Category Archives: Public health law
The Network provides assistance and resources to public health lawyers and officials on legal issues related to public health, including health reform, emergency preparedness, drug overdose prevention, health information privacy and food safety. More than 3,500 public health practitioners, attorneys, researchers, policy makers and others have joined the Network since it was formed in 2010 as a national initiative of the Robert Wood Johnson Foundation (RWJF).
“We are delighted that Ms. Levin, an experienced leader in public health law, will be joining a stellar Network team,” said Michelle Larkin, JD, assistant vice president for RWJF. “Laws and policies that help people lead healthier lives are among the cornerstones for building a culture of health. Through Ms. Levin’s leadership, we look forward to continued growth in the Network—a strategic resource for state and local public health officials.”
NewPublicHealth recently spoke with Levin about her new position with the Network.
NewPublicHealth: How does your previous work as the general counsel for a state health department help inform your goals for the Network for Public Health Law?
Donna Levin: During my decades at the Massachusetts Department of Health I saw the responsibility of the state health department grow exponentially. We were trusted by the legislature and given many new initiatives. So public health grew and grew and public health law has grown alongside it. So what informs my view is that the range of issues is so incredibly broad. And so I really know firsthand how the availability of technical assistance from the Network is so valuable both to lawyers working in the field and to practitioners.
Earlier this month U.S. Department of Transportation Secretary Anthony Foxx kicked off April’s National Distracted Driving Awareness Month by announcing the department’s first-ever national advertising campaign and law enforcement crackdown in states with distracted driving bans. That effort ended last week, but through individual interactions with drivers by law enforcement and through ads on television, radio and online, the effort raised attention to the dangers—and penalties—of distracted driving, according to the National Highway Traffic Safety Administration (NHTSA.) According to NHTSA 3,328 people were killed and an estimated 421,000 were injured in distraction-related crashes in 2012, the latest year for which data is available.
"This campaign puts distracted driving on par with our efforts to fight drunk driving or to encourage seatbelt use," said Foxx.
According to NHTSA, the national campaign built upon the success of federally funded distracted driving state demonstration programs in California and Delaware, “Phone in One Hand, Ticket in the Other.” Over three enforcement waves, California police issued more than 10,700 tickets for violations involving drivers talking or texting on cell phones, and Delaware police issued more than 6,200 tickets. Observed hand-held cell phone use dropped by approximately a third at each program site, from 4.1 percent to 2.7 percent in California, and from 4.5 percent to 3.0 percent in Delaware.
Currently 43 states, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands ban text messaging for drivers of all ages; 12 states, Washington, D.C., Puerto Rico, Guam and the U.S. Virgin Islands prohibit drivers of all ages from using hand-held cell phones while driving; and 37 states and D.C. ban cell phone use by new drivers.
More state campaigns are expected to be launched, according to NHTSA. To find out more about the ability of public health laws such as laws aimed at reducing distracted driving to improve health and save lives, NewPublicHealth recently spoke with Kathleen Hoke, director of the Network for Public Health Law, Eastern Region. The Network is a program of the Robert Wood Johnson Foundation.
NewPublicHealth: In his announcement of the campaign, Secretary Foxx said that the national distracted driving reduction efforts show how public health laws can be transformative. What public health does this build on? Could this have been done if there hadn’t been a history of using laws to help improve the public’s health?
Kathleen Hoke: I think there is kind of a cycle that we see in public health using law to effectuate improvements in public health, particularly injury prevention. I know we can’t think today that there was a time that children weren’t in car seats, but there was. And what happened was there was an education campaign much like the Department of Transportation’s current campaign that was all about encouraging folks to put their children in safety seats. The law took it to a certain level, so we went from roughly 20 percent of people putting their kids in car seats to maybe 60 percent of people putting their kids in car seats.
Happy National Public Health Week! All week we've been sharing stories on the value of public health across all aspects of life, and all ages and stages.
