Footer Katherine, Windle Michael, Ferguson Laura, Hatcher Jordan, Lyons Carrie, Gorin Emma, Stangl Anne L, Golub Steven, Gruskin Sofia, Baral Stefan
Assistant scientist in the Center for Public Health and Human Rights, Department of Epidemiology, Department of Health Behavior and Society, Johns Hopkins School of Public Health, Baltimore, MD, USA.
Doctoral research assistant in the Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA.
Health Hum Rights. 2018 Dec;20(2):65-84.
Legal empowerment is increasingly recognized as a key approach for addressing socio-structural determinants of health and promoting the well-being and human rights of vulnerable populations. Legal empowerment seeks to increase people's capacity to understand and use the law. However, limited consensus remains on the effectiveness of legal empowerment interventions in optimizing health outcomes. Leveraging a meta-narrative approach, we synthesized literature describing how legal empowerment interventions have been operationalized and empirically studied with respect to health determinants. The studies included here document diverse legal empowerment approaches and highlight how interventions changed the context surrounding the health of vulnerable populations. The absence of robust conceptualization, operationalization, and measurement of the risk contexts in which legal empowerment approaches operate limits the clarity with which interventions' impact on health can be ascertained. Despite this, legal empowerment is a promising approach to address the health of marginalized populations. To foster support between the fields of legal empowerment and health, we explore the limitations in study design and measurement of the existing evidence base; such scrutiny could strengthen the rigor of future research. This paper provides a guide to the socio-structural levels across which legal empowerment interventions impact health outcomes in order to inform future interventions.
法律赋权日益被视为解决健康问题的社会结构决定因素以及促进弱势群体福祉和人权的关键途径。法律赋权旨在提高人们理解和运用法律的能力。然而，对于法律赋权干预措施在优化健康结果方面的有效性，目前仍存在有限的共识。利用元叙事方法，我们综合了描述法律赋权干预措施如何在健康决定因素方面得以实施和实证研究的文献。此处纳入的研究记录了多样的法律赋权方法，并突出了干预措施如何改变了弱势群体健康状况的背景。法律赋权方法所运作的风险背景缺乏强有力的概念化、实施和衡量，这限制了确定干预措施对健康影响的清晰度。尽管如此，法律赋权仍是解决边缘化人群健康问题的一种有前景的方法。为促进法律赋权与健康领域之间的支持，我们探讨了现有证据基础在研究设计和衡量方面的局限性；这种审视可以加强未来研究的严谨性。本文提供了一份指南，说明法律赋权干预措施影响健康结果所涉及的社会结构层面，以便为未来的干预措施提供参考。
