and incidents of slavery, there remains a lack of clarity on the scope of material conditions or forms of discrimination that constitute such lingering harms, leading some lower courts to limit the Amendment’s enforcement to literal slavery or involuntary servitude.

Accordingly, this Article proposes a dignity based normative framework to assess the nature of injuries or material conditions that are proximately traceable to the political economic system of American slavery. Using the problem of food insecurity as a guiding explanatory thread, this framework reveals how modern badges of slavery can inflict: (i) equality-based; (ii) liberty-based; and (iii) integrity-based dignitary harms. These dignitary harms, individually and collectively, can perpetuate the types of oppression levied by chattel slavery; in this instance, the exploitative, marginalizing, and violent harms of food oppression. Whether modern-day food oppression is animated by state action (or inaction) or by private actors, it not only hinders public health and degrades democracy, but most importantly, it also violates the spirit and letter of the Thirteenth Amendment.

News Article: From a one-way flight to sleeping in a parking lot: Diary of a California dream gone sour

News Article: Connor Sheets, “From a one-way flight to sleeping in a parking lot: Diary of a California dream gone sour”, Los Angeles Times July 23, 2023.

New Article (Forthcoming): Immigrant Workers’ Voices as Catalysts for Reform in the Long-Term Care Industry

Shefali Milczarek-Desai & Tara Sklar, Immigrant Workers’ Vices as Catalysts for Reform in the Long-Term Care Industry, Ariz. State L. J. (2023). Abstract Below.

The COVID-19 pandemic exposed a long-term care crisis that has been brewing for decades. It also offered lessons for much-needed reform to the long-term care industry. One such lesson is that both older Americans and their caregivers experience unnecessary suffering and death due to entrenched industry practices that marginalize long-term care aides, a worker population that is increasingly made up of immigrant and migrant (“im/migrant”) women. Even though im/migrant women constitute at least one-third of the long-term care workforce, their perspectives are largely absent from the legal and public health literature and national conversations around long-term care reform. Indeed, to date, no systematic and comprehensive attempt has been made to collect and publish the lived experiences of im/migrant women who work as long-term care aides in the U.S. This Article is the first to use empirical data, collected by the authors through qualitative interviews of im/migrant aides in Arizona, to explore and analyze the failures of state and federal laws and policies, including Arizona’s paid sick leave law, to protect long-term care aides and the vulnerable, older, adult population that relies on their caregiving.

The Article describes the use of critical race and health law theories to inform the study’s design and details the study’s methodology and findings. Through the voices of im/migrant women aides, the Article demonstrates that this subset of frontline, essential workers consistently experience violations of state and federal employment and labor laws and face significant barriers to accessing their workers’ rights, including paid sick time and protection from employer retaliation. The study’s findings show that im/migrant aides work in conditions that are unsafe not only for them but also for their patients. Together, these failures contribute to poor quality of care, chronic labor shortages, and increased potential for harm in future public health emergencies. The Article draws on im/migrant women’s voices to make recommendations for changes to laws and policies in Arizona and nationwide to help these workers and a rapidly growing, aging, American population. This research fills a critical gap in the literature regarding the shortcomings of workplace laws and healthcare policies in long-term care settings. It comes at a moment when the country’s long-term care system must be changed or face a crisis of epic proportions that will leave older adults and their loved ones with few, if any, options.

New Article (Forthcoming): Affirmatively Furthering Health Equity

Mary Crossley, Affirmatively Furthering Health Equity, Brooklyn L. Rev. (2023). Abstract Below.

Pervasive health disparities in the United States undermine both public health and social cohesion. Because of the enormity of the health care sector, government action, standing alone, is limited in its power to remedy health disparities. This Article proposes a novel approach to distributing responsibility for promoting health equity broadly among public and private actors in the health care sector. Specifically, it recommends that the Department of Health and Human Services issue guidance articulating an obligation on the part of all recipients of federal health care funding to act affirmatively to advance health equity. The Fair Housing Act’s requirement that recipients of federal housing funds take steps to affirmatively further fair housing, an obligation justified by the history of government support for racial residential segregation, inspires this proposal. Perhaps less well known is the government’s role in producing and tolerating de facto segregated health care facilities and racial health disparities. Anti-discrimination laws, including Title VI of the Civil Rights Act, §1557 of the Affordable Care Act, and §504 of the Rehabilitation Act, provide statutory underpinnings for an affirmatively furthering health equity (AFHE) obligation. Moreover, existing legal and regulatory frameworks relating to hospital tax exemption, community-based supports for disabled people, and administration of Medicare and Medicaid suggest models for implementing an AFHE obligation. Receipt of federal funding by hundreds of thousands of health sector actors should come with some responsibility for working to ameliorate health inequities.

New Issue: Georgetown Journal on Poverty Law and Policy

New Issue: Georgetown Journal on Poverty Law & Policy Volume 30, Issue 2 (Winter 2023).

Samantha M. Rudelich & Megan C. Kilduff, Letter from the Editors, 30(2) Geo. J. on Poverty L. & Pol’y (2023).

Mark E. Budnitz, New Developments in Payment Systems and Services Affecting Low-Income Consumers: Challenges and Opportunities, 30(2) Geo. J. on Poverty L. & Pol’y (2023).

