Category Archives: Public health law
As the nation grapples with last week’s school shooting in Connecticut, discussions across the nation are focused on how we can reduce gun-related violence and the devastation it causes. NewPublicHealth joins that conversation today, beginning with an interview with Jeffrey Swanson, PhD, a professor of psychiatry and behavioral sciences at Duke University School of Medicine. Swanson is a member of the Methods Core of the Public Health Law Research (PHLR) program at Temple University, a project of the Robert Wood Johnson Foundation. The researchers analyze the intersection of public health and law, selecting studies for funding and providing technical assistance and support to strengthen research on law and health.
>> Read a blog post by Scott Burris, director of PHLR, on developing new laws to increase the safety of having guns in society.
An article published last year by Dr. Swanson following the shooting of Congresswoman Gabrielle Giffords and eighteen other people in Tucson, Arizona, argued that homicides committed with guns against strangers by individuals with mental disorders occur far too infrequently to allow for explanatory statistical modeling and predictability. However, improving treatment access, continuity and adherence for people with serious mental illnesses can help prevent some violent episodes, according to Swanson.
NewPublicHealth spoke with Swanson a few days after the shooting in Newtown, Conn.
NewPublicHealth: What is the role of law and public health in efforts to prevent gun and other forms of violence?
Swanson: We need to think about gun violence as a public health problem. Homicide and suicide are the second- and third-leading causes of mortality in the U.S. population ages 15-34, and firearms are involved in most violent fatalities. In theory, the law should be an effective public health tool in trying to address the problem. Law can regulate what kinds of guns are available, where they can used, by whom, and even how they are stored. But since the U.S. Constitution protects a citizen’s basic right to possess a gun, the law can’t go too far in limiting legal access to guns in the population. That means we have to focus more on trying to identify dangerous people who should not have guns. That’s very complicated, because violence is complicated and so are people. The law could be used even more effectively, though, if we had better research evidence about what features of gun laws and policies work best to protect safety while safeguarding civil rights. That’s what we’re trying to do.
Inspired by the 2012 American Public Health Association (APHA) Annual Meeting, the Robert Wood Johnson Foundation recently talked with a range of national thought leaders to discuss what’s needed—and what works—to achieve better health.
Today, we're featuring video interviews with Mel Kohn, MD, MPH, Public Health Director and State Health Officer for Oregon.
Kohn spoke with us about the important roles that law and policy will play in the future of public health—especially as health care reform continues and expands.
He also explained how injury prevention, while a relatively new area of practice in the world of public health, can help to dramatically reduce human and financial costs for both individuals and communities.
Public Health Law Research, a national program of the Robert Wood Johnson Foundation housed at the Temple University Beasley School of Law, recently released a new, comprehensive online portal called LawAtlas that allows users to explore variation in laws across U.S. states and over time. Having more information about state laws, and their effect on health over time, is a critical step toward understanding what works to improve health. LawAtlas offers:
- Interactive Law Maps to show how certain laws differ by state and how they have changed over time.
- Policy Surveillance Reports to summarize the state of various public health laws across the country
- Data that public health law researchers can work with to expand upon existing research
NewPublicHealth caught up with Damika Webb, JD, Law Fellow at the Center for Health Law Policy and Practice at Temple University, at last week’s APHA Annual Meeting to chat about LawAtlas and how it can be used to better understand why policy surveillance is critical, and what we can learn from a program like LawAtlas.
NewPublicHealth: Why is it important to conduct research to know whether particular laws and policies are working to improve public health?
Damika Webb: By measuring the dimensions of a law, you can figure out which components of the law are having a positive or negative effect on health outcomes.
NPH: Why is it important to track how public health laws and policies differ from state to state?
Childhood lead poisoning is 100% preventable. So what's stopping us from eliminating it all together?
This week marks the 13th annual National Lead Poisoning Prevention Week, a chance to energize efforts to keep all kids safe from the dangers of lead-based paint.
Nearly one million children are affected by lead poisoning in the United States today, with 38 million U.S. households currently at risk. Lead poisoning knows no boundaries and can affect children of all races and ethnicities, in rural and urban communities, and at every socioeconomic level.
