Why Inequitable And Burdensome Court-Issued Fines And Fees Are A Health Issue—And What Health And Policy Leaders Can Do About It


Stress from indebtedness can manifest in the form of poorer physical and mental health outcomes.

Social determinants like court debt can negatively influence an individual’s health. Through healthcare hotspotting, the Rutgers Law School/Camden Coalition, Medical-Legal Partnership (MLP) serves individuals with various medical and legal issues by creating patient care teams trained to identify and address legal problems like fines, fees, and outstanding warrants. Court debt can have severe consequences on a person’s life that manifest in their health. Collateral consequences of court debt such as the driver’s license suspension, loss of employment including health insurance, and loss of the ability to pay for medication can take a physical and mental toll on individuals. Camden’s MLP has helped 30 percent of their clients resolve municipal violations, driver’s license suspensions, outstanding warrants, and debt from additional fines and fees. This brief chronicles the adverse effects of court-imposed fines and fees on individuals’ health and strategizes how healthcare providers, advocates, and policymakers can address fines and fees.

You can read the full text here.  

Key Findings:

  • Fines and fees exacerbate health and social issues.
  • Legal issues can become barriers for individuals with complex health and social needs.


Health & Social Service Providers

  • Engage in care planning around fines and fees issues.
  • Support and advocate for patients with court engagement.

Advocates & Policy Makers 

  • Suspend the imposition of fines and fees and related enforcement mechanisms like driver’s license suspensions due to court debt. 
  • Courts should utilize ability to pay assessments as an interim solution for fines.
Puja A. Upadhyay, Ashley D. Maddison, Jeremy S. Spiegel, & Donald M. Berwick
Camden Coalition of Healthcare Providers