Marc Canellas, Abolish and Reimagine: The Pseudoscience and Mythology of Substance Use in the Family Regulations, 30(2) Geo. J. on Poverty L. & Pol’y (2023). 

Elaina Marx, Punishment, Poverty, and the Limits of Judicial Policymaking, 30(2) Geo. J. on Poverty L. & Pol’y (2023). 

Brianna Borrelli, The Interplay of Mass Incarceration and Poverty, 30(2) Geo. J. on Poverty L. & Pol’y (2023). 

Mohammed Hossain, Not Surviving, but Thriving: Indexing to the Cost of Living, 30(2) Geo. J. on Poverty L. & Pol’y (2023). 

Emily L. Webb, Promoting Economic Mobility Through Adequate Community College Funding, 30(2) Geo. J. on Poverty L. & Pol’y (2023). 

New Book: Uninsured in Chicago, How the Social Safety Net Leaves Latinos Behind

Robert Vargas, Uninsured in Chicago, How the Social Safety Net Leaves Latinos Behind, (NYU Press 2022). Overview below

Why millions of Latinx people don’t access the healthcare system, even in times of need

More than a decade after the passage of the Affordable Care Act, around eleven million Latinx citizens around the country remain uninsured. In Uninsured in Chicago, Robert Vargas explores the roots of this crisis, showing us why, despite their eligibility, Latinx people are the racial group least likely to enroll in health insurance.

Following the lives of forty uninsured Latinx people in Chicago, Vargas provides an up-close look at America’s broken healthcare system, and how it impacts marginalized groups. From excruciatingly long waits and expensive medical bills, to humiliating interactions with health navigators and emergency room staff, he shows us why millions of Latinx people avoid the healthcare system, even in times of need.

With a compassionate eye, Vargas highlights the unique struggles Latinx people face as the largest racial group without health insurance in the United States. An intimate account of the lives of uninsured Latinos, this book imagines new, powerful ways to strengthen our social safety net to better serve our most vulnerable communities.

Disability Benefits as Poverty Law: Revisiting the “Disabled State”

Karen M. Tani, Disability Benefits as Poverty Law: Revisiting the “Disabled State,” 170 U. Pa. L. Rev. 1687 (2022). Abstract below:

This essay uses the history of Sullivan v. Zebley, a famous disability benefits case, to revisit political scientist Deborah Stone’s argument in THE DISABLED STATE (1984). Observing that “[m]edical certification” of disability had “become one of the major paths to public aid in the modern welfare state,” Stone wondered whether policymakers were asking the “concept of disability” to do too much and whether they were sufficiently alert to the concept’s tendency to expand over time.

Filed in 1983 and decided by the Supreme Court in 1990, Sullivan v. Zebley is an example of those expansionary pressures and their results. When the Social Security Administration stopped making Supplemental Security Income payments to 5-year-old Brian Zebley, despite his continuing and severe disabilities, lawyers at the legal aid organization Community Legal Services filed a class action. They contended that not only had the Social Security Administration erred in Zebley’s case, but also that the Agency’s overall eligibility determination process for child disability benefit claimants was too restrictive. The plaintiffs’ ultimate victory before the Supreme Court, and the surprising allies it amassed along the way, illustrate how readily many actors and institutions connected disability to deservingness and embraced disability as a distributional device in the late twentieth century. The post-Zebley backlash against child claimants, however, illustrates how closely the public continued to associate disability with deviance and fraud, especially when they observed take-up among Black citizens. Negative perceptions contributed to the program’s reform in 1996. Congress preserved the new path to eligibility that Zebley created, but also narrowed it. Decisional power, meanwhile, remained in the hands of medical gatekeepers.

This essay casts the Zebley story as one of triumph and tragedy. It was a triumph for poverty lawyers and their clients, who, under hostile circumstances, pressed for a more generous and life-affirming social welfare system. They saw that the boundaries of disability were malleable and they pushed on them. But it remains a tragedy that the best route to subsistence for so many children has further entangled disability with medicalization, suspicion, and surveillance.

New Article: Medical-Legal Partnership as a Model for Access to Justice

New Article: Yael Zakai Cannon, Medical-Legal Partnership as a Model for Access to Justice, 75 Stan. L. Rev. Online 73 (2023).

New Article: Senior care is crushingly expensive. Boomers aren’t ready

New Article: Christopher Rowland, Senior care is crushingly expensive. Boomers aren’t ready., Washington Post, (March 20, 2023). Overview below:

Beth Roper had already sold her husband Doug’s boat and his pickup truck. Her daughter sends $500 a month or more. But it was nowhere near enough to pay the $5,950-a-month bill at Doug’s assisted-living facility. So last year, Roper, 65, abandoned her own plans to retire.

To the public school librarian from Poquoson, Va., it feels like a betrayal of a social contract. Doug Roper, a longtime high school history teacher and wrestling coach, has a pension and Social Security. The Ropers own a home; they have savings. Yet the expense of Doug’s residential Alzheimer’s care poses a grave threat to their middle-class nest egg. At nearly $72,000, a year in assisted living for Doug67, costs more than her $64,000 annual salary.

“It’s devastating,” she said. “You can’t wrap your head around it.”