Public Health Law

What is public health law?"

• “Public health law is the study of the legal powers and duties of the state, in collaboration with its partners (e.g., health care, business, the community, the media, and academe), to assure the conditions for people to be healthy(to identify, prevent, and ameliorate risks to health in the population) and the limitations on the power of the state to constrain the autonomy, privacy, liberty, proprietary, or other legally protected interests of individuals for the common good." Laurence Gostin

• This definition emphasizes the dynamic tension between the government’s powers and duties to protect the public's health and the limitations on government’s power by individual liberties.
• Includes any law that has important consequences for the health of populations; not limited to laws related to the public health department

Why use law? Because it works!

• "In the realm of public health, law really does the work. That has been demonstrated time and again, in areas ranging from mandatory vaccinations to requiring automobile seatbelts and reducing drunk driving to improving workplace safety to providing access to family planning services to fluoridation of water and more." Michael Bloomberg
• Of the 10 Great Public Health Achievements of the last century, ALL were influenced by law or policy. 
• Law not only provides the underlying authority for public health to act, but also impacts public health outcomes by:
  • Changing the physical environment (ex. water fluoridation; zoning laws)
  • Penalizing risky behavior (ex. tickets for not wearing a seatbelt, fines for pollution)
  • Altering the informational environment (ex. mandating violence prevention programs in schools; regulation of advertising for tobacco products)

Separation of Powers

• Public Health is not expressly mentioned in the Constitution.
  • Federal public health activity is carried out under Article 1, Section 8 under authority to tax and spend or to regulate interstate commerce. 
  • State public health authority is derived from the "police powers," reserved under the 10th Amendment. 

Constitutional Limitations

• 1st Amendment
  • Freedom of Speech and Assembly
  • Freedom of Religion
• 4th Amendment
  • Unreasonable Search and Seizure
• 5th Amendment
  • Due Process: “No person shall be deprived of life, liberty, or property, without due process of law…” (read to include Equal Protection)
  • Criminal Procedure
  • Property Rights - Takings
• 14th Amendment
  • Due Process: “No state…shall deprive any person of life, liberty, or property, without due process of law…”
  • Equal Protection: "no state shall ... deny to any person within its jurisdiction the equal protection of the laws".
  • Incorporates/Applies most of the Bill of Rights to states

Five Essential Public Health Law Services

1. Access to Evidence and Expertise   
2. Expertise in Designing Legal Solutions
3. Help Engaging Communities and Building Political Will 
4. Support for Enforcing and Defending Legal Solutions
5. Policy Surveillance and Evaluation

https://www.networkforphl.org/resources/topics/trainings/five-essential-public-health-law-services/