For the Public's Health Investing in a Healthier Future (2012) / Chapter Skim
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Appendix G: For the Public's Health: Revitalizing Law and Policy to Meet New Challenges; Report Summary
Appendix G: For the Public's Health: Revitalizing Law and Policy to Meet New Challenges; Report Summary
Pages 269-280
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From page 269... ...
. The committee's charge in preparing the current report was to "review how statutes and regulations prevent injury and disease, save lives, and optimize health outcomes" and to "systematically discuss legal and regulatory authority; note past efforts to develop model public health legislation; and describe the implications of the changing social and policy context for public health laws and regulations." "Law is foundational to U.S.
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From page 270... ...
In this chapter, the committee also continues its discussion of the broad determinants of health begun in its first report, but now in the context of legal and policy interventions, many located outside the health sector or involving multiple sectors. The chapter ends with a discussion of the evidence needed for "healthy" policymaking.
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From page 271... ...
model law composed of nine articles and incorporating two other model acts -- a revised version of the MSEHPA in the article pertaining to emergency powers, and the Model State Public Health Privacy Act (Gostin et al., 2001, 2002)
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From page 272... ...
Efforts may be made to identify statutory benchmarks in additional areas not explicitly covered in the existing model acts, such as performance measurement and accreditation, and contemporary leading causes of disease and death. Recommendation 1: The committee recommends that state and lo cal governments, in collaboration with their public health agencies, review existing public health laws and modernize these as needed to assure that appropriate powers are in place to enable public health agencies to address contemporary challenges to population health.
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From page 273... ...
delivered directly by the state health department, by each local health department, by public health system partners, or by various permutations thereof including through centralization, regionalization, or interjurisdictional compacts among different agencies. Many local public health agencies are small and have limited capabilities.
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From page 274... ...
For the reasons described -- the widespread use of accreditation in health care, and the public and policymaker familiarity with the notion; the need for a higher level of accountability and transparency; and the potential usefulness of accreditation in improving quality and other outcomes -- the committee finds that national accreditation holds promise as a conduit in aiding governmental public health agencies to demonstrate minimum structural and quality process capabilities. Recommendation 3: The committee recommends that states revise their laws to require public health accreditation for state and local health departments through the Public Health Accreditation Board accreditation process.
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From page 275... ...
Consequently, unless there are compelling reasons to the contrary, the federal government ought not preempt state and local authority in advancing the public's health. A provision of the Affordable Care Act, for example, preempts state and local authority to require menu labeling in restaurants and vending machines that diverges from (e.g., is stricter than)
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From page 276... ...
Preemption should avoid language that hinders public health action. Some recent legislation, such as the Affordable Care Act's establishment of menu labeling requirements, extends particular public health protections nationally, but also vests the Food and Drug Administration with regulatory authority over facilities it has not previously regulated, such as food service establishments that have been in the purview of state or local public health agencies.
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From page 277... ...
In its present discussion about law and policy, the committee uses the model of the National Prevention, Health Promotion, and Public Health Council and its associated public–private advisory group as a point of departure for envisioning how intersectoral action on population health could be planned
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From page 278... ...
In those cases, new laws and judicial review of public health legal interventions will need to be built on sound theory and the opinion of content experts. Such limited evidence may be used to craft legal interventions when health threats and potential harms from inaction are large; when opportunity costs and unintended harms from action are within acceptable limits; and when the time or costs required for gathering more definitive evidence are substantial relative to the expected value of the additional evidence.
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From page 279... ...
A knowledge base exists for crafting an accepted framework for evaluating the evidence of public policies, but an interdisciplinary team of experts is needed to build on the existing literature, review methodological challenges, and arrive at a consensus on preferred criteria. Recommendation 10: The committee recommends that HHS con vene relevant experts to enhance practical methodologies for assess ing the strength of evidence regarding the health effects of public policies as well as to provide guidance on evidentiary standards to inform a rational process for translating evidence into policy.
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From page 280... ...
2002. The Model State Emergency Health Powers Act: Planning for and response to bio terrorism and naturally occurring infectious diseases.
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