Public Health Law Research (PHLR), a grantee of the Robert Wood Johnson Foundation, has also been participating in the week by contributing graphics and posts on the particular role of public health law—when backed by evidence and grounded in research—to save lives and make a difference. Below, we are highlighting some of the critical statistics PHLR has shared, along with some context on the research behind the numbers.
Child Seat Safety
Today, every state has a law requiring children to be restrained in federally-approved child safety seats while riding in motor-vehicles. These laws differ from state to state based on number of factors (e.g., age, height and weight of the children requiring safety seats). All current child safety seat laws allow for primary enforcement, meaning a police officer can stop a driver solely for a violation of such laws.
Read more about the research behind child seat safety laws:
In 1990 approximately 20 percent of all U.S. children had elevated levels of lead in their blood. However, only a decade later that percentage was down to 1.6 percent, thanks to public health laws researched and crafted to look out for the wellbeing of children. One of the most significant pieces of legislation was The Lead Contamination Control Act of 1988, which was already on the path to improving public health in 1990.
Read more about the research behind lead laws:
Eating too much sodium can cause high blood pressure, which raises the risk for heart disease and stroke—the first- and fourth-leading causes of death in this country. A variety of laws and legislatively enabled regulations attempt to reduce sodium in the food supply, including lowering the amount of salt in foods served in schools and child care facilities or purchased by state-regulated elder and health care facilities and prisons. Almost half of all U.S. states have laws to help reduce tghe sodium in processed foods.
Read more about the research behind laws to reduce sodium levels in food:
Sports-Related Traumatic Brain Injuries
As many as 300,000 kids suffer traumatic brain injuries (TBIs) from playing sports each year. TBIs can have serious short- and long-term health effects. Can public health law make a difference? The latest study finds that while all 50 states have laws in place to combat this problem, they haven't helped stop kids with concussions from playing. However, the research does help provide some context on how those laws have been implemented and how they might be revamped to work better.
Read more about the research behind sports-related traumatic brain injury laws:
Georgia State University College of Law Names Ten Faculty Fellowships to Promote Public Health Law Education
The Georgia State University College of Law and its Center for Law Health & Society have announced ten faculty fellows to participate in the Future of Public Health Law Education: Faculty Fellowship Program. “This fellowship program is an extraordinary opportunity to promote innovative teaching, create a supportive community of practice and share best practices in teaching public health law,” said Charity Scott, JD, MSCM, Catherine C. Henson Professor of Law and director of the Center for Law, Health & Society. “The fellows’ projects will serve as models for innovation in public health law education and the resources developed will be shared with other law and public health faculty nationally.” The program is funded by the Robert Wood Johnson Foundation. Among the five faculty members serving as mentors will be Mary Crossley, JD, professor of law at the University of Pittsburgh School of Law, who NewPublicHealth previously spoke with about her role in the Scholars in Residence program. Read more on public health law.
Study: Better Boundaries, Enforcing Rules Can Improve Kids’ Sleep Health
Parents can improve their children’s sleep habits and overall health by setting boundaries around electronics use, enforcing rules and setting a good example, according to new findings from the National Sleep Foundation’s (NSF) Sleep in America poll. The annual study began in 1991, with the 2014 poll focusing on sleep practices and beliefs of the modern family with school-aged children. “For children, a good night’s sleep is essential to health, development and performance in school,” said Kristen L. Knutson, PhD, University of Chicago. “We found that when parents take action to protect their children’s sleep, their children sleep better.” The NSF recommends that children ages 6-10 get 11 hours of sleep per night, although the poll found that parents estimate their kids in that age group only get about 8.9 hours. The poll also found averages of 8.2 hours for kids ages 11-12, 7.7 hours for ages 13-14 and 7.1 hours ages 15-17; NSF recommends between 8.5 and 9.5 hours for each of those groups. Read more on pediatrics.
