When Health Outcomes Depend on More Than Medicine
Research By: Samantha L. Simpson, MD | Andrew Beck, MD, MPH | Adrienne W. Henize, JD | John Feister, MD, MS
Post Date: June 9, 2026 | Publish Date: May 1, 2026
Cincinnati Children’s researchers and legal advocates show how medical‑legal partnerships can support families during hospitalizations
During a prolonged neonatal intensive care unit (NICU) hospitalization, a medically complex infant’s family faced repeated eviction threats while navigating critical medical decisions about their child’s care. Legal advocacy helped stabilize the family’s housing during this period, supporting care delivery and discharge planning.
Cases like this raise an important question: how should healthcare systems respond when social needs complicate medical care and threaten outcomes?
A NeoReviews article, co-led by researchers at Cincinnati Children’s, describes how healthcare teams can better respond when medical care alone is not enough. The article, published in May 2026, uses neonatal care as a high‑stakes example of how integrating legal advocacy into healthcare delivery can help address housing instability and other health‑harming legal needs during critical periods.
“Prolonged hospitalizations, particularly in the NICU at the very beginning of life, highlight that factors like safe, stable housing and access to legal support are important parts of family well-being and child health,” says first author of the study, Samantha Simpson, MD, Division of Neonatology and Pulmonary Biology. “Even as we provide highly intensive medical care during these critical periods, clinicians across healthcare settings often lack the tools to address these needs.”
When social needs affect medical outcomes
Infants born extremely preterm often require months of intensive care and frequent follow‑up visits. Their health outcomes depend not only on medical treatment, but also on the safety and stability of the homes and communities they return to after discharge.
Similar challenges arise across healthcare settings.
Patients and families may face legal and social needs that affect care delivery. Housing instability, unsafe living conditions or delays in accessing public benefits are just some of the challenges that can limit caregiver presence, disrupt follow‑up care and complicate discharge planning. In certain cases, unresolved legal issues directly interfere with medical care and make optimal outcomes far more difficult to achieve.
Clinicians frequently recognize these risks, but they are not always equipped to address them. While social work support is essential, issues such as eviction threats or housing code violations often require legal intervention to achieve durable solutions.
Prior research has shown that addressing these types of legal and social needs can have measurable effects on health outcomes, including reduced hospital admissions.
How Medical-Legal Partnerships work
Medical‑legal partnerships integrate legal services into healthcare delivery through on‑site legal staff or formal referral pathways with legal aid organizations, including partnerships such as the Cincinnati Child Health-Law Partnership (Child HeLP) with the Legal Aid Society of Greater Cincinnati. This approach allows healthcare teams to identify legal needs as part of routine care and connect families with legal support early.
“Evidence shows that medical‑legal partnerships improve health outcomes,” says Andrew Beck, MD, MPH, Associate Chief Population Health Officer and Co-Director of the Michael Fisher Child Health Equity Center. “Such partnerships can reduce caregiver stress, support treatment adherence, and address challenges that often compete for a family’s attention.”
Several programs have also demonstrated cost savings for health systems, reinforcing the model’s value at both the family and system levels.
Implications for long-term health
Using a life-course health development framework, the authors examine the role of medical‑legal partnerships in advancing health outcomes. Early experiences can shape health well into adulthood. Addressing housing instability and other legal needs during hospitalizations may help prevent the accumulation of risk that contributes to long‑term disparities.
For care teams, this work reinforces the importance of viewing social and legal needs as part of comprehensive care. In practice, this includes:
- Identifying legal and social concerns early during prolonged hospitalizations
- Using clear referral pathways to connect families with legal support
- Stabilizing housing or benefit access to support safe discharge and follow‑up care
These steps can directly support child health, particularly for babies who require complex care after discharge.
Looking ahead
The article highlights practical considerations for implementation, including standardized screening for legal needs, clear referral processes, and sustained institutional investment.
“Across healthcare systems, funding and scalability remain real considerations,” says Adrienne Henize, JD, Lead, Clinical-Community Partnerships, Michael Fisher Child Equity Center. “But the evidence shows that medical‑legal partnerships offer a practical way to support families when legal issues threaten medical care.”
By pairing medical care with legal advocacy, healthcare teams can better support families during high‑risk periods, helping ensure that medical and nonmedical needs are addressed together rather than in isolation.
About the study
Cincinnati Children’s co-authors include experts from the Divisions of Neonatology and Pulmonary Biology, General and Community Pediatrics and Hospital Medicine and the Office of Population Health and Health Equity.
Additional co-authors include experts from Legal Aid Society of Southwest Ohio and Children’s Hospital of Philadelphia.
Child HeLP is supported through philanthropic funding, operational support from Cincinnati Children’s, and grant funding to the Legal Aid Society of Greater Cincinnati, including support from the Ohio Access to Justice Foundation and the Legal Services Corporation.
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| Original title: | A Life Course Approach to Health Equity: Lessons From Medical-Legal Collaborations |
| Published in: | NeoReviews |
| Publish date: | May 1, 2026 |
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I help lead Cincinnati Children’s community health initiative which seeks to equitably optimize child health outcomes.
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The Research Horizons blog features news and insights about the latest discoveries and innovations developed by the scientists of Cincinnati Children's. This blog does not provide medical advice, diagnosis, or treatment. Email researchnews@cchmc.org with questions or ideas.
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