You're currently on:

Back Issues and Articles
Back Issues and Articles

Contents - JLME - 2017 Volume 45: 1 - Supplemental Issue
Full Journal
  1. Full Journal Download
Table of Contents
  1. Table of Contents
Introduction
  1. Introduction
Symposium Articles
  1. Maximizing Community Voices to Address Health Inequities: How the Law Hinders and Helps
  2. The Latest in Vaccine Policies: Selected Issues in School Vaccinations, Healthcare Worker Vaccinations, and Pharmacist Vaccination Authority Laws
  3. Action, Not Rhetoric, Needed to Reverse the Opioid Overdose Epidemic
  4. Public Health and Politics: Using the Tax Code to Expand Advocacy
  5. Homelessness and the Public's Health: Legal Responses
  6. Expanding Access to Care: Scope of Practice Laws
  7. Promoting Mental Health and Well-Being in Public Health Law and Practice
  8. Finished with Menthol: An Evidence-Based Policy Option That Will Save Lives
  9. The Prescription Drug Pricing Moment: Using Public Health Analysis to Clarify the Fair Competition Debate on Prescription Drug Pricing and Consumer Welfare
  10. Motorcycle Policy and the Public Interest: A Recommendation for a New Type of Partial Motorcycle Helmet Law
  11. Immigration and Health: Law, Policy, and Ethics
  12. Collaborating for Health: Health in All Policies and the Law
  13. EPSDT's Role in Improving Child Vision, Hearing, and Oral Health
  14. Legal Epidemiology: The Science of Law
  15. Employer Requirements to Work during Emergency Responses: Key Ethics Considerations
  16. Applying an Equity Lens to the Child Care Setting
  17. Climate Change and Public Health Policy
  18. Reducing Hospital Readmissions: Addressing the Impact of Food Security and Nutrition
  19. Policy Approaches to Improving Housing and Health
  20. Health Care System Transformation and Integration: A Call to Action for Public Health
  21. Background Checks for all Gun Buyers and Gun Violence Restraining Orders: State Efforts to Keep Guns from High-Risk Persons
Full Journal
Full Journal Download
Table of Contents
Table of Contents
Introductions
Introduction
Donna E. Levin - [PDF] (Free Download)
In September 2016, the Network for Public Health Law and the American Society of Law, Medicine & Ethics (ASLME), with the generous support of the Robert Wood Johnson Foundation, co-sponsored the 2016 Public Health Law Conference - Lead, Connect, Innovate: Strategies for Achieving Health Equity, in Washington, D.C. This symposium issue of the Journal of Law, Medicine & Ethics (JLME) is dedicated to an examination of some of the critical topics discussed at this conference.
Symposium Articles
Maximizing Community Voices to Address Health Inequities: How the Law Hinders and Helps
Julie Ralston Aoki, Christina Peters, Laura Platero, and Carter Headrick - [PDF] (Free Download)
A community's ability to develop public health policy solutions tailored for its needs and priorities is an essential part of achieving health equity. Policies to address health inequities are more likely to succeed when they come from and are supported by the communities they are meant to serve. Authentic community engagement supports the development of laws tailored to meet specific community needs that carry legitimacy and will be sustainable over time. It also can foster innovative policymaking. Thus, an important goal of law should be to maximize community voices, and especially the voices of socially disadvantaged and marginalized groups, in public health solutions.
The Latest in Vaccine Policies: Selected Issues in School Vaccinations, Healthcare Worker Vaccinations, and Pharmacist Vaccination Authority Laws
Leila Barraza, Cason Schmit, and Aila Hoss - [PDF] (Free Download)
Vaccine policies have played a vital role in protecting the public's health through disease prevention. The Centers for Disease Control and Prevention (CDC) lists vaccination as one of the "Ten Great Public Health Achievements in the 20th Century" because of its tremendous impact on morbidity and mortality in the United States. Despite these successes, recent outbreaks of certain vaccine-preventable diseases have been on the rise. While measles was declared eliminated in the United States in 2000, there were 23 measles outbreaks and a reported 668 cases of the disease in the U.S. in 2014. Intentionally unvaccinated individuals comprised a substantial proportion of the recent U.S. cases of measles, suggesting a continued role for vaccine policies to increase vaccination rates and reduce disease outbreaks.
