Over the last several decades, states and localities across the United States have increased the number and amount of monetary fines and fees imposed for municipal code violations — civil and low-level criminal offenses such as parking and traffic violations.

Fines and fees have far-reaching consequences and can lead to a devastating cycle of debt, poverty, and even incarceration, disproportionately impacting people of color and low-income people, who are overrepresented in the criminal justice system and have the least ability to pay. Fines and fees also perpetuate long-standing health and economic disparities in affected communities.

In this brief, Jeremy Spiegel, Esq., Ashley Maddison, Esq., and Puja Upadhyay of the Rutgers Law School/Camden Coalition Medical-Legal Partnership (MLP) describe the negative health effects that court-imposed fines and fees can have on individuals with complex health and social needs. The brief includes insights from a Camden Coalition nurse and an MLP client, as well as recommendations for providers and policymakers to address the problem of inequitable fines and fees at both the individual and systems levels.

Special thank you to Donald M. Berwick, MD, MPP for providing the brief’s foreword.