Public Health Law

*Per 100,000 population per year.

Authority

• Public Health Service Act, Section 361 (42 U.S.C. §264)
  • Authorizes the Secretary of Health and Human Services to make and enforce regulations “to prevent the introduction, transmission, or spread of communicable diseases”
    • into the states and possessions of the United States from foreign countries or possessions, OR
    • from one state into another.

Online Resources

• CDC Vaccination & Immunizations Requirements & Laws
• CDC Legal Authorities for Isolation and Quarantine
  • This document helps the reader to learn the difference between isolation and quarantine, where the federal government derives its authority from to quarantine and isolate, CDC's role in the process, as well as state, local, and tribal law.
     

Articles

• Bruesewitz v. Wyeth: What the Supreme Court Decision Means for Vaccines
• Vaccination Mandates: The Public Health Imperative and Individual Rights
• Through the Quarantine Looking Glass: Drug-Resistant Tuberculosis and Public Health Governance, Law, and Ethics
  • This article uses the Speaker incident to explore how isolation and quarantine authority provides a lens through which to assess public health commitments, competencies, and capabilities. Thorough analysis of legal/public health implications of quarantine; uses the Speaker case for context; explains the difference between quarantine and isolation.
• Andrew Speaker vs. CDC: Speaker’s Lawsuit Dismissed …. Again
• Jacobson v. Massachusetts: It's Not Your Great-Grandfather's Public Health Law : This article uses the seminal case of Jacobson v. Massachusetts to analyze the evolution of the state's power and authority regarding public health law powers.  
• The Legitimacy of Vaccine Critics: What is Left After the Autism Hypothesis?

State Surveys

• NCSL Health Innovations State Law Database
  • NCSL’s Health Program seeks to help state legislators and their staff learn about promising health system reforms and policy innovations that promote a more efficient and effective health care system and improve Americans’ health.
  • This database of recently enacted laws includes information on state health transformation initiatives and related changes in state statutes, as well as a description of topics and categories of legislation for 2015-2020. 
• NCSL 50 State Survey of Quarantine and Isolation Statutes
• States with Religious and Philosophical Exemptions from School Immunization Requirements
  • All fifty states have legislation requiring specified vaccines for students.  Although exemptions vary from state to state, all school immunization laws grant exemptions to children for medical reasons.  Almost all states grant religious exemptions and nineteen (19) states allow philosophical exemptions (i.e. against moral beliefs).
     

Blog Posts

•  "Liability for Failure to Vaccinate" - Art Caplan - A brief article published by Bill of Health, Harvard's journal examining the intersection of law and health. In it, Caplan makes the case that people who choose not to vaccinate their children should be held liable if their children get sick and infect another. 
• "Crack Down on Those Who Don't Vaccinate?: A Response to Art Caplan" - Mary Holland, J.D. - A response to the above-mentioned article by Art Caplan.
• "No Liability for Failure to Vaccinate? The Case Has Not Been Made: A Response to Mary Holland" - Dorit Rubenstein Reiss, LLB, Ph.D. - A further response to Mary Holland's response to Art Caplan. 

Communicable disease prevention and control is focused on the way diseases spread under different circumstances. The crux of this field is focused on the monitoring, managing, preventing, and treating communicable diseases. Communicable disease experts in public health analyze data detailing the spread of certain diseases, work in an interdisciplinary capacity to develop best practices and guidelines for treatment and control, and implement those guidelines in the field. There are numerous Constitutional and statutory authorities that dictate how these experts must proceed, both to control the spread of disease and to ensure the protection of the rights of citizens who may be infected. 

The primary authority for the United States Governement to control the spread of communicable disease derives from the United States Constitution, specifically that of the Commerce Clause. This allows the Secretary of Health and Human Services to isolate or quarantine people who may be ill, or who may have been exposed to an illness, by preventing them from entering into the United States or preventing their movement between states. This is an important power, but one in which many people do not fully understand. Although isolation and quarantine are often used interchangably, the two terms present different concepts: isolation is the separation of a person who shows signs of illness from others who are healthy; quarantine, on the other hand, is the separation of people who may have been exposed so that they may be monitored for an illness. The primary difference is that those who are isolated have shown signs of the illness that authorities seek to mitigate, while those who have been quarantined may still be well. These powers are, arguably, the most important tools public health authorities use to stop widespread proliferation of communicable diseases such as influenza, tuberculosis, SARS, and Ebola.

Statutory Authority

• Public Health Service Act, Section 361 (42 U.S.C. §264)
• Authorizes the Secretary of Health and Human Services to make and enforce regulations “to prevent the introduction, transmission, or spread of communicable diseases” 
• into the states and possessions of the United States from foreign countries or possessions, OR
• from one state into another. 
• This section also authorizes the apprehension, detention, examination, and conditional release of individuals with certain communicable diseases that are specified in an executive order of the President.
• Communicable diseases for which individuals can be detained, examined or released under surveillance by federal public health authorities under federal regulations (42 C.F.R.. Parts 70 and 71) MUST be named in an executive order
• Most recent Executive Order 13375 lists the following diseases:
• Cholera
• Diphtheria
• Infectious TB
• Smallpox
• Yellow Fever
• Viral Hemorrhagic Fevers
• Severe Acute Respiratory Syndrome (SARS)
• Influenza capable of causing a pandemic

Social Distancing

• Social measures to decrease the frequency of contact among people in order to diminish the risk of spread from communicable diseases.
• Possible Social Distancing Measures:
• Isolation – separation of ill persons or groups
• Quarantine – separation, restriction of movement of exposed persons
• Quarantine of groups – separation, restriction of movement of people exposed to the same source of illness
• Community‐wide quarantine (cordon sanitaire) – erecting real or virtual barriers around a defined geographic area
• Closing public venues
• Cancelling public events
• School exclusion
• Dismissing school

TB is caused by an airborne bacterium that usually attacks the lungs. Not everyone infected with TB becomes sick

• CDC Tuberculosis Fact Sheets
• Basic TB information, data & statistics, treatment, and more
• CDC Public Health Law Program Tuberculosis
• WHO Tuberculosis Fact Sheet
• Quick overview of TB (i.e. who is most at risk, global impact, symptoms and diagnosis, treatment, WHO's approach to addressing TB).
• CDC Tuberculosis Controls and Policies
• Provides a comprehensive look at TB (i.e. public health background, legal issues, resources).  Includes a list of selected public health, law, and federal acronyms.  Includes a table which characterizes express laws regarding the control of TB in selected U.S. Jurisdictions.