Cal ATJ Policy Paper: California's Attorney Deserts, Social Determinants of Health, and COVID-19

Here's an excerpt from the paper, which you can find in its entirety here.   

California faces a statewide access-to-justice crisis, with 85 percent of low-income Californians receiving inadequate or no legal assistance. Low-income Californians need legal services: 60 percent deal with at least one civil legal issue annually, while 23 percent navigate six or more. Yet, just one civil legal aid attorney is available to assist every 5,500 low-income Californians who qualify for their services.

Statewide access issues are compounded by geography. “Attorney deserts” are rural parts of the state and country where there are few or no lawyers. A little over three percent of California’s 200,000 lawyers have offices in rural areas. While the ratio of attorneys to residents in urban areas is 1:175, it decreases to 1:626 in rural areas.

Attorney deserts signal an inadequate supply of attorneys to help rural residents. Yet, these Californians need services: 59 percent of Californians at all income levels living in rural areas faced at least one civil legal issue in the survey year. These critical issues include housing, debt, employment, intimate partner violence, consumer protection, and public benefits. All of these civil justice issues are at the nexus of social and legal problems faced by low- and moderate-income rural Californians.

In the context of COVID-19, attorney deserts hinder people with legal claims stemming from the parallel economic and public health crises from getting legal help. For example, Imperial County has the highest per capita rate of COVID-19 cases in the state and a poverty rate of nearly 20 percent, but just 164 lawyers. Attorney deserts present an entrenched problem for ensuring everyone can participate in the civil justice system to rectify legal wrongs, including those arising due to COVID-19.

Social Determinants of Health (SDOH) Often Implicate Civil Legal Issues
Access to housing, employment, and public benefits, and domestic violence are both civil legal issues and what public health scholars call “social determinants of health.” Social determinants of health are the “[c]onditions in the places where people live, learn, work, and play” that “affect a wide range of health risks and outcomes.” Public health scholars are beginning to recognize that rural attorney deserts are, in and of themselves, a social determinant of health for those living in them. By providing free legal services to help with these matters, lawyers assist clients in both providing redress for legal wrongs and creating more favorable SDOH in the midst of COVID-19 and beyond.

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COVID-19, SDOH, and Legal Help
In the context of a legal system that is already inaccessible to many, COVID-19 has rendered access to justice more precarious still. COVID-19 has produced a massive public health crisis that is indelibly linked to an economic crisis. Lawyers play an important role in regard to both the public health and economic crises by ensuring a level playing field in enforcing rights and providing redress for legal wrongs. Many of the civil legal issues arising during the pandemic are interrelated with SDOH. Lawyers can keep people housed when facing unlawful evictions; ensure they have access to the unemployment benefits they are entitled to; and assist a survivor of domestic violence receive a restraining order. All of these outcomes interact as socio-legal determinants of health, specifically regarding the impacts of the pandemic.

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Conclusion
Attorney deserts are a fact of life for many rural residents. They are a barrier to addressing legal issues that implicate social determinants of health, including quality housing. The public health and economic crises resulting from the pandemic implicate a wide range of civil justice issues. Lawyers must be part of the solution to the legal issues resulting from the pandemic, including eviction defense. Supporting legal aid and pro bono efforts is a necessary aspect of a system that addresses the concurrent legal and social determinants of health arising from COVID-19. At the same time, justice system stakeholders must take steps to achieve long-term solutions to California’s rural attorney shortage.