Action, Not Rhetoric, Needed to Reverse the Opioid Overdose Epidemic
Corey Davis, Traci Green, and Leo Beletsky - [PDF] (Free Download)
In 2011, the Office of National Drug Control Policy (ONDCP) released a watershed report, Epidemic: Responding to America's Prescription Drug Abuse Crisis. The report broke with decades of tradition to shift the agency's rhetorical focus toward a more evidencebased, proactive approach to what had previously been termed the "War on Drugs," and announced the agency's goal of decreasing unintentional opioid overdose deaths in the United States by 15% within five years. Unfortunately, that has not come to pass: the number of Americans lost to overdose increased from 41,340 in 2011, when ONDCP set its goal, to 47,055 in 2014. More Americans now die each year of drug overdose than died of HIV/AIDS during the peak of that terrible epidemic.
Public Health and Politics: Using the Tax Code to Expand Advocacy
Eric Gorovitz - [PDF] (Free Download)
Protecting the public's health has always been an inherently political endeavor. From its roots in preventing the spread of infectious disease to its modern, vastly expanded arena encompassing the promotion of nutrition and exercise, the health impact of paid sick leave, and preventing obesity, gun violence, and bioterrorism, public health has relied on the machinery of public policy to define and deploy effective interventions.
Homelessness and the Public's Health: Legal Responses
James G. Hodge, Jr., Barbara DiPietro, and Amy E. Horton-Newell - [PDF] (Free Download)
Homelessness remains a prevalent, pervasive public health issue in the United States despite years of legal and policy interventions offering short- and long-term solutions. In 2002, the U.S. Interagency Council on Homelessness (USICH) began working with states and localities to create ten-year plans to end homelessness. Over the last 6 years alone, USICH reports a 33% reduction of veteran homelessness, 21% reduction of individuals experiencing chronic homelessness, and a 53% reduction in unsheltered homelessness among families. These achievements are laudable. Still, 564,000 people were homeless on average each night in 2015, according to the U.S. Department of Housing and Urban Development (HUD), and 1.5 million accessed homeless services in 2014.
Expanding Access to Care: Scope of Practice Laws
Kathleen Hoke and Sarah Hexem - [PDF] (Free Download)
Allied healthcare professionals play an integral role in the healthcare system: healthcare teams depend on nurses; comprehensive patient care often cannot be achieved without a pharmacist; dental offices thrive with the work of dental hygienists; and emergency medical technicians play a vital role in emergency care. The contributions of these and other allied healthcare professionals are typically defined by state laws governing the particular practice. These laws may be hurdles or enablers to expanding access to care in a community. We examine scope of practice laws for nurse practitioners (NPs) and allied dental providers to demonstrate how these laws may impact access to care and population health.
Promoting Mental Health and Well-Being in Public Health Law and Practice
Jill Krueger, Nathaniel Counts, and Brigid Riley - [PDF] (Free Download)
Mental health, our cognitive and affective tools for processing and making decisions about the world, is one of the most meaningful resources in maximizing our well-being. When we talk about mental health and well-being, too often our conversations move immediately to mental illness. We have neither built a vocabulary to clearly express what "mental well-being" means, nor communicated the findings of scientific research that illuminate the connection between the brain and the body. We have been slow to recognize mental health and well-being as amenable to efforts at disease and injury prevention, health promotion, and population-wide interventions. But, as research finds that mental health is especially influenced by social determinants of health, and related morbidity can be mitigated or entirely prevented, these attitudes are changing.
Finished with Menthol: An Evidence-Based Policy Option That Will Save Lives
Joelle M. Lester and Stacey Younger Gagosian - [PDF] (Free Download)
Smoking remains the number one preventable cause of death and disease in the United States, killing more than 480,000 people per year. Despite steep decreases in current smoking prevalence in both adults and youth, cigarettes have become more lethal over time, causing more death and disease. Without bold action, 5.6 million of youth today will die prematurely from smoking.
The Prescription Drug Pricing Moment: Using Public Health Analysis to Clarify the Fair Competition Debate on Prescription Drug Pricing and Consumer Welfare
Ann Marie Marciarille - [PDF] (Free Download)
The American Public Health Association tells us that "[p]ublic health promotes and protects the health of people and the communities where they live, learn, work and play." It further distinguishes public health concerns from clinical health concerns by the latter's focus on the individual's special circumstances. When it comes to prescription drug cost and access, both the health of the community and the health of the individual may be implicated. Even individual prescription drug access has a collective element, in that we do not typically purchase or acquire prescription pharmaceuticals as individuals until the very last stage of distribution: retail sale. Rather, the journey of a prescription drug from manufacturer to individual consumer occurs in stages, most of them highly intermediated by collective contracting by a pharmacy benefit manager or by the government before the pharmaceutical reaches the level of retail distribution. This pre-retail sale collective phase of pharmaceutical acquisition and distribution has direct and serious implications for pharmaceutical cost and access for all.
