Evan D. Anderson

State Laws Restricting Driver Use of Mobile Communications Devices Distracted-Driving Provisions, 1992-2010

BACKGROUND State laws limiting the use of mobile communications devices (MCDs) by drivers are being enacted at an accelerating pace. Public health law research is needed to test various legislative models and guide future legal innovation. PURPOSE To define the current state of the law, facilitate new multi-state evaluations, and demonstrate the utility of systematic, scientific legal research methods to improve public health services research. METHODS Westlaw and Lexis-Nexis were used to create a 50-state, open-source data set of laws restricting the use of any form of MCD while operating a motor vehicle that were in effect between January 1, 1992, and November 1, 2010. Using an iterative process, the search protocol included the following terms: cellphone, cell phone, cellular phone, wireless telephone, mobile telephone, text, hands-free, cell! and text! The text and citations of each law were collected and coded across 22 variables, and a protocol and code book were developed to facilitate future public use of the data set. RESULTS Thirty-nine states and the District of Columbia have at least one form of restriction on the use of MCDs in effect. The laws vary in the types of communication activities and categories of driver regulated, as well as enforcement mechanisms and punishments. No state completely bans use of MCDs by all drivers. CONCLUSIONS State distracted-driving policy is diverging from evidence on the risks of MCD use by drivers. An updatable data set of laws is now available to researchers conducting multistate evaluations of the impact of laws regulating MCDs by drivers. If this data set is shown to be useful for this public health problem, similar rigorously developed and regularly updated data sets might be developed for other public health issues that are subject to legislative interventions.

The Law (and Politics) of Safe Injection Facilities in the United States

Safe injection facilities (SIFs) have shown promise in reducing harms and social costs associated with injection drug use. Favorable evaluations elsewhere have raised the issue of their implementation in the United States. Recognizing that laws shape health interventions targeting drug users, we analyzed the legal environment for publicly authorized SIFs in the United States. Although states and some municipalities have the power to authorize SIFs under state law, federal authorities could still interfere with these facilities under the Controlled Substances Act. A state- or locally-authorized SIF could proceed free of legal uncertainty only if federal authorities explicitly authorized it or decided not to interfere. Given legal uncertainty, and the similar experience with syringe exchange programs, we recommend a process of sustained health research, strategic advocacy, and political deliberation.

Emergency legal preparedness for hospitals and health care personnel.

During the past decade, hospital emergency preparedness has become a focus of local, state, and federal governments seeking to address emergencies or disasters that affect the public health. Integral to hospital emergency preparedness are numerous legal challenges that hospitals and their health care personnel face during declared states of emergencies. In this article, we evaluate legal requirements for hospital emergency preparedness, key legal concerns that hospitals should consider in emergency preparedness activities, and how the changing legal landscape during emergencies necessitates real-time decision making. We then analyze legal issues including negligence, discrimination, and criminal culpability that may arise during or after medical triage. Finally, we examine the legal risks of evading preparedness, specifically asking how a hospital and its personnel may be held liable for failing to plan or prepare for an emergency.

A Framework Convention on Global Health: Social Justice Lite, or a Light on Social Justice?

With the publication of the final report of the WHO Commission on the Social Determinants of Health, it becomes clear that there is considerable convergence between a policy agenda rooted on social epidemiology and one rooted in a concern for human rights. As commentators like Jonathan Mann have argued, concern for human rights and the achievement of social justice can inform and improve public health. In this article, we ask a different question: what does a health perspective adds to the enduring fight for a more just world? We consider three possibilities: (1) that public health, in an inversion of Manns argument, actually provides useful tools for specifying social injustice; (2) that, contrary to the usual critical stance and assumption of weakness, the institutions of public health bring powerful capacities to the practical promotion of social justice; and (3) that health as a banner mobilizes people who would not be mobilized to act in the name of social justice.

Emergency Legal Preparedness Among Select US Local Governments

Legal preparedness is an essential component of effective public health emergency response, evinced recently by the numerous emergency declarations issued at the federal, state, and local levels to address the 2009 H1N1 influenza outbreak. Although the impact of these emergency laws at the federal and state levels has been studied extensively, the scope and role of local emergency laws have not been similarly assessed. In this article, we examine key issues of emergency laws among select US localities in the context of the recent H1N1 outbreak and their application to volunteer health professionals, who are often needed to meet patient surge capacity during local emergencies.Localities represent the front line of emergency preparedness and must address an array of legal challenges before and during declared emergencies. Local legal preparedness differs based on overarching restrictions such as the degree of home rule provided to localities under state law. Some localities take innovative legal approaches to address emergency preparedness. Although beneficial in many respects, these variations add additional complexity to legal preparedness and intensify the need for predisaster planning, exercises, and coordination.

