Rural Legal Scholarship: Rural Legal Deserts are a Critical Health Determinant

This commentary by Michele Statz, PhD, and Paula Termuhlen, MD, both of the University of Minnesota Medical School Duluth, was published in the American Journal of Public Health today.

This commentary introduces “rural legal deserts,” or rural areas experiencing attorney shortages, as a meaningful health determinant. We demonstrate that the absence of rural attorneys has significant impacts on public health—impacts that are rapidly exacerbated by COVID-19. Our work builds on recent scholarship that underscores the public health relevance of attorneys in civil and criminal contexts. It recognizes attorneys as crucial to interprofessional health care teams and to establishing equitable health-related laws and policies. Taken together, attorney interventions transform institutional practices and help facilitate the stability necessary for health maintenance and recovery. Yet critically, many rural residents cannot access legal supports.

As more individuals experience unemployment, eviction, and insecure benefits amid COVID-19, there is a need for attorneys to address these social determinants of health as legal needs. Accordingly, the growing absence of attorneys in rural America proves particularly consequential, both because of this pandemic context but also owing to existing rural health disparities. We argue that unless a collaborative understanding of these interrelated phenomena is adopted, justice gaps will continue to compound existing rural health inequities.