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SDOH and the Judiciary

Social determinants of health (SDOH) are relevant to many legal issues and arise in a broad array of cases.  A nuanced and informed understanding of SDOH can aid courts in resolving a wide range of legal issues.

The law affects SDOH through many mechanisms, from determining the nature and distribution of social goods such as housing, education and employment, to regulating behaviors and industries that implicate the social or physical environment. Much of the law’s impact on SDOH occurs through statutes and regulations, but the work of the judiciary can also impact health.

 

Judges are often faced with decisions that implicate the SDOH. For example, judges regularly make decisions relating to sentencing, protection orders, and evictions. Civil suits may award damages or settlement awards that can work to address public health issues, and judges can play a role in these outcomes.

 


"The protection and preservation of public health has continually played a central role in American jurisprudence." 


During the COVID-19 pandemic, courts were asked to review the constitutionality of state emergency orders that implicated employment, access to housing, and the provision of health care. The COVID-19 cases have confirmed that the protection of public health is well established as a legal norm. Courts accept that protection of public health is a legitimate and important (if not compelling) state interest.  In addition, courts generally attempt to rule in accordance with the law in ways that respect public health.
 

"[A]n increased understanding of the SDOH helps to inform judges about the constricted choices available to individuals who come before the court, as well as the role of social context in preventing recidivism and promoting social integration."


Judges can also impact SDOH through their review of the regulations and orders of agencies charged with protecting public health, occupational health, transportation, and the environment. School funding cases and similar questions of constitutional law can impact the availability and quality of education, a key SDOH. By deepening their understanding of SDOH, judges will be better equipped to apply constitutional rules and interpret statutory and regulatory language that relate to public health. Judges will also be given a better appreciation of how SDOH affect the decisions and behaviors of litigants. Ultimately, judges who have some familiarity with the research relating to social determinants will be better equipped to rule on the admissibility of evidence in private and public law cases in which the SDOH are relevant.