Researchers all across the University of Illinois at Urbana-Champaign campus are working toward advancing knowledge and creating solutions to critical health disparities on both local and global scales. These researchers evaluate health disparities from a variety of interdisciplinary perspectives, and work to find ways to address the discrepancies within medicine, child development, law, food access, education, and health communication. Each Researcher Spotlight features a health disparities researcher doing important work right here at Illinois.
Robin Fretwell Wilson, JD
Director, Epstein Health Law and Policy Program
Roger and Stephany Joslin Professor of Law, College of Law
Robin Fretwell Wilson, J.D., is the Roger and Stephany Joslin Professor of Law and the Director of the Epstein Health Law and Policy Program at the University of Illinois College of Law, and has placed special focus on poverty as a social determinant of health care costs and health generally. Professor Wilson believes that as a land-grant institution, we have the obligation to do more for those who have the least. She believes smart, engaged policy holds the promise to enhance human flourishing for all.
What is your research in health disparities about?
My current research focuses on what I call the Medicalization of Poverty. It is well documented that many diseases are strongly linked to poverty, and poverty is a strong predictor of health status. But a second aspect of poverty is less well-explored—that we have “medicalized” poverty. We spend inordinate amounts of money and other resources to address healthcare needs brought on by poverty instead of directly addressing the tangible needs of the poor before illness strikes. We treat the symptom, not the problem.
In 2017, in partnership with the Carle Foundation, Discovery Partners Institute, the University of Virginia, and IHSI, the Epstein Program convened a dialog workshop exploring how we can better address poverty as a driver of health expenditures. The conference brought together perspectives on topics relating to poverty and health outcomes—housing, income, marital status, race, family caregiving, reproductive choices, gun violence, opioid misuse, literacy, data collection, and more.
One sustaining output of that thinking is the recent symposium issue of The Journal of Law, Medicine, and Ethics, which I co-edited. It has become clear that we need to start looking more upstream to identify and fix the root causes of poverty before they become causes of negative health outcomes. A hallmark of the Epstein Program is to translate our research-based findings into felt policy in the world. To this end, we convened a Roundtable on the Medicalization of Poverty in Chicago under the umbrella of the Discovery Partners Institute, with assistance from the University of South Florida School of Public Health, University of Virginia, and IHSI. As with the symposium, we brought together public health experts and policymakers to discuss the impact of poverty on health outcomes in Chicago and other Illinois communities, and are now working on taking next steps to act on the ideas and proposals that came from that discussion.
How are you conducting your research?
One of the key drivers of my work is using an interdisciplinary approach to identify solutions, particularly because the medicalization of poverty touches on many different scholarly and policy areas. For example, the symposium issue brought together social scientists such as Madhu Viswanathan and colleagues from the Subsistence Marketplaces Initiative at the College of Business to explore the behavioral and social aspects of living with low income, and how low literacy rates can result in alienation and poor health choices. Perhaps more defining our our approach is bringing policymakers and lawmakers to the table. For example, former Wisconsin Governor Tommy Thompson shared lessons from his experience reforming Wisconsin’s welfare program and the creation of Medicare Part D while he served as Secretary of Health and Human Services to stress that bipartisan solutions are possible.
Meanwhile, our recent Roundtable on the Medicalization of Poverty brought in input from the Utah Legislature on their successful expansion of Medicaid cover all homeless individuals in the state. The Roundtable also brought both Chicago and Cook County Public Health Commissioners to the discussion to get a sense of what their current work looks like and where there may be opportunities to partner to expand on that work.
My work in the symposium centers on providing qualitative analyses of the legal and regulatory landscape affecting the relationship between family form and social safety nets around healthcare. My findings show that healthcare coverage and services would be better utilized and more effective if they were not limited only to families formed by married parents. As this brief summary shows, we think it’s very important to bring diverse perspectives into these important discussions.
How does being a part of the Illinois community support and enhance your research?
The university has a strong national and international presence, as the new Discovery Partners Institute makes clear. The Medicalization of Poverty work has benefitted greatly from local and national partnerships like those with the Carle Foundation, the University of Virginia, and now the University of South Florida. I regularly work alongside those at the new Carle Illinois College of Medicine, where I co-teach a course on the Rights of Conscience; the Gies College of Business; the Carl R. Woese Institute for Genomic Biology; and more recently with faculty from the Beckman Institute. The recent roundtable discussion succeeded in large measure because of the extraordinary umbrella of the University of Illinois System. Being in the Illinois community has facilitated connections that only great institutions can bring to bear on the most complex challenges facing us as a nation.
Do you have a personal story to share or path that led to your interest in this area of study?
My father grew up in Appalachia. My father’s parents died when he was young, so he joined the military and got skilled as a welder. When I was 10 years old, my father’s life changed forever when he was severely burned in an industrial accident. He was in the burn unit for 42 days after receiving seven skin grafts to patch the third-degree burns covering his body.
If this accident were to occur today, his treatment would cost millions of dollars. My father was fortunate because the expert care he received at a large tertiary care facility was covered by workers' compensation, but what happens to others who have no hope in paying for needed care?
The memory of how little separated my father from a far grimmer fate propels me to want to chart better policy to help those who are struggling today. In a process I call translational law, I believe great research-focused scholarship can serve as the launching pad for smart engaged policy that promotes human flourishing for all of us. It is incumbent upon us to see that our scholarship does good in the world.