Recently, the Coalition to End Childhood Lead Poisoning, the U.S. Environmental Protection Agency (EPA), the U.S. Department of Housing and Urban Development (HUD) and the Ad Council rolled out a new partnership with the goal of eliminating childhood lead poisoning in the United States. Facts about lead poisoning:
- If not detected early, lead paint poisoning causes lifelong learning disabilities, hearing loss, speech delays, developmental disabilities and aggressive/violent behaviors
- Children under age 6 are most at risk for lead poisoning
- Any home built before 1978 is at risk for lead-based paint hazards
Lead poisoning prevention resources are available at www.LeadFreeKids.org, including information on:
Watch a Public Service Announcement from the Ad Council about the danger lead-based paint continues to have on young children.
Read more on lead poisoning prevention:
- The Centers for Disease Control and Prevention offers a map of healthy home efforts from health departments across the country.
- HUD’s Healthy Home Rating System helps identify household conditions that affect health and safety. Download the HHRS Hazards Chart to learn more about all dangers – in addition to lead – found in the home.
>>Read a Q&A on local lead laws and their impact on ending childhood lead poisoning.
A new study out this week finds New Jersey’s law requiring novice drivers to display a red decal on their license plates was effective in helping police officers enforce regulations unique to new drivers, and in preventing crashes. New Jersey is the first state in the nation to enact a decal law, which went into effect in May 2010 as part of N.J.’s Graduated Driver Licensing (GDL) law. Nearly every state has a GDL law on the books, but “Kyleigh’s Law,” named for a teen driver killed in a 2006 N.J. crash, is the first one that helps support enforcement of GDL restrictions using a visible decal.
The study showed that in its first year of implementation, the New Jersey decal law prevented an estimated 1,624 crashes by probationary drivers. Allison E. Curry, PhD, MPH, director of Epidemiology and Biostatistics at the Center for Injury Research and Prevention at The Children’s Hospital of Philadelphia, was a lead author on the study, published in the American Journal of Preventive Medicine. The study was funded by a grant from Public Health Law Research, a national program of the Robert Wood Johnson Foundation.
NewPublicHealth caught up with Allison Curry to get her take on why decals work as a law to help protect the public’s health.
NewPublicHealth: Can you summarize the new study?
Allison Curry: Graduated driver licensing (GDL) was first introduced in the U.S. around the mid-1990s and since then it’s been really effective in reducing the burden of crashes on teens. New Jersey in particular has a really progressive GDL program, and it’s served as one of the models in the U.S. But even so it still has what we would still consider an unacceptable number of crashes each year. So by introducing decals, New Jersey was trying to take their law a step further in improving the effectiveness of their GDL program.
What we wanted to understand was if the decals really did have an additional safety benefit for both adolescents and other road users. The aims were to examine the effect of the decals on both the police’s ability to enforce graduated driver licensing restrictions among probationary or intermediate drivers, as well as the crash rate among intermediate drivers (those who are in the stage between licensed permit holder and full unrestricted driver). We did this by linking New Jersey’s crash and licensing database in order to compare the rate of crashes and citations in the two years before the decal requirement was implemented, compared to the year after it was implemented.
NPH: And what were the findings?
What new laws or changes to existing laws—even simple ones—could dramatically improve public health in communities across the country?
Last week's Public Health Law Conference closed with a “Critical Opportunities” event discussing just that. During the session, seven presenters pitched their ideas for laws to solve critical public health issues. The presenters were each given five minutes to share the background of the issue to be addressed, their idea for the law, evidence that it could work and the feasibility of implementing the change.
Paul Kuehnert, a senior program officer for the Robert Wood Johnson Foundation and director of its Public Health team, believes enacting new laws could have a positive effect on public health.
“We need to focus on improving the quality and impact of public health across the country—by building the evidence for what works, advancing smarter laws and policies and strengthening public health departments,” he said in his introduction.
Alan Schwarz spent the majority of his career as a baseball reporter before authoring dozens of stories for The New York Times unearthing the dangers of concussions in football at all levels—from the professional leagues down to kids’ leagues. He was working as a freelancer when first approached about the public health issue. The end result was a series that made him a Pulitzer Prize-finalist and helped change the face of football.
NewPublicHealth sat down with Schwarz before he delivered a keynote address at the 2012 Public Health Law Conference to discuss how his interest in sports-related concussions began and what he thinks about the impact he made on public health.
NewPublicHealth: How did you come to report on this issue?
