The Health Cost of Civil‐Law Problems: Further Evidence of Links Between Civil‐Law Problems and Morbidity, and the Consequential Use of Health Services

Abstract

There is considerable evidence of links between social and health problems. Some of these links involve social problems that can be addressed through civil legal process, and may be described as civil‐law problems. Various initiatives have been implemented around the world to link health and legal advice services to promote better health and justice outcomes. This study examines the links between civil‐law problems and morbidity. It uses new data to replicate an earlier analysis of these links, then builds on this by exploring the extent to which problems are reported to act to bring about ill health. It also details the reported consequent use of health services. We examined survey respondents’ self‐reports of long‐standing illness/disability, use of health services, and experience of 18 types of civil‐law problems. Data were drawn from a random national survey of 5,015 adults living in 3,832 residential households across England and Wales. Having controlled for a range of other social and demographic predictors, we found a significant association between age‐standardized illness/disability and civil‐law problems, one that increases with illness/disability severity. In particular, we found significant associations with 10 of 18 principal problem types. We found that adverse health consequences were reported to have followed over one‐third of problems, and some problem types in particular. This led to significant use of health services. We highlight the contribution that legal services may make to public health. We argue that despite the difficulties faced in England and Wales by initiatives such as Health Action Zones and Community Legal Services Partnerships, and despite the cost‐benefit ratio of legal advice and assistance (in either the justice or health fields) remaining unclear, the more effective coordination of health and legal services is likely to improve both health and justice outcomes.

Debt and disadvantage: the experience of unmanageable debt and financial difficulty in England and Wales

“…Kempson, ; Department for Trade and Industry, ; Kempson et al ., ). There was also evidence that people with a long‐term illness or disability were more likely to experience unmanageable debt and financial difficulty, once one accounts respondent age, consistent with previous research showing an interaction between age and health in the experience of civil justice problems more generally (Pleasence et al ., ).…”

Bridging the Empirical Gap: New Insights into the Experience of Multiple Legal Problems and Advice Seeking

“…Crucially, our research suggests that the relationship between health and legal needs is complex and multilayered. Although the interlinkages between health and legal problems has been well documented (e.g., Balmer et al 2010;Pleasence et al 2008a), and research has demonstrated the benefits from coordinated provision of health and legal services (Cohen et al 2010;Lawton et al 2010), our research reveals some additional challenges to effective provision. Notable among these is the need for delivery and service structures to take account of the ways preexisting medical conditions, or treatment for them, interfere with problem detection.…”

“…; Pleasence et al. ), and research has demonstrated the benefits from coordinated provision of health and legal services (Cohen et al. ; Lawton et al.…”

“…Again, research previously published in this journal has documented the significant association between civil‐law problems and morbidity and the consequent public costs arising from the increased call on health services (Pleasence et al. ). The authors also suggest that civil‐law problems can bring about a vicious cycle of problems and increasing morbidity, and advocate the coordination of services that integrate legal and health provision.…”

Psychiatric morbidity and people’s experience of and response to social problems involving rights

“…The English and Welsh Civil and Social Justice Survey (CSJS) used in the present study has been designed to capture a broad range of such rights problems in eighteen areas (see Table 1, which also provides some examples). Previous research has highlighted the relationship between morbidity and the experience of social problems involving legal rights (‘rights problems’) (Pleasence et al . 2004a, 2008), a relationship observed in a number of countries (e.g.…”