Social epidemiologists insist fundamental social conditions play a large role in the health problems of the American urban poor, but these well-intentioned scholars and practitioners do not necessarily appreciate how greatly law is intertwined with those social conditions. Law helps create and maintain the urban poor’s shabby and unhealthy physical environment, and law also facilitates behaviors among the urban poor that can result in chronic health conditions. Then, too, law shapes and configures the very poverty that consigns the urban poor to the inner city with its limited social capital and political clout. Overall, law creates and perpetuates the health problems of the urban poor more than it eliminates or ameliorates them. Social epidemiologists and others concerned with improving the urban poor’s health might therefore approach law as a foe more than a friend.