Strengthening Ties Between the Public Health and Legal Communities to Improve Public Health
Although the law can be a powerful tool in addressing public health concerns, local officials often lack knowledge of public health law and how to use it, according to the Atlanta-based Public Health Law Association. In 2007, the association launched a project to examine ways to strengthen the collaboration between the public health and legal communities.
- The association commissioned three articles published as a special supplement to the Journal of Law, Medicine & Ethics, Vol. 36, September 2008. See the Bibliography for details:
- "Training Individuals in Public Health Law"
- "Building Public Health Law Capacity at the Local Level"
- "Enhancing Public Health Law Communication Linkages"
- Tailor training programs in public health to meet the separate and distinct educational needs of public health officials and attorneys.
- Build a network of independent, state-based organizations to provide training and educational information in public health law as well as expert legal counsel.
- Host an annual, national public health law conference focusing on cutting-edge laws and regulations in public health.
- Create a Web-based public health law portal.
The Robert Wood Johnson Foundation (RWJF) supported this project with a 22-month grant of $239,525 that started in February 2007.
Laws are important tools in efforts to protect and improve society's overall health. For example, public health laws have led to high childhood immunization rates, improved motor vehicle safety and reduced tooth decay, according to the Centers for Disease Control and Prevention (CDC).
Yet, many local communities do not have the expertise to harness the power of laws to improve the public's health. Administrators of local health departments often have little knowledge of the law, whereas local lawyers have little understanding about the field of public health, according to the Public Health Law Association. This prevents local officials from implementing cutting-edge legal strategies and tools, such as model laws, to meet public health goals.
The Public Health Law Association in Atlanta, founded in 2002, is an interdisciplinary membership organization dedicated to advancing the use of law to improve public health. The 200-member association has a part-time executive director, but most of its work is carried on by volunteers.
RWJF first funded public health law as part of its national program, Turning Point. Jointly funded with the W.K. Kellogg Foundation from 1996 to 2006, the program's mission was to "transform and strengthen the public health system in the United States to make the system more effective, more community-based and more collaborative." RWJF and Kellogg partnered to support 22 states and 41 local communities in those states in working together to strengthen their public health systems. RWJF also supported five National Excellence Collaboratives that allowed states to work together on important public health infrastructure challenges. See Grant Results for more information.
In 2007, the Public Health Law Association commissioned three papers on strengthening the collaboration between the public health and legal communities. The papers addressed:
- Training practitioners in public health law—in particular, training public health officials in legal matters and lawyers in public health issues.
- Building the capacity of state and local public health agencies to use the law on behalf of public health.
- Enhancing the dissemination of information about public health law to the public health field.
The association held a series of teleconferences in which small groups of public health experts worked with each author to shape the final papers. It also hosted an all-day, invitation-only meeting in conjunction with the American Public Health Association's annual meeting in November 2007 to discuss the project's findings and recommendations. About 50 experts in public health law attended the gathering in Washington.
As part of the research for the paper on information dissemination, the association conducted a small electronic survey to gauge how comfortable practitioners are with different means of dissemination (e.g., conferences, Web-based documents, video recordings).
The three papers (see Results and the Bibliography for details) were published in a special supplement to the September 2008 issue of the Journal of Law, Medicine & Ethics. Staff at the American Society of Law, Medicine & Ethics, which publishes the journal, assisted with the preparation of the articles.
In addition, the project team:
- Presented preliminary research and recommendations to a public audience during the American Public Health Association's annual conference in November 2007 in Washington. (Available online for a fee.)
- Sponsored a poster presentation about the project at a joint conference of the Association of State and Territorial Health Officials and the National Association of County and City Health Officials in September 2008 in Sacramento, Calif.
The project produced three papers:
- "Training Individuals in Public Health Law," by Jason Smith, M.T.S., J.D., offers an overview of that topic. (Article available online for a fee.) Smith concluded that:
- It is hard to design training programs that meet the needs of both public health officials and lawyers. Legal training focuses on applying the law to different factual situations, whereas public health programs teach competencies for specific jobs.
- The content of most training materials available today on public health law is too general to be useful to attorneys.
