Identifying and treating a substandard housing cluster using a medical-legal partnership

Pediatrics. 2012 Nov;130(5):831-8. doi: 10.1542/peds.2012-0769. Epub 2012 Oct 22.


Background and objective: There is a documented connection between the home environment and health. Medical-legal partnerships (MLPs) can address social and environmental determinants of health. Our objective was to describe a cluster of substandard housing identified and treated by an MLP based in a pediatric primary care setting.

Methods: Potential cases of poor-quality housing were identified during outpatient primary care. A case was defined as any rented housing unit with a reported unaddressed housing risk within a defined building portfolio (owned by a single developer) in which ≥ 1 child lived. An on-site MLP offered affected families legal services including ordinance enforcement and connection to resources. They also initiated portfolio-wide advocacy. Legal advocates reported case outcomes. Medical history and household demographics were collected from the medical record and compared with clinic-wide data by using Fisher's exact test or χ(2) statistics.

Results: After identification of a single case, an additional 15 cases were identified. Pest infestation was the most common initial risk identified. Of 14 units with outcome data, repairs were completed in 10 (71%). Of the 19 building complexes with the same owner, 11 received significant systemic repairs. Of the 45 children living within the 16 identified case units, 36% had asthma, 33% had developmental delay or behavioral disorder, and 9% had an elevated lead level. Affected children were more likely to have one of these diagnoses than the general clinic population (all P < .01).

Conclusions: An MLP identified and improved home environmental conditions for children living in a cluster of substandard housing.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child
  • Child, Preschool
  • Female
  • Housing / standards*
  • Humans
  • Infant
  • Jurisprudence*
  • Male
  • Ohio
  • Partnership Practice*
  • Pediatrics*
  • Quality Improvement
  • Surveys and Questionnaires