Many of us no doubt recall the highly influential training of judges on law and economics sponsored by the Olin Foundation, described here. My colleague at Northeastern, Wendy Parmet, wisely spotted the need for a similar program acquainting judges with key issues in public health. Better still, she has founded such a program, dubbed Salus Populi, that has been in operation since 2020 and has already educated over 2100 judges, attorneys, and court personnel. Particularly timely in light of current events. The next session will be June 12 at Northeastern. Wendy and her partners offer this fuller description.
Salus Populi: Educating the Judiciary on the Social Determinants of Health
Jasmine M. Howard, Wendy E. Parmet, Marjani Green
The social determinants of health, also called the social drivers of health (SDOH), are the conditions in the environment in which we are born, live, work, worship, play, and age that affect a wide range of health, functioning, and quality of life outcomes and risks.[1] Research has consistently demonstrated that laws, along with their implementation and enforcement, can significantly affect population health and health equity by impacting the social determinants of health.[2]
Salus Populi (SP) is a unique judicial education program that trains judges, lawyers, and other legal professionals on the relationship between the law and the SDOH. SP was developed in recognition of the fact that the judicial system has an important and often adverse impact on the health of individuals, families, and communities. Issues relating to the SDOH also appear pervasively in court cases, including those relating to criminal justice, child welfare, housing, the environment, and mental health. For example, when an individual becomes involved with the criminal justice system, health outcomes decline for the entire family.[3] Yet for the most part, the judges who preside over such cases and the lawyers who appear before them have little knowledge about the SDOH, the methods that researchers use to study them, and their relationship to judicial decision-making.
The judicial system’s adverse impact on health can lead, in turn, to increased interactions with the judicial system. For example, a tenant facing eviction, after losing her job due to an uncontrolled medical condition, may have to uproot her children, destabilizing the family unit, creating education leaning loss that harms the children’s mental well-being. Children with education loss are, in turn, more likely to become involved with child protective services.[4] A child that becomes involved with child protective services and is placed in foster care is more likely to become involved with the criminal justice system.[5] We refer to this as the vicious cycle in which one interaction with the court system leads to additional health harms and involvement with the justice system that can cause further health harms. When judges understand this potential vicious cycle, they may utilize tools to both promote the health of litigants and their communities, while enhancing judicial efficiency.
Since its founding in 2020, SP has educated over 2100 judges, attorneys, and court personnel on the SDOH and their relationship to judicial decision making. The program also introduces judges to some of the research methodologies that epidemiologists use to study the ways that social forces, including law, affect population health. SP achieves this through a full day, in-person eight-hour training, that is open to judges and lawyers from around the country. These programs are highly interactive, affording judges the opportunity to problem solve and learn from each other. Additionally, SP provides shorter trainings that are held in collaboration with judicial and legal partners across the country. These programs are customized in both subject matter and length of presentation to fit the needs of the partner.
To assess if SP is reaching its goals, the program conducts both a process and outcome evaluation utilizing survey data and post training interviews. Through these efforts, SP has found that the program doesn’t just increase participants’ knowledge about the SDOH but, in the view of the judges, provides them with a framework for and ideas on how they can change some of their interactions with litigants to improve the health outcomes of at-risk populations. Judges who have taken the program have also stated that SP shifted their mindset and their judging. In a three-month post training interview, one judge stated that learning about the SDOH in the program “simply confirmed what I knew to be true and has given me a little more confidence to express what I know and why I believe it is important and believe that it should factor into the ultimate decision making.” Another powerful example highlighting the programs’ impact on judging was seen in our November 2025 full day training. In closing remarks, one state trial judge, who had participated in our June 2025 program, spoke powerfully about how he had initially been skeptical about our training, but it had changed how he ran his court. He also offered a list of “best practices” that he had adopted since the training to reduce the adverse impact that the judicial system has on individual and community health.
Based on our evaluation efforts and the discussions we have had with judges, the program has shown us not only how powerful this type of information can be, but also that it is information that all lawyers should have. The relationship between the SDOH on health and the judicial system should be taught widely throughout legal education to reduce the judicial system’s adverse effect on health and thereby promote both health equity and justice.
[1] Healthy People 2030, Social Determinants of Health, U.S. Dep’t Health & Hum. Servs., Off. Disease Prevention & Health Promotion (last visited Mar. 16, 2026) https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health.
[2] Joel Teitelbaum et al., Law and Policy as Tools in Healthy People 2030, 27 J. Pub. Health Mgmt. & Prac. S265 (Supp. 6 2021), https://pmc.ncbi.nlm.nih.gov/articles/PMC8478297/.
[3] Emily Widra, New Data: People with Incarcerated Loved Ones Have Shorter Life Expectancies and Poorer Health, Prison Pol’y Initiative (July 12, 2021), https://www.prisonpolicy.org/blog/2021/07/12/family-incarceration/.
[4] Layal Bou Harfouch & Christina Mojica, Housing Instability is Driving Child Welfare Involvement, Reason Found. (Jan. 2, 2026), https://reason.org/commentary/housing-instability-is-driving-child-welfare-involvement/.
[5] Widra, supra note 3; see also Juvenile L. Ctr., What is the Foster Care-to-Prison Pipeline? (May 26, 2018), https://jlc.org/news/what-foster-care-prison-pipeline.
