Prevalence of Health Harming Legal Needs of Patients Seeking Care in the Emergency Department

Patients seeking care in the emergency department (ED) often have unmet social needs that impact their health and health outcomes. Medical-legal partnerships (MLPs) have been shown to positively impact social and legal needs of patients yet few ED-MLPs exist. The goal of this study was to explore the prevalence of health-harming legal needs (HHLNs) that could be addressed through an ED-MLP.

We conducted a survey study of a convenience sample of patients seeking care in one ED located in the Southeastern United States over a 6-month period. Research assistants conducted a HHLNs survey following the income/insurance, housing and utilities, education and employment, legal status, personal and family stability (I-HELP) framework with eligible consenting participants. Results were analyzed using descriptive statistics.

Of the total 205 participants, almost all the participants reported one or more HHLNs (n = 187, 91.7%) with many reporting 2 or more overlapping HHLNs (n = 152, 74.1%). The most common HHLNs reported were financial issues, access to benefits, and access to government insurance coverage or benefits. Many participants had concerns about housing and food insecurity.

Our results demonstrate that patients seeking care in the ED had multiple overlapping social and legal needs that could be addressed through an MLP. As EDs increasingly utilize social screeners to identify unmet needs, inclusion of HHLNs would be an important addition to expand resources and interventions available to patients.