How Legal and Policy Levers Can Amplify Efforts to Reach Healthy People Goals
Webinar Question and Answer:
At the end of the webinar, the presenters answered questions from participants. Where relevant, some of the presenters’ responses have been included in their summary sections.
What other ways can law act as a barrier to health?
Lindsay Wiley: In many instances, there can be an assumption that legal and policy interventions that implicate privacy concerns or freedom of choice must be subject to constitutional or other legal restriction. For example, courts have found that states have wide leeway to require vaccinations. However, even in these cases where the law itself is not a barrier, this kind of tension between public health and the protection of individual choices can make using a legal or policy approach more difficult.
How might states use laws and these kinds of policy tools to educate people more about human papillomavirus (HPV) and to encourage HPV vaccinations?
Lindsay Wiley: Over the last 10 to 12 years, since the development of the HPV vaccination, legislatures across the United States have introduced and adopted legislation to encourage, or in some cases, to mandate, inclusion of information about HPV-related cancer risks and vaccinations as part of well-child visits with health care providers or school-based sex education. This kind of approach runs along a spectrum that moves from the lighter touch of making resources available to those interested through offering best practices or guidelines through professional licensing boards, all the way to more aggressive mandates to include information in school-based curriculums or mailings to parents.
How would you leverage legal or policy tools to address an issue like sexual violence prevention?
Lindsay Wiley: It’s interesting to apply the public health law toolkit to problems where the connections might not be as intuitive. Sexual violence prevention is an area where the most intuitive legal or policy tools would be addressing the problem through criminal sanctions, like long sentences and harsher penalties. However, public health advocates are moving beyond addressing violence prevention, including sexual violence, through a lens of interpersonal blameworthiness or punishment. In terms of sexual violence, things like provisions in immigration laws that protect individuals who report sexual violence from certain immigration-related consequences have a positive role in prevention. Another example is restricting firearm ownership by individuals with a history of domestic violence or sexual assault, who are more likely to use firearms in repeat incidents. Moving to the 10,000-foot view, laws that promote gender equality and prohibit discrimination based on sex can empower women—and by doing that, they combat the normalization of sexual violence in a society. These kinds of approaches may be difficult politically, as they run counter to many people’s assumptions of how to address criminal behavior, but they can have a significant impact.
Resources and More Information
Healthy People 2020 contains a variety of objectives that have policy components, such as community fluoridation, tobacco use, and immunizations. The following organizations provide useful resources and analysis of laws, and they can help individuals understand what is happening within a specific state or local jurisdiction:
- CDC Public Health Law Program
- Temple University’s Center for Public Health Law Research
- ChangeLab Solutions
- Association of State and Territorial Health Officers (ASTHO)
- National Association of County and City Health Officers (NACCHO)
- Network for Public Health Law
- National Conference of State Legislatures (NCSL)
- National Association of Local Boards of Health (NALBOH)
- National Network of Public Health Institutes (NNPHI)