Motorcycle Policy and the Public Interest: A Recommendation for a New Type of Partial Motorcycle Helmet Law
Kurt B. Nolte, Colleen Healy, Clifford M. Rees, and David Sklar - [PDF] (Free Download)
In the U.S., motor vehicle crashes are one of the leading causes of injury-related death accounting for 34,485 deaths in 2009. Of all road traffic fatalities, motorcycle crashes account for 14%, though motorcycles represent less than 1% of all vehicle miles traveled. Compared to automobile drivers, motorcycle riders are 34 times more likely to die in a traffic collision.
Immigration and Health: Law, Policy, and Ethics
Wendy E. Parmet, Lorianne Sainsbury-Wong, and Maya Prabhu - [PDF] (Free Download)
Immigration poses numerous challenges for health care professionals and public health lawyers. Health professionals must care for patients with different cultural backgrounds, some of whom have experienced traumas in their country of origin, may not speak English, or lack access to health insurance. Public health lawyers must untangle the multifaceted interactions between immigration law and health law, which add complexity, inefficiency and inequity to the U.S. health care system. These challenges are apt to intensify under the Trump Administration, which has pledged to increase deportations and repeal the Affordable Care Act (ACA). This paper offers an overview of some of these issues, as well as the arguments that are given for denying immigrants equal access to health care.
Collaborating for Health: Health in All Policies and the Law
Dawn Pepin, Benjamin D. Winig, Derek Carr, and Peter D. Jacobson - [PDF] (Free Download)
Health in All Policies (HiAP) is a policy framework resulting from movements beginning in the 1970s and 1980s. HiAP highlights the importance of intersectoral collaboration and shifts focus away from the biological basis of health outcomes to a broader understanding of the role of behavioral and other lifestyle considerations. Since 2006, the HiAP approach has spread across Europe and is gaining momentum in the United States. This article discusses the concept of HiAP and explores emerging trends in HiAP law. It also examines California’s HiAP experience, including the development and evolution of HiAP in the state and the ability to leverage a HiAP framework to improve health outcomes, advance health equity, and counteract laws and policies that contribute to health inequities.
EPSDT's Role in Improving Child Vision, Hearing, and Oral Health
Jane Perkins - [PDF] (Free Download)
Medicaid's Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit is an expansive legal entitlement for Medicaid-eligible children under age 21. Among other things, EPSDT targets vision, hearing, and dental health. Today, more than 40 million children in the United States qualify for Medicaid and EPSDT. Congress added the EPSDT provisions to the Medicaid Act (the Act) in 1967 for a simple reason - to make children healthier. In doing so, it recognized that the law can play a significant role in advancing child health. Properly implemented, EPSDT's clinical and community coordination requirements can improve child health while creating a bridge between medical and social services to emphasize prevention, health promotion, and community integration. After providing a brief explanation of the EPSDT benefit, this article discusses EPSDT's role in improving child vision, hearing, and oral health.
Legal Epidemiology: The Science of Law
Tara Ramanathan, Rachel Hulkower, Joseph Holbrook, and Matthew Penn - [PDF] (Free Download)
In Thomas R. Frieden's A Framework for Public Health Action, law appears as a primary driver for "changing the context to make individuals' default decisions healthy." The notable public health interventions he mentions use law and policy to achieve this goal: fluoridating the public water supply, removing trans-unsaturated fatty acids in processed foods, and dis-incentivizing tobacco use through taxes and zoning. Laws also impact socioeconomic factors such as poverty, education, and housing, together responsible for creating the greatest impacts on public health.