- "Building Public Health Law Capacity at the Local Level," by Diane E. Hoffman, J.D., M.S., and Virginia Rowthorn, J.D., discusses better ways to deliver legal services at the local level. (Article available online for a fee.) The authors, who interviewed both local and national public health officials, make the case for creating an infrastructure to train public health officials and lawyers in local communities, as well as to disseminate information on cutting-edge legal tools. They conclude that:
- Public health officials and lawyers at the local level are not well versed in public health law.
- They often lack access to the expertise they need to fulfill their professional duties.
- "Enhancing Public Health Law Communication Linkages," by Ross D. Silverman, J.D., M.P.H., evaluates numerous electronic means of sharing information on cutting-edge public health laws. (Available online for a fee.) Approaches covered include:
- Online lectures, webinars and podcasts.
- A Web-based compendium of educational materials that is updated regularly with new content to spur interest in the site.
- Online, interactive, user-created educational materials similar in structure to the open-source encyclopedia, Wikipedia.
The project team offered the following recommendations:
- Tailor training programs in public health to meet the separate and distinct educational needs of public health officials and attorneys. For example:
- Produce practice guides and procedure manuals for attorneys, including in-depth commentary on case law to show how legal principles were applied in different factual situations.
- Include classes in basic legal principles in curricula for students in public health degree programs.
- Build a network of independent, state-based organizations to provide training and educational information in public-health law as well as expert legal counsel. Universities or professional associations would be the best places to house these centers because of their independence from the political and legislative processes. Although the centers would be interconnected as a national network, each state-based organization should tailor products and services to its local audience.
- Host an annual, national public health law conference focusing on cutting-edge laws and regulations in public health. The target audience should include state, local and federal officials in public health, as well as local attorneys, experts in public health law, physicians and elected officials. The conference organizer should archive materials digitally—including presentation slides and audio and video recordings—to increase the number of people who benefit from the meeting.
- Create a Web-based public health law portal. Add new information regularly to spur interest in and use of the site. In designing this site:
- Avoid advanced technologies that the potential audience might be uncomfortable using. For example, opt for prerecorded digital content over a user-generated, online encyclopedia of public health law.
- Offer seminars in both webinar and DVD formats. Employees of cash-strapped local organizations often do not have the bandwidth or software to download large, multimedia files.
- When relying on teleconferencing rather than face-to-face meetings, schedule a series of calls rather than a single one. It takes more than a single telephone encounter for people to build solid working relationships. (Project Director/Wasserman)
- For a face-to-face meeting, piggyback on a large conference that people already plan to attend. It is more efficient for people to add an extra day to a trip rather than to schedule a second trip. (Project Director/Wasserman)
AFTER THE GRANT
In spring 2009, RWJF awarded a grant of $399,733 to the American Society of Law, Medicine & Ethics to sponsor a national conference on public health law in 2010. The Public Health Law Association will help plan speakers and topics.
The American Society of Law, Medicine & Ethics was a co-sponsor, along with the CDC, of a series of annual conferences on public health law from 2002 to 2006. The 2010 conference will be modeled after these earlier meetings.
In March 2009, RWJF funded its $19-million program Public Health Law Research. This national initiative will build the evidence for and strengthen the use of effective regulatory, legal and policy solutions to improve public health.
GRANT DETAILS & CONTACT INFORMATION
Building a consensus agenda on the use of law to protect and improve public health
Public Health Law Association (Atlanta, GA)
Dates: February 2007 to December 2008
Martin P. Wasserman, M.D., J.D.
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
Hoffmann DE and Rowthorn V. "Building Public Health Law Capacity at the Local Level." Journal of Law, Medicine & Ethics, 36: 6–28, 2008. Available online for a fee.
Silverman RD. "Enhancing Public Health Law Communication Linkages." Journal of Law, Medicine & Ethics, 36: 29–49, 2008. Available online for a fee.
Smith JA. "Training Individuals in Public Health Law." Journal of Law, Medicine & Ethics, 36: 50–60, 2008. Available online for a fee.
Presentations and Testimony
Daniel J. O'Brien, "Public Health Law Education: Critical Competencies and Communication in the Field," at the Annual Meeting of the American Public Health Association, November 5, 2007, Washington. Available online for a fee.
Report prepared by: Linda Wilson
Reviewed by: Robert Narus
Reviewed by: Molly McKaughan
Program Officer: Angela K. McGowan