Stress of Racism Tied to Obesity in Black Women
Frequent experiences of racism are associated with a higher risk of obesity among African-American women, according to a new study in the American Journal of Epidemiology. Researchers analyzed data from the Black Women's Health Study, a longitudinal study of approximately 59,000 African-American women who were tracked beginning in 1995, finding that the psychosocial stress associated with long-term experience with racism can result in dysregulation of neuroendocrine functions that influence the accumulation of excess body fat. Yvette C. Cozier, DSc, MPH, assistant professor of epidemiology at Boston University who led the analyses, said in a release that work-place- and community-based programs to combat racism and interventions to reduce racism-induced stress could help prevent and combat obesity in high-risk communities. Approximately half of African-American women are obese, which raises their risk factors for cardiovascular diseases, type 2 diabetes, orthopedic problems, and death. Read more on health disparities.
A new study published recently in the American Journal of Public Health finds that non-medical exemption laws for vaccines required for school or daycare admission have significantly impacted the vaccination rates of at least one disease. The researchers reviewed relevant laws and regulations for each year between 2001 and 2008 and rated them on their restrictiveness in granting exemptions. The study was funded by a grant from the Public Health Law Research program, a national program of the Robert Wood Johnson Foundation.
According to the study, state laws that make it difficult for children to be exempted from vaccines on religious or philosophical grounds could reduce the number of whooping cough cases, but did not have an impact on cases of measles, mumps, haemophilus influenza type B (Hib) or Hepatitis B.
“Our research shows that during the study period, if all states increased the restrictiveness of their non-medical exemption laws by one level, the number of U.S. whooping cough cases would decline by 1.14 percent, resulting in 171 fewer cases per year,” according to study author Y. Tony Yang, ScD, MPH, associate professor at the College of Health and Human Services at George Mason University.
The study found that the impact on whooping cough may be greater than for the other diseases studied simply because whooping cough affects more people. Researchers call this a “threshold effect,” which means laws may not have a significant impact unless they works to prevent a disease that affects a critical mass of people. During the study period, whooping cough was much more prevalent than the four other diseases studied—the average incidence rate for whooping cough was 18 per 100,000 individuals from 2001 to 2008. For Hib, Hepatitis B, measles, and mumps, the mean incidence rates were less than 1 per 100,000.
New Report: Most States Not Implementing Enough Proven Strategies to Prevent Prescription Drug Abuse
Prescription drug-related deaths now outnumber deaths from heroin and cocaine combined, and drug overdose deaths exceed motor vehicle-related deaths in 29 states and Washington, D.C.
A new report about prescription drug abuse released today by Trust for America’s Health (TFAH), finds that few states are implementing more than just a few promising strategies that have been identified to help combat the widespread drug abuse that continues to increase across the U.S. The report, Prescription Drug Abuse: Strategies to Stop the Epidemic, which was funded by a grant from the Robert Wood Johnson Foundation, shows that only two states – New Mexico and Vermont – have implemented all ten strategies.
According to the National Center for Injury Prevention and Control (NCIPC), nationally, sales of prescription painkillers per capita have quadrupled since 1999 – and the number of fatal poisonings due to prescription painkillers has also quadrupled. Enough prescription painkillers were prescribed in 2010 to medicate every American adult continually for a month.
>>Watch a one-minute video on the scope of the prescription drug abuse epidemic in the United States.
The report also found that the number of drug overdose deaths – a majority of which are from prescription drugs – has doubled in 29 states, tripled in ten states and quadrupled in four states since 1999.
“The rapid rise of abuse requires nothing short of a full-scale response – starting with prevention and education all the way through to expanding and modernizing treatment,” said Jeffrey Levi, PhD, executive director of TFAH. “There are many promising signs that we can turn this around – but it requires urgent action,” says Levi.