Employer Requirements to Work during Emergency Responses: Key Ethics Considerations
Lainie Rutkow, Holly A. Taylor, and Tia Powell - [PDF] (Free Download)
Local health departments (LHDs) are at the forefront of emergency preparedness, response, and recovery. LHD workers participate in epidemiological investigations, staff vaccination clinics, and implement response plans for scenarios ranging from floods to salmonella outbreaks. LHD workers provide crucial disaster services. For instance, when lower Manhattan lost power after Hurricane Sandy, LHD workers coordinated evacuation of over 6,000 patients from multiple health care facilities. Yet, studies have found that, depending on the emergency scenario, between seven and 40 percent of LHD workers would not report to work. This can greatly compromise a response, as many LHDs need "all hands on deck" to effectively meet increased demands. While the precise reasons are unknown, LHD workers' lack of willingness may be due to several factors, including unclear or inconsistent explanations about work requirements during emergency responses.
Applying an Equity Lens to the Child Care Setting
Krista Scott, Anna Ayers Looby, Janie Simms Hipp, and Natasha Frost - [PDF] (Free Download)
The majority of brain development happens before children enter the formal schooling system, positioning the early care and education system ("ECE system") to have a profound and long-lasting impact on a child's health, learning, and ability to regulate emotion. However, the current ECE system in the United States is fragmented, under-funded, and lacks cultural competence. As a result, many children are being cared for in a system that does not always have resources to support optimal development for all, setting the most vulnerable on a trajectory aimed lower than their peers. Providing examples from Indian Country, this article examines systemic barriers to equity, and how the system's fragmentation leads to lower child care outcomes in some communities. It is imperative that we strategically focus attention on aligning systems in a way that decreases health inequities.
Climate Change and Public Health Policy
Jason A. Smith, Jason Vargo, and Sara Pollock Hoverter - [PDF] (Free Download)
The science supporting climate change is robust and compelling to the point that actions to prevent catastrophic and irreversible alteration of the climate system and avoid related impacts are not only justified, but required. The breadth of the evidence and number of potential impacts to human systems related to changing climate are immense and varied. In this summary we provide an argument that making climate change the focus of public health may bring significant benefits.
Reducing Hospital Readmissions: Addressing the Impact of Food Security and Nutrition
Mathew Swinburne, Katie Garfield, and Aliza R. Wasserman - [PDF] (Free Download)
In 2015, approximately 42.2 million Americans lived in households that lacked adequate access to food due to insufficient money or other resources. Food insecurity is associated with a range of negative health outcomes. Many food insecure individuals must decide whether to spend their limited resources on medication or food. Food insecurity is also associated with increased hospital admissions and a range of health conditions including anxiety and depression, hypertension, diabetes, and obesity.
Policy Approaches to Improving Housing and Health
William C. Tilburg - [PDF] (Free Download)
The United States subprime mortgage crisis (2007- 2009) is widely associated with a dramatic increase in home foreclosures, declining home values, and the Great Recession. During the crisis annual foreclosure filings nearly quadrupled, median home prices dropped 13 percent, and 8.8 million Americans lost their jobs. Less well known is the impact the crisis had on physical housing conditions. From 2007 to 2011, home improvement and repair expenditures declined 28 percent for owner-occupied homes and 23 percent for rental units. This reduction in housing investment had an immediate impact on the quality of the U.S. housing stock. The number of "inadequate" housing units, classified as housing with moderate or severe physical deficiencies, increased significantly for the first time since tracking housing quality began in 1940.
Health Care System Transformation and Integration: A Call to Action for Public Health
Lindsay F. Wiley and Gene W. Matthews - [PDF] (Free Download)
We are on the cusp of a total rewiring of the circuitry that connects public health departments, health care providers, third-party payers, and government programs. Experts have long argued for integration of public health and health care goals. Now, financial pressure to integrate is coming from both sides, creating unprecedented opportunities to serve public health goals by integrating them into financing and delivery structures within the better-resourced health care sector. But there are also challenges. The population perspective, social justice commitment, and structural interventions that characterize public health could easily be dismissed in favor of more individualistic strategies reliant on ineffective patient counseling and expensive technological solutions. In this unique moment, the health care sector is receptive to the public health perspective. Public health leaders must be ready to answer the call.
Background Checks for all Gun Buyers and Gun Violence Restraining Orders: State Efforts to Keep Guns from High-Risk Persons
Jon S. Vernick, Ted Alcorn, and Joshua Horwitz - [PDF] (Free Download)
Despite an upsurge of public interest in gun violence prevention since the Newtown shooting, the U.S. Congress has been unable to overcome resistance by a vocal minority to enact new gun laws. And more than 40 states have laws that specifically forbid cities from enacting at least some types of local public safety ordinances relating to firearms. As a result, states have become the primary engines of change for firearm policy.