Jennifer K. Ibrahim

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.

Moving from intersection to integration: Public health law research and public health systems and services research

Context For three decades, experts have been stressing the importance of law to the effective operation of public health systems. Most recently, in a 2011 report, the Institute of Medicine recommended a review of state and local public health laws to ensure appropriate authority for public health agencies; adequate access to legal counsel for public health agencies; evaluations of the health effects and costs associated with legislation, regulations, and policies; and enhancement of research methods to assess the strength of evidence regarding the health effects of public policies. These recommendations, and the continued interest in law as a determinant of health system performance, speak to the need for integrating the emerging fields of Public Health Law Research (PHLR) and Public Health Systems and Services Research (PHSSR). Methods Expert commentary. Findings This article sets out a unified framework for the two fields and a shared research agenda built around three broad inquiries: (1) the structural role of law in shaping the organization, powers, prerogatives, duties, and limitations of public health agencies and thereby their functioning and ultimately their impact on public health (“infrastructure”); (2) the mechanisms through which public health system characteristics influence the implementation of interventional public health laws (“implementation”); and (3) the individual and system characteristics that influence the ability of public health systems and their community partners to develop and secure enactment of legal initiatives to advance public health (“innovation”). Research to date has laid a foundation of evidence, but progress requires better and more accessible data, a new generation of researchers comfortable in both law and health research, and more rigorous methods. Conclusions The routine integration of law as a salient factor in broader PHSSR studies of public health system functioning and health outcomes will enhance the usefulness of research in supporting practice and the long-term improvement of system performance.

Critical Opportunities for Public Health Law: A Call for Action

Although legal interventions are responsible for many sentinel public health achievements, law is underutilized as a tool for advancing population health. Our purpose was to identify critical opportunities for public health lawmaking. We articulated key criteria and illustrated their use with 5 examples. These opportunities involve significant health problems that are potentially amenable to change through law and for which an effective legal intervention is available: optimizing graduated driver licensing laws, increasing tax rates on alcoholic beverages, regulating sodium in foods, enacting laws to facilitate reversal of opioid overdoses, and improving mental health interventions in the college setting. We call for a national conversation about critical opportunities for public health law to advance evidence-based policymaking.

Policy Surveillance: A Vital Public Health Practice Comes of Age

Governments use statutes, regulations, and policies, often in innovative ways, to promote health and safety. Organizations outside government, from private schools to major corporations, create rules on matters as diverse as tobacco use and paid sick leave. Very little of this activity is systematically tracked. Even as the rest of the health system is working to build, share, and use a wide range of health and social data, legal information largely remains trapped in text files and pdfs, excluded from the universe of usable data. This article makes the case for the practice of policy surveillance to help end the anomalous treatment of law in public health research and practice. Policy surveillance is the systematic, scientific collection and analysis of laws of public health significance. It meets several important needs. Scientific collection and coding of important laws and policies creates data suitable for use in rigorous evaluation studies. Policy surveillance addresses the chronic lack of readily accessible, nonpartisan information about status and trends in health legislation and policy. It provides the opportunity to build policy capacity in the public health workforce. We trace its emergence over the past fifty years, show its value, and identify major challenges ahead.

State health department structure and pandemic planning.

Pandemic influenza is an imminent threat, with the April/May 2009 A(H1N1) outbreak as a testament to the potential for rapid transmission and spread of a novel influenza strain. Research has shown that there are great disparities in state pandemic planning; however, little work has been done to assess how health department structure impacts pandemic preparedness. The purpose of this article was to examine the impact of state health department structure on state pandemic influenza plan integration of federal recommendations. The study consisted of a cross-sectional analysis of 41 states and found that structural and strategy-making variables have the greatest impact on pandemic plan inclusion of federal recommendations. Strong, multilayered health department hierarchies and the tenure of senior staff are negatively associated with preparedness, whereas professionalization is positively associated with pandemic plan comprehensiveness. State health departments can take minimally invasive steps to increase their effectiveness in pandemic preparedness by reducing layers of bureaucracy and increasing training for staff.

Comparing intervention strategies among rural, low SES, young adult tobacco users.

OBJECTIVE To evaluate 3-month tobacco quit rates of young adult tobacco users randomized to 2 intervention conditions. METHODS Overall 192 non-treatment-seeking 18-to-24-year-old tobacco users received educational information and advice to quit smoking. Participants were then block randomized to 2 brief intervention conditions: (1) a telephone quitline (TQ) N = 90; or (2) a brief direct treatment intervention (BDTI) N = 102. RESULTS A 90-day follow-up evaluation found that 19.6% of BDTI and 10.2% of TQ participants reported 30-day point prevalence tobacco quit rates (chi-square = 2.37, P = .09). CONCLUSIONS BDTI can help non-treatment-seeking, low SES, young adult tobacco users quit smoking.

Variability of Healthcare Practitioner Intervention Among 18- to 24-Year-Old Tobacco Users

A survey of 184 young, rural, tobacco users found that healthcare professionals often assessed tobacco use, although there was significant variability by professional type (physician vs. dentist) and tobacco service (advise vs. referral). Females reported significantly higher levels of receiving tobacco services (advice to quit) than males.

Using Public Health Legal Counsel Effectively: Beliefs, Barriers and Opportunities for Training

Effective use of public health law can be a powerful tool to advance the mission of public health departments to protect and promote the health of the population. However, there is little known about the way that public health officials think about law, use law, and/or interact with their legal counsel. The purpose of this paper is to examine some of the beliefs and barriers facing public health officials and legal counsel in their efforts to collaborate and to describe specific opportunities to better facilitate the use of law and collaboration, particularly in the area of training and education. Our findings are based on two studies: (1) a mixed methods study of state and local public health officials and their legal counsel, including surveys and qualitative interviews; and (2) a survey-based needs assessment of training for public health law. While state health officials and legal counsel view the role of public health law in similar ways, variation exists in organization, interactions and perceptions of collaboration on issues of public health law. Tremendous opportunity exists for improving collaboration between legal counsel and public health agencies through additional education and training opportunities. Improving the use of law in public health is possible - if practitioners and legal educators work together to fulfill its promise.

Better health faster: The 5 essential public health law services

Successful public health campaigns like tobacco control demonstrate that effective legal interventions can be expeditiously developed, evaluated and diffused, even in the face of powerful opposition. Success for legal health interventions depends on a well-designed and nurtured legal infrastructure that assured the timely delivery of public health law services that are essential to successful policy innovation that improves health. We describe Five Essential Public Health Law Services and suggest investment in the people, methods and tools needed to move major policy initiatives from conception to widespread implementation. The model reflects a transdisciplinary approach integrating public health legal practice with law-related surveillance, evaluation and enforcement functions usually performed by public health practitioners. As an elaboration of law-related activities within the Ten Essential Public Health Services, the framework can be used to define, evaluate and strengthen public health law functions. The framework presented defines the components of a strategic investment that can turn evidence and expertise into better health, faster.