In Colorado, low-income and minority children live shorter and less healthy lives than wealthier and white children. Data on childhood asthma, obesity, and infant mortality disparities are disheartening. For example, although Colorado has the 5th lowest infant mortality rate nationally, Colorado's black infants die nearly three times more often than the state's white infants; Latino infants are 70% more likely to die during their first year than whites. Data from 2015 not only show the immunization rate for Colorado toddlers continued a troubling downward trend so that Colorado children rank 30th in the nation, but a research collaborative between the University of Colorado School of Medicine and Children's Hospital Colorado reported that "[s]ignificant disparities exist in vaccination delivery by age group..., race/ethnicity, and socioeconomic status."

This dissertation presents a study premised on the understanding that the inequitable distribution of access to important social determinants of health is an underlying cause of these health disparities among Colorado children. The study examines the impact of medical-legal partnerships (MLPs), an intervention designed to equalize access to preventive medical care, decent housing, and other social determinants in order to disrupt the fundamental association between poverty, minority race and ethnicity status, and poor health. MLPs are an innovative health delivery model that integrate lawyers into clinical delivery teams to help equalize vulnerable patients' access to the social determinants of health that are guaranteed by law. The MLP studied here operated between 2009 and 2013 between Children's Hospital of Colorado, Colorado Legal Services, and a law school program called the Colorado Health Equity Project. This study retrospectively analyzed quantitative medical and qualitative legal data to examine whether MLP services improved children's health and social outcomes by reducing upstream social risk factors that could decrease health disparities over the life course. Specifically, this study analyzed the MLPs impact on young children's vaccination compliance and access to better neighborhood resources due to upward residential mobility. Although this MLP did not have a statistically significant impact on either outcome of interest, the methodology developed here suggested a relationship between MLPs and other health outcomes that warrants further study.