Health Disparities and the Law: Wrongs in Search of a Right
Mary Anne Bobinski

This article explores the promise and limits of law in addressing
disparities in health. Part II summarizes the research detailing
disparities in treatment, outcomes, and health status associated with
gender, ethnicity/race, and socioeconomics. Part III evaluates the proper
scope of public health interventions to reduce disparities in health
status. Most health law scholars have focused on the problem of access to
health care. Yet, access to care accounts for a relatively small percentage
of a population's health. Part III considers the utility of law in
addressing determinants of health status in two general areas derived from
the Healthy People 2010 framework: "behavioral" health risks and
socioeconomic status. Legal approaches to behavioral health risks such as
those involving tobacco, HIV, and obesity are controversial. Using law to
address socioeconomic disparities would be an even more radical approach in
the United States. Part IV concludes that there are great risks to
retaining a narrow definition of public health and public health
interventions. A narrow conception of public health restricts society's
ability to address serious problems that have a major impact on health
status. The article concludes that there is little public or governmental
support for a more expansive conception of public health. Interventions
into behavioral risk factors for poor health status often are stymied by
the competing paradigm of personal responsibility. Socioeconomic factors
are even less likely to be considered the proper domain of regulation.
Health status disparities thus are likely to remain a wrong in search of a
right.

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dr

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