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Mechanisms for Advancing Public Health

Barriers to a Diverse and Robust Public Health Law Workforce

February 24, 2022


According to Burris et al., a public health lawyer’s objective is “to support the design, implementation, monitoring, evaluation, and scale up of legal measures to improve public health and health systems,” including by advancing health equity.  Accordingly, the public health law workforce is comprised of attorneys who advise public health officials, practitioners, and advocates in using law to accomplish public health goals. To date, legal interventions have helped to enforce policies, change behavior, and reduce some health disparities.

But to truly eliminate health disparities, the public health law workforce will need to help public officials craft and implement legal interventions that are reflective of and sensitive to the multicultural population of the U.S. A competent and diverse public health law workforce is essential to accomplishing this goal. Yet the public health law field—like the public health field generally—has struggled to create and maintain a robust and racially diverse workforce. Several barriers to entering the field, such as financial impediments, historic and persistent racial disparities which create a lack of mentorship for young attorneys of color, and a dearth of full-time, accessible job opportunities, may hint at possible approaches to expanding and strengthening the public health law workforce for the future.

Finances are a significant obstacle to newly minted lawyers entering the public health law field. For one, a law school education is an expensive prerequisite to joining the public health law workforce. Financial burdens begin early, as even the law school application process costs hundreds, if not thousands, of dollars, not only for the Law School Admissions Test (LSAT), preparation courses, and application fees, but also due to time away from income-producing opportunities.  And, of course, the cost of attending law school is substantial. As of 2019, 39 percent of all law school graduates anticipated completing law school with over $100,000 in debt.  The student loan burden is even higher for students of color, with almost half (49 percent) expecting to be indebted by over $100,000 at graduation. Because of these burdens, many law school graduates base their early career decisions on financial need rather than on the values and interests that initially brought them to law school.

For example, a 2021 American Bar Association (ABA) survey found that for 55 percent of indebted law students, salary influenced their job choices more than they expected upon entering law school. Furthermore, nearly one-third of indebted law graduates pursued jobs “less focused on public service or doing good” than they envisioned when beginning law school. On top of a basic legal education, public health lawyers are increasingly expected to obtain further graduate training in public health (e.g., a Master of Public Health degree), adding additional costs. State and local health departments have been chronically underfunded and are generally unable to pay salaries competitive with private sector wages which makes choosing to work at these agencies a hard or impossible choice for new lawyers with these considerable entry costs.

Another significant barrier to building a diverse public health law workforce stems from historic inequities reproduced and reinforced through structural racism.  The legal profession has long used racial gatekeeping mechanisms such as entrance exams that favor White test-takers, discriminatory admission practices, and exclusionary bar admission processes that impede Black Americans and other people of color from entering the profession. These gatekeeping mechanisms have yielded poor representation of students of color in law schools and the least racially diverse profession in the country. Given this context, it is somewhat unsurprising that the public health law workforce lacks diversity as well.

But the problem is not just one of currently low numbers; it is a problem that reproduces itself by creating obstacles for students and attorneys of color to thrive in law schools and the legal profession. For example, first-generation law students—disproportionately comprised of students of color—face unique challenges in gaining employment in bar passage-required jobs, likely due to a lack of guidance and mentorship.  Furthermore, law students of color consistently experience a lower satisfaction level and a decreased sense of belonging during law school as compared to their White peers. Indeed, for students and attorneys of color, a sense of community and belonging becomes crucial when taking up space in a profession that has been historically challenging to attain and one that includes few people with whom they can identify.

Finally, for recent law school graduates of all backgrounds, it can be challenging to find entry-level attorney roles in public health law, making it difficult to gain the experience and expertise necessary to build a public health law career. One possible reason is that dedicated public health attorney jobs are relatively scarce and often difficult to find. This is partly due to a lack of attorney roles in health departments—especially local health departments. Rather than hiring in-house legal counsel, many local health departments rely on an attorney who is employed by another local agency (e.g., county corporation counsel) or on private counsel.

In either case, it can be difficult for job seekers to identify roles involving public health law. Furthermore, once employed in one of these roles, an attorney is likely to have a wide-ranging caseload that may impede development of expertise in any one area. Another potential obstacle to securing a first public health law job is that many relevant positions are not described as “public health attorneys.” To the contrary, there are a plethora of roles which are not described as public health law positions despite advancing public health goals via law and policy. Many relevant positions may “prefer” rather than “require” a J.D., which is a distinction that many new job seekers may be unsure how to evaluate as a first career step. Finally, obstacles to finding public health attorney roles, especially in government, may also reflect broader recruitment challenges plaguing the public health field generally. For example, many health departments employ a fairly limited range of recruitment strategies, and the field as a whole lacks a centralized location for advertising public health jobs.

Skilled, dedicated attorneys are crucial partners to the public health officials charged with effectively responding to routine and emergent public health threats, while also promoting and increasing health equity.  A capable, diverse, and competent public health law workforce is comprised of attorneys who can navigate the law to protect community health and improve the social and political determinants of health, while an insufficiently robust and diverse public health law workforce can yield capacity gaps and inadequate legal preparedness.

Overcoming the obstacles to achieving a diverse and competent public health law workforce requires a multi-faceted, multi-dimensional approach that includes addressing both law student barriers and public health infrastructure needs. To achieve a genuinely robust, competent, and diverse public health law workforce, there must be an intentional effort to mitigate financial impediments, offer mentorship, foster a sense of belonging for law students and new attorneys of color, and develop and promote appropriately compensated entry-level jobs.

This post was written by Emely Sanchez, J.D., M.P.H., Legal Fellow, Network for Public Health Law – Mid-States Region Office, and reviewed by Colleen Healy Boufides, J.D., Deputy Director, Network for Public Health Law – Mid-States Region Office.

The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document do not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.

Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not represent the views of (and should not be attributed to) RWJF.