In the new report, TFAH, based on consultations with experts in public and clinical health, injury prevention, law enforcement and community organization, reviewed national recommendations and examined strategies currently in use to help curb the epidemic. Recommendations include expanding access to treatment options; ensuring responsible prescribing practices; and improving Prescription Drug Monitoring Programs.
>> Learn how your state scores on the 10 key steps to curb prescription drug abuse, with a new app from the Robert Wood Johnson Foundation.
Ohio is one of several states that have implemented six of the proven strategies recommended in the report and today, in fact, will introduce new prescriber guidelines.
NewPublicHealth spoke with Ted Wymyslo, MD, director of the Ohio Department of Health about that state’s review of drug abuse and recent efforts to reduce the epidemic through a variety of means, including public and provider education.
Home fires account for 85 percent of fire deaths in the United States, yet the majority of family homes lack fire sprinklers. Since the late 1970s, a grassroots movement has successfully promoted close to 400 local ordinances that mandate fire sprinklers in all new residential construction. In response, the homebuilding industry has sought out state preemption of local authority, a strategy used by other industries as well, in an effort to reduce costs and shield profits. A new study just published in the American Journal of Public Health looks at grassroots public health movements, including the one mobilized to push back against preempting residential fire sprinklers.
To learn more about how preemption can have a negative impact on public health, NewPublicHealth spoke with Marjorie Paloma, MPH, senior policy adviser and senior program officer for the Robert Wood Johnson Foundation’s Health Group, and a co-author of the new AJPH article on preemption, grassroots efforts and public health.
NewPublicHealth: How does the effort to increase installed sprinklers in the U.S. add to the conversation on the grassroots public health movement?
Marjorie Paloma: The residential fire sprinkler story illustrates the power of grassroots movements and the chilling effect preemption can have. I use power very explicitly because when you look at the residential sprinklers movement, over time, you see how much power people have when they come together and act. Families who lost someone to fire, fire officials and others came together first in local communities and then across the nation to advocate sprinklers and save lives. The new article in the American Journal of Public Health shows that over three decades, 34 states passed legislation on this — over 350 local ordinances — and I think that this example shows you the arc of a grassroots movement. This example also shows how powerful preemptive legislation is on a grassroots movement. In those two years between 2009 and 2011, 13 states passed preemptive legislation and that essentially pulled the wind out of the sails of advocates who had been working on this issue. And, it shows you how that tactic, that strategy of preemption can really deflate, thwart, and potentially kill a movement.
NPH: How does the grassroots movement intervene and explain what the impact of preemption is on movements that promote health?
Critical Opportunities: New Journal Article, Videos Offer Proposed Legal and Policy Changes that Can Impact Public Health
Ten new videos released today by Public Health Law Research (PHLR), a national program of the Robert Wood Johnson Foundation, with direction and technical assistance from Temple University, offer suggestions of proposed changes to laws and policies that can impact public health, such as fortifying corn masa flour to prevent neural tube defects and increasing taxes on alcohol to reduce consumption. The five-minute videos offer examples of PHLR’s “Critical Opportunities” initiative—brief presentations which showcase legal approaches to improving public health.
“Laws can be cost-efficient and popular tools for achieving public health goals. This initiative captures specific actionable, evidence-based ideas for creative ways of using law or legal interventions to improve a public health problem,” said Scott Burris, JD, director of the PHLR program.
The release of the videos is accompanied by an article published this week in the American Journal of Public Health, “Critical Opportunities for Public Health Law: A Call to Action.” It outlines five high-priority areas where evidence suggests legal interventions can have big impacts on health, and calls for a national conversation to continue to identify and prioritize opportunities for legal and policy action.
“The Centers for Disease Control and Prevention, the Institute of Medicine, and others have called for better, smarter use of legal interventions to advance public health,” said Michelle Mello, JD, PhD, the lead author of the article and professor of law and public health at Harvard University. “That’s no small task, but there’s a treasure trove of great ideas to draw on and evidence to back them up.”
