Evidence map›Paper›PMID 33308146›Full record

Observational studyBMC family practice2020

Legal needs of patients attending an urban family practice in Hamilton, Ontario, Canada: an observational study of a legal health clinic.

Gina Agarwal, Melissa Pirrie, Dan Edwards, Bethany Delleman, Sharon Crowe, Hugh Tye, Jayne Mallin

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMC family practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.2field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 12 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Gina AgarwalDepartment of Family Medicine, McMaster University, Hamilton, Canada. gina.agarwal@gmail.com.ORCID 0000-0002-5691-4675
Melissa PirrieDepartment of Family Medicine, McMaster University, Hamilton, Canada.
Dan EdwardsMcMaster Family Practice, Hamilton Health Sciences, Hamilton, Canada.
Bethany DellemanDepartment of Family Medicine, McMaster University, Hamilton, Canada.
Sharon CroweHamilton Community Legal Clinic, Hamilton, Canada.
Hugh TyeHamilton Community Legal Clinic, Hamilton, Canada.
Jayne MallinLegal Aid Ontario, Hamilton, Canada.
McMaster University · CAHamilton Health Sciences · CAImpact · CA

Funding

Ontario Trillium Foundation PR10028
6 · The paper itself

Abstract

backgroundIndividuals living in poverty often visit their primary care physician for health problems resulting from unmet legal needs. Providing legal services for those in need may therefore improve health outcomes. Poverty is a social determinant of health. Impoverished areas tend to have poor health outcomes, with higher rates of mental illness, chronic disease, and comorbidity. This study reports on a medical-legal collaboration delivered in a healthcare setting between health professionals and lawyers as a novel way to approach the inaccessibility of legal services for those in need.

methodsIn this observational study, patients aged 18 or older were either approached or referred to complete a screening tool to identify areas of concern. Patients deemed to have a legal problem were offered an appointment at the Legal Health Clinic, where lawyers provided legal advice, referrals, and services for patients of the physicians. Fisher's exact test was used to compare populations. Binary logistic regression was used to determine the factors predicting booking an appointment with the clinic.

resultsEighty-four percent (n = 648) of the 770 patients screened had unmet legal needs and could benefit from the intervention, with an average of 3.44 (SD = 3.42) legal needs per patient screened. Patients with legal needs had significantly higher odds of attending the Legal Health Clinic if they were an ethnicity that was not white (OR = 2.48; 95% CI 1.14-5.39), did not have Canadian citizenship (OR = 4.40; 95% CI 1.48-13.07), had housing insecurity (OR = 3.33; 95% CI 1.53-7.24), and had difficulty performing their usual activities (OR = 2.83; 95% CI 1.08-7.43). As a result of the clinic consultations, 58.0% (n = 40) were referred to either Legal Aid Ontario or Hamilton Community Legal Clinic, 21.74% (n = 15) were referred to a private lawyer; one case was taken on by the clinic lawyer.

conclusionThe Legal Health Clinic was found to fulfill unmet legal needs which were abundant in this urban family practice. This has important implications for the future health of patients and clinical practice. Utilizing a Legal Health Clinic could translate into improved health outcomes for patients by helping overcome barriers in accessing legal services and addressing social causes of adverse health outcomes.

Indexed as

Ambulatory Care FacilitiesFamily PracticeHousingHumansLawyersOntarioLegal needsMedical-legal partnershipPovertyPrimary careSocial determinants of healthSystem navigation

Identifiers

PMID33308146
PMCPMC7733261
OpenAlexW3111650507

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.