Alan Schwarz: Most regularly I was, along with David Leonhardt, the Keeping Score columnist for the Times sports section on Sundays, where every week we looked at some phenomenon through a statistical lens. But my beat was exclusively baseball. However, I came to know a fellow named Chris Nowinski, former Harvard football player turned professional wrestler, who had written a book about concussions and how serious they were. This was the summer of 2005.
Chris called me up. I got lots of calls from lots of young writers at that time and tried to be nice to them and Chris sent me the manuscript and it was incredible. It was really, really well done, and I thought “this is a very important book.” So I introduced him to a few people I knew here in New York in publishing, because I thought this was really good stuff. Well, no one really gave him the time of day, frankly. No one thought it was commercial enough to succeed as a book. And that was that. I didn't hear from him again, nor did I expect to.
NPH: Then what happened?
Cynthia Hallett, executive director of Americans for Nonsmokers’ Rights, will speak today about tobacco policies at a Public Health Law Conference session on innovative community policy. The other presenters include Aaron Wernham of the Health Impact Project and Marion Standish, director of community health at the California Endowment. NewPublicHealth caught up with Ms. Hallett before the session.
NewPublicHealth: What is the focus of the panel discussion you’re a part of?
Cynthia Hallett: We will be sharing some of our collective experiences on successful health policy efforts and some of the resources that would be available for others as they’re thinking about what kind of health policies they want to try to pursue at the community level.
NPH: What will you be presenting about tobacco?
Martin Fenstersheib, MD, MPH, director of the Santa Clara County Public Health Department in California led a session on safe outdoor activity for kids and adults at the 2012 Public Health Law Conference. NewPublicHealth spoke to Dr. Fenstersheib about what is keeping our communities from safely getting outside to play—violence, blight and communities built for cars—and solutions grounded in evidence-based public health law.
NewPublicHealth: You presented at a key session on making outdoor physical activity opportunities safer. What makes this an important issue for you?
Dr. Fentersheib: Often when we talk about physical activity, we hear people say that all we need to do is convince kids to go outdoors. A lot of us then say, “when we were kids, our parents let us out of the house in the morning and we came back at nighttime and all was well.” There wasn’t any problem with that. But, of course, we’ve all become aware of safety as a barrier to outdoor physical activity. And the issue has to do with not only criminal or violence safety, but safe streets generally. Do cars in an area make it less safe for example? And, is our environment built in a way that it is safe for kids to walk to school? My presentation will be an overview of the benefits of physical activity, and what some of the barriers are.
We’ll also look at the legal side of the issue, including a study on mixed use land zoning. I think the bottom line is that safer neighborhoods will have more of a mixed use flavor so that you don’t have to go far to get to work or play or to recreational areas. In such neighborhoods, there are stores and other places for you to go, and you’re closer to public transportation. The data to be presented will show that the crime rates in those areas are lower than in pure industrial areas or areas where there isn’t mixed use. Mixed use is helping to improve the built environment in the communities in which we live by having more eyes on the street, by having people basically looking out for one another and be more of a community.
NPH: What are examples in Santa Clara of new plans to create safer outdoor spaces for children and adults?
More than 500 public health legal experts, advocates, practitioners and researchers gathered in Atlanta, Georgia, this week to discuss the top issues facing the field. William Foege, MD, MPH, kicked off the conference with a keynote address at the 2012 Public Health Law Conference. Foege is a celebrated epidemiologist and physician who played a leading role in many of the important public health campaigns of the past half-century, including efforts to eradicate smallpox. Dr. Foege previously served as the director of the Centers for Disease Control and Prevention and formed the Task Force for Child Survival and Development.
In his keynote address, Dr. Foege said, “Every public health decision is based on a political decision. The basis for political decisions is law.” He also urged attendees to take action. “Burying our heads is no longer an option. There are solutions, but they require changing the laws that affects what happen to our health.”
We caught up with Dr. Foege to get his take on the critical role of public health law.
>>Follow continued coverage of the Public Health Law Conference.
NewPublicHealth: As keynote speaker, what was important to you to convey to the hundreds of people in public health capacities attending the 2012 Public Health Law Conference?
Dr. William Foege: What I have emphasized is that the law is probably the second best tool we have ever had in public health after epidemiology. We’ve used it for a long time even if we did not have a formal organization, and when one looks at all of the spectrum of things accomplished from fluoridation to school entry requirements for immunization to what’s happened with air quality and water quality, you realize that this has been very important for public health.
NPH: What is one public health issue you’d point to that has been helped significantly by laws to carry it forward?