In Part I, this Article examines the health justice framework through which laws are understood as determinants of health equity. In Part II, this Article argues that when unaddressed for low-income individuals, legal needs serve as social determinants of health. Applying the health justice framework, the Article examines the major domains of social determinants of health (“SDOH”) and identifies areas of law for which unmet legal needs contribute to poor health and health inequity. Specifically, it analyzes how the five major domains of SDOH of the Healthy People 2030 paradigm of the U.S. Department of Health and Human Services (“HHS”) implicate legal issues in the fundamental area of human need identified as critical for access to counsel by the ABA. This Part explores the exacerbation and urgency of these challenges created by the pandemic and examines racial inequities driven by structural racism that create a compounding burden of health disparities for people who are both low-income and people of color. In line with the health justice framework’s exploration of how law can be leveraged to mitigate inequities, Part II concludes by examining how legal representation can address fundamental legal needs that affect health, providing support for access to counsel in these areas.

Finally, in Part III, this Article engages with potential critiques of an emphasis on individual legal representation as a downstream and overly individualistic approach to health justice. This Part addresses these critiques and argues that individual legal representation to enforce extant laws is required for health justice to address the immediate, health-harming legal issues affecting individuals from marginalized communities and improve their health and well-being. However, even though such individual legal advocacy is necessary, it is insufficient. Instead, legal representation should be used as a platform for advocacy in pursuit of structural change through law, policy, and systems reform. This Article proposes a multitiered, integrated clients-to-policy approach for lawyers to facilitate health justice to improve the health of individuals and pursue structural reform to address health equity up-
stream.

This Article takes a closer look at digital contact tracing in the United States during the coronavirus pandemic and why it failed. It begins by explaining the shortcomings of traditional analog methods and the resulting need for digital contact tracing. It then turns to the norms regarding consent, the scope of the data collected, and the limits on subsequent use necessary for cooperative surveillance. We argue that any successful digital contact-tracing program must incorporate these elements. Yet while necessary, those strategies alone may not be sufficient. People justifiably lack trust in public health authorities, in new technologies, and in the tech industry itself. Consequently, we conclude that public health authorities must do more than simply seek consent, minimize collection, and prohibit subsequent use. They must take proactive steps to establish public confidence in digital contact tracing.

Emily Berman, Associate Professor & Royce R. Till Professor, University of Houston Law Center

Leah R. Fowler, Research Assistant Professor and Research Director of the Health Law & Policy Institute, University of Houston Law Center

Jessica L. Roberts, Professor of Law, Leonard H. Childs Chair in Law, Professor of Law, and Director of the Health Law & Policy Institute, University of Houston Law Center