Public health law research reveals significant complexities underlying the use of law as an effective tool to improve health outcomes across populations. The challenges of applying public health law in practice are no easier. Attorneys, public health officials, and diverse partners in the public and private sectors collaborate on the front lines to forge pathways to advance population health through law. Meeting this objective amidst competing interests requires strong practice skills to shift through sensitive and sometimes urgent calls for action (...) to address known threats to the health of individuals and the community. It also necessitates objective, timely information and national and regional legal support. (shrink)

During an emergency, laws serve crucial functions, including clarifying responsibilities, authorizing critical interventions, and protecting vulnerable populations. However, provisions of existing laws designed for normal, non-emergency circumstances may sometimes hinder emergency response efforts, thereby potentially endangering the public's health rather than protecting it. Pursuant to declared states of emergency, disaster, or public health emergency, however, the legal landscape changes in several important ways. Interventions not legally permissible under non-emergency circumstances become available. One key example is authority to temporarily waive legal (...) provisions that may impede emergency response efforts, such as professional licensing requirements, facility capacity limitations, pharmaceutical pedigree obligations, and state contract restrictions, among other laws spanning a host of legal spheres.This article examines the structure and use of waiver authority in emergencies. It provides recent examples of waivers and analyzes potential application to a hypothetical emergency scenario. (shrink)

Despite historic efforts to enact the Patient Protection and Affordable Care Act in 2010, national health reform is threatened by multiple legal challenges grounded in constitutional law. Premier among these claims is the premise that PPACA’s “individual mandate” is constitutionally infirm. Attorneys General in Virginia and Florida allege that Congress’ interstate commerce powers do not authorize federal imposition of the individual mandate because Congress lacks the power to regulate commercial “inactivity.” Stated simply, Congress cannot regulate individuals who choose not to (...) obtain health insurance because they are not engaged in a commercial venture. Several courts initially considering this argument have rejected it, but two federal district courts in Virginia and Florida have concurred, leading to numerous appeals and the near promise of United States Supreme Court review. (shrink)

Major disasters and public health emergencies constantly test the nation's resolve to rally and recover from tragedy. Public health crises stemming from prolonged threats like the 2009/2010 H1N1 influenza pandemic require sustained preparedness and response over many months. Even shorter-duration events, like tornados, earthquakes, or hurricanes, leave lasting impacts for which full recovery may take years. Telling examples include the displacement of thousands of persons across the Gulf Coast states following Hurricane Katrina in 2005 and difficulties obtaining basic housing and (...) services that persisted in the Northeast months after Hurricane Sandy in 2012. Whether the result of natural disasters, infectious disease outbreaks, bioterrorism, or other causes, these events can change the societal landscape in affected regions.Despite the challenges of recovery across populations stemming from national or regional emergencies, Americans have consistently supported those directly affected. (shrink)

Amid the action of the 2013 Super Bowl aired the usual array of high-priced advertisements. Most ads were original. Some were unusual. One regional ad, however, seemed distantly familiar. The 30-second commercial promoted the NJOY King electronic cigarette1 to at least 10 million viewers in several major markets. It featured an attractive male model taking a drag from what looks like a cigarette. He then slowly blows smoke to the tune of Foreigner’s “Feels Like the First Time.” Of course, the (...) “smoke” does not come from burning tobacco. Rather, it is the water vapor produced by an e-cigarette as part of its nicotine delivery process. This, however, was not evident from the imagery. For those watching the broadcast, including thousands of minors, NJOY’s advertisement depicted what tobacco companies have not portrayed on television for decades: a person engaged in smoking behavior. (shrink)

Used appropriately, reliance on science distinguishes public health from policymaking driven more by theory and opinion and enhances trust in public health interventions. Evidence-based vaccine policymaking aims to control communicable disease by urging decision makers to base policies on the best available evidence rather than politics or personal views. The results of this approach, such as smallpox eradication, have been dramatic. Historically, mandatory childhood vaccination has been perhaps the most successful evidence-based tool in combating many epidemics. Philosophically, vaccination mandates correspond (...) to the legal system’s dual role in codifying what society deems undesirable behavior and declaring beneficial social norms and values consistent with understandings of the social contract. Despite their effectiveness and philosophical grounding, vaccination mandates present serious legal and ethical questions. Public health policymakers have a continuing responsibility to rely on evidence not only as a basis for generating policy, but also for evaluating and improving elements of its legal design. (shrink)