Legal Financial Obligations: An Understudied Public Health Exposure
Abstract
The impacts of exposure to the criminal justice system on health-related outcomes are well studied in the United States (US). However, while previous studies focus on the impacts of arrest, incarceration and re-entry on health, they neglect a critical component of the criminal justice system: legal financial obligations (LFO’s). LFOs, which include fines, fees, and other surcharges are levied at nearly every stage of the criminal justice process, entrench individuals into a cycle of poverty and exacerbate known social determinants of health such as food and housing instability and loss of health insurance. Although LFOs are the most widely-used form of punishment in the US, they are understudied as a public health exposure. This paper represents a call for researchers to address this gap in knowledge by including measures of LFOs in research related to the impacts of criminal justice exposure. This article describes what is known in the literature around LFOs, presents a framework outlining hypothesized pathways linking LFOs to health outcomes, discusses gaps in research related to public health costs and outcomes, and highlights critical areas for future research.
Keywords
Criminal Justice System
Health Outcomes
Social Determinants of Health
Courts
Policy
Citation
Lindenfeld, Z., & Rouhani, S. (2026). Legal financial obligations: an understudied public health exposure. American Journal of Preventive Medicine, 108312. https://doi.org/10.1016/j.amepre.2026.108312