Facilitating Hospital Emergency Preparedness: Introduction of a Model Memorandum of Understanding

Effective emergency response among hospitals and other health care providers stems from multiple factors depending on the nature of the emergency. While local emergencies can test hospital acute care facilities, prolonged national emergencies, such as the 2009 H1N1 outbreak, raise significant challenges. These events involve sustained surges of patients over longer periods and spanning entire regions. They require significant and sustained coordination of personnel, services, and supplies among hospitals and other providers to ensure adequate patient care across regions. Some hospitals, however, may lack structural principles to help coordinate care and guide critical allocation decisions. This article discusses a model Memorandum of Understanding (MOU) that sets forth essential principles on how to allocate scarce resources among providers across regions. The model seeks to align regional hospitals through advance agreements on procedures of mutual aid that reflect modern principles of emergency preparedness and changing legal norms in declared emergencies.

National Public Health Law: A Role for WHO in Capacity-Building and Promoting Transparency

Abstract A robust health infrastructure in every country is the most effective long-term preparedness strategy for global health emergencies. This includes not only health systems and their human resources, but also countries’ legal infrastructure for health: the laws and policies that empower, obligate and sometimes limit government and private action. The law is also an important tool in health promotion and protection. Public health professionals play important roles in health law – from the development of policies, through their enforcement, to the scientific evaluation of the health impact of laws. Member States are already mandated to communicate their national health laws and regulations to the World Health Organization (WHO). In this paper we propose that WHO has the authority and credibility to support capacity-building in the area of health law within Member States, and to make national laws easier to access, understand, monitor and evaluate. We believe a strong case can be made to donors for the funding of a public health law centre or unit, that has adequate staffing, is robustly networked with its regional counterparts and is integrated into the main work of WHO. The mission of the unit or centre would be to define and integrate scientific and legal expertise in public health law, both technical and programmatic, across the work of WHO, and to conduct and facilitate global health policy surveillance.

The Challenges of Quantitative Public Health Law Research

Public health law research (PHLR) has been defined as the scientific study of the relation of law and legal practices to population health. The scientific collection of legal data is a precondition for epidemiological or behavioral research in which law is the independent variable. This commentary discusses some of the challenges that arise out of efforts to reduce legal text into quantifiable data that can be used for statistical analysis. It does so while highlighting the strengths and key conceptual hurdles in a Spengler et. al. article analyzing the extent to which recreational user statutes insulate localities from liability when opening their land up for community activities. This commentary touches upon the importance of careful coding, transparency and study design as well as the intrinsic difficulty in quantifying indeterminate laws.

Making the Case for Laws that Improve Health: The Work of the Public Health Law Research National Program Office

No one who attended the 2010 national public health law conference hosted by the Public Health Law Association (PHLA) and the American Society of Law, Medicine, and Ethics (ASLME) could miss the sense of excitement and momentum. The revival of this annual public health law meeting, with the support of the Robert Wood Johnson Foundation (RWJF), the energetic leadership of the PHLA president and board, ASLME’s expert guidance, and a rousing address by Dr. Tom Frieden, Director of the Centers for Disease Control and Prevention (CDC), symbolize the continued commitment of a wide range of important individuals and institutions to the proposition that law is of substantial importance to public health. There is more than just symbolism to be excited about. RWJF has made a dramatic and farsighted commitment to building the field with an integrated program of support for the effective use of law in public health. This includes investments in exemplary programs like the Public Health Institute, the National Policy and Legal Analysis Network, Healthy Eating Research and Active Living Research, and the Public Health Law Network. This paper introduces the Public Health Law Research (PHLR) Program, another integral part of RWJF’s vision for improving public health through law. Public health law research, the scientific study of the relation of law and legal practices to population health, builds the evidence base for public health law. This paper describes PHLR’s work in funding research and helping strengthen the quality and rigor of public health law research. It also discusses how this approach fits within the larger RWJF effort to put law to work in practice by working as allies with a wide community of health agencies and organizations.

Policing and Public Health: Not Quite the Right Analogy

ABSTRACT Policing matters to public health, and it makes sense to consider how greater cooperation and even integration between health and law enforcement systems might lead to new and better approaches to chronic problems at the intersection of health and security. The fact that policing is important to public health does not mean, however, that police work is ‘like’ public health work, let alone that police agencies and public health agencies share important features in culture and methods that might support better alignment. It may be more useful to focus on the similarities between policing and medicine. Medicine and policing devote most of their energies to addressing the acute needs of individuals, and have relatively little capacity to change upstream structural factors. Each is a source of considerable incidental harm. Past and current efforts to align public health and medicine provide useful insights into work at the intersection of policing and public health. In this paper, we pursue analogies between policing and patient-centred care, preventing medical error, reducing overutilisation, and focusing care on high-risk patients. We conclude with an exploration of what a ‘culture of health’ would add to current police culture.