Putting The T In Mlp: The Role Of Trust In Medical Legal Partnerships

Jenny Ajl

This thesis is restricted to Yale network users only. It will be made publicly available on 08/28/2020


The United States spends more on healthcare than any other country, while health outcomes lag behind many nations. This is often attributed to the disproportionately low spending on social services, and social determinants of health (SDOH) need to be addressed in order to improve the nation’s health. SDOH are increasingly understood to be key factors in predicting health outcomes. Medical legal partnerships (MLPs) are one intervention that seek to address SDOH. The MLP model comprises three core components: providing legal care for patients, improving systems of healthcare, and creating policy change outside the healthcare system. In this qualitative study, we interviewed caregivers of children who have received legal care through the MLP at the Yale Pediatric Primary Care Center. After coding and analyzing these interviews, we came to several important conclusions. Assessing the relationship between patient and provider, we found that a lack of trust in this relationship led to decreased disclosure of health-harming legal needs. We also found that once participants did disclose their needs and connect to legal care, they gained agency and empowerment with the healthcare, legal, and educational institutions. Lastly, participants expressed that after receiving legal help, they then disseminated information into their communities. These findings suggest that improved methods to promote trust are needed when developing MLPs and performing screeners to assess SDOH.