Quantifying the Need for Attorney Pro Bono Services in Connection with the Social Determinants of Health

TL;DR

This study estimates that over 34 million attorney hours annually are needed to address social determinants of health-related legal issues for indigent clients in the U.S., highlighting a significant justice gap.

Contribution

It provides the first quantitative estimate of attorney hours required for social determinants of health-related legal needs, informing policy and resource allocation.

Findings

Over 34 million attorney hours needed annually for five key issues.

Each U.S. attorney would need to contribute about 26 hours per year.

The justice gap is substantial relative to total practicing attorneys.

Abstract

The paper estimates the need for additional attorney hours annually to address the legal needs of indigent clients throughout the United States in matters that comprise the so-called social determinants of health (SDoH). The result will inform stakeholders such as policy makers and private donors so they can allocate resources appropriately and design programs to close the do-called justice gap. As a pilot study, the scope of the project covers only a few major justice problems related to the social determinants of health (standard housing, evictions and foreclosures, guardianships for the incapacitated, and victims of domestic violence) because they significantly impact health outcomes and there are data available. Based on our calculations, we estimate that the total number of attorney hours to address only these five legal issues is over 34 million per year. To put that in perspective, the American Bar Association estimated that in 2018, the year from which much of our data comes, the total number of practicing attorneys in the United States was 1,338,678 (Weiss). Thus, to provide the needed hours, every single practicing attorney in the United States would need to contribute about 26 hours a year. While many lawyers do in fact contribute pro bono hours, they address the full range of legal needs that go well beyond just the five we studied.