PHLR has also developed a toolkit for use by organizations or instructors to host Critical Opportunities sessions at their meetings or in classrooms. The toolkit offers a how-to guide for using the format to identify ways laws can be used to address public health issues.
All ten of the new Critical Opportunities videos are available here. To highlight just one of the presentations, NewPublicHealth recently spoke with Adam Finkel, ScD, of the University of Pennsylvania Law School, about his Critical Opportunity presentation on the benefit and limitations of “smart disclosures,” an alternative to regulations and laws for improving public health.
Public Health Presentations Cap First Class of Network for Public Health Law Mentorship Program for Young Attorneys
Laws and policies that impact public health can create healthier conditions for entire communities—a more cost-effective approach than treating one person at a time, and then only after they’re sick. Last week, five inaugural Visiting Attorneys in Public Health Law presented on their efforts over the past year as part of a program hosted by the Network for Public Health Law and the Robert Wood Johnson Foundation (RWJF). The attorneys focused on public health law around:
- The legality of tobacco “power walls” that put colored cigarettes boxes directly in the line of vision of children
- The impact of environmental noise on heart disease
- Displacement of residents through gentrification
- The challenges and promise of “health in all policies”
- Legal avenues toward reducing sodium intake by the public
The post-JD program is designed to help develop exceptional skills in practice-based public health law than can help lawyers to advance their public health law careers. During the program, the five attorneys were each located at a host site under the mentorship of a renowned public health legal expert. This year’s mentors included Doug Blanke, founder and director of the Public Health Law Center at the William Mitchell College of Law in Minnesota, and Clifford Rees, practice director of the western region of the Network for Public Health Law.
“This fellowship is one that we developed in conjunction with the Network for Public Health Law to help to build the field of public health law and to allow bright, new attorneys with an interest in public health, to be able to experience working in [that] setting while being mentored and coached by leaders in the field,” says Angela McGowan, JD, MPH, RWJF’s senior program officer.
McGowan says RWJF hopes this type of experience will highlight that public health law is an exciting career option, as well as show the value of engaging new professionals in this practice as a way of making meaningful impacts at the local, state and federal levels of public health. McGowan added that the Visiting Attorneys were able to really be engaged with the real work that public health and law practitioners face daily, and to apply their legal knowledge to solving public health problems.
NewPublicHealth is partnering with Grassroots Change: Connecting for Better Health to share interviews, tools, and other resources on grassroots public health. The project of the Robert Wood Johnson Foundation Health Group supports grassroots leaders as they build and sustain public health movements at the local, state and national levels.
In this excerpted Q&A, conducted by Grassroots Change, California State Fire Marshal Tonya Hoover shared her thoughts on a quiet but highly successful public health movement: fire sprinkler requirements as a cost-effective measure to reduce civilian deaths, injuries, and property damage while protecting fire fighters and the natural environment. Tonya Hoover is a 20-year veteran of the fire service and an experienced advocate for fire prevention. She has promoted residential fire sprinkler ordinances as a local fire marshal in California and a statewide requirement that went into effect on January 1, 2011.
>>Read the full Q&A on GrassrootsChange.net.
Grassroots Change: Tell us about the grassroots movement for residential fire sprinklers.
Tonya Hoover: California has seen the passage of residential sprinkler laws since the first local adoption in San Clemente in 1978. Since that time, over 160 local ordinances have passed [fire sprinkler requirements for all new construction, including 1- and 2-family homes].
Other states have also adopted residential sprinkler ordinances for many years. Residential sprinklers aren’t new. What is new is they’re getting their time in the sun with the public because we already sprinkler apartments and larger buildings. People are used to seeing sprinklers in commercial buildings and office spaces. Most apartments in California – the complexes that have been going up in the past 20-25 years – have sprinklers. We hope to get people to look up and say: “Why isn’t my house sprinklered? This is supposed to be my safe haven.”