Julie Samia Mair

Regulation of firearm dealers in the United States: an analysis of state law and opportunities for improvement.

Firearms were associated with 30, 136 deaths in the United States in 2003. Most guns are initially sold to the public through a network of retail dealers. Licensed firearm dealers are an important source of guns for criminals and gun traffickers. Just one percent of licensed dealers were responsible for more than half of all guns traced to crime. Federal law makes it difficult for ATF to inspect and revoke the licenses of problem gun dealers. State licensing systems, however, are a greatly under-explored opportunity for firearm dealer oversight. We identify and categorize these state systems to identify opportunities for interventions to prevent problem dealers from supplying guns to criminals, juveniles, or gun traffickers. Just seventeen states license gun dealers. Twenty-three states permit routine inspections of dealers but only two mandate that those inspections occur on a regular basis. Twenty-six states impose record-keeping requirements for gun sales. Only thirteen states require some form of store security measures to minimize firearm theft. We conclude with recommendations for a comprehensive system of state licensing and oversight of gun dealers. Our findings can be useful for the coalition of more than fifty U.S. mayors that recently announced it would work together to combat illegal gun trafficking.

How the law affects gun policy in the United States: Law as intervention or obstacle to prevention

n our experience, public health practitioners (rather than scholars) seeking to address a health problem often have I just two very basic questions about the law: (1) how can I use the law to create new interventions, or improve existing ones, to protect the public’s health; and (2) will the law prevent me from successfully implementing certain interventions? In this way, the law is seen as either an opportunity for intervention to affect a public health problem, or an obstacle to enacting or implementing a desired intervention. In addition, because some public health practitioners may not fully understand the intricacies of a given legal area, some possible obstacles to intervention may be either real or perceived. A real legal obstacle is not necessarily an insurmountable one, but it does have genuine legal force. A perceived obstacle has little, if any, true legal application to a given kind of intervention. Of course, the two questions public health practitioners might ask, and their notion of law as intervention and real or perceived obstacle, are a more focused (and colloquially phrased) subset of the issues captured by more scholarly definitions of public health law generally..’ But the questions do reflect the very practical mindset of many public health practitioners regarding the law. Practitioners often simply want to know: What can I use the law to do, and what will the law prevent me from doing? In the United States, one particularly fertile intersection between law and the public’s health concerns the prevention of firearm-related injuries. Firearms were associated with more than 30,000 deaths in the United States in 1998, making them the second-leading cause of injury-related death? For some groups, though, the health burden of firearms is

How Litigation Can Promote Product Safety

Jon S. Ernick, Jason W Sapsin, Stephen I? Teret, and Julie Samia Mair or at least the past three decades, injuries have been recognized as an important public health F problem in the United States. In 2001, there were approximately 157,000 deaths due to injuries in the US. There were also almost 30 million non-fatal injury incidents.’ Injuries have been defined as: “...any unintentional or intentional damage to the body resulting from acute exposure to thermal, mechanical, electrical, or chemical energy or from the absence of such essentials as heat or oxygenl’z Within public health, the field of injury prevention and control is dedicated to reducing the burden of injuries on the lives of people around the world. Injury prevention seeks to reduce injuries by: 1) identifying risk factors, 2) designing interventions to address the risk factors, 3) implementing those interventions, 4) evaluating their effectiveness, and 5 ) replicating those that work. As with many other public health problems, interventions can target factors associated with the human or host, vehicle or vector, and the physical or social environment.3 Injuries associated with consumer or other products are an important part of the injury problem. Motor vehicles alone are responsible for approximately 40,000 deaths in the U.S. each year.* There are a number of strategies that have been used to prevent product-related injuries. Legislation or regulation can be used to require manufacturers to change the design of the product itself to reduce risks for example, by requiring seat belts to be installed in all passenger cars. Education can also be used to attempt to modify the behavior of the user of the product to minimize the likelihood of injury for example, by using the media to encourage car occupants to wear their seatbelts. And the physical environment can be improved for example, by adding guard-rails to the roadway -

A complementary approach to bioterrorism prevention

Michael Mair, MPH, is a senior research assistant at the Center for Civilian Biodefense Strategies, Johns Hopkins Bloomberg School of Public Health. Julie Samia Mair, JD, MPH, is an assistant scientist in the Department of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health and a core faculty member of the Center for Law and the Public’s Health at Johns Hopkins and Georgetown Universities.1

Vaccine liability in the era of bioterrorism.

THIS PAPER ANALYZES Section 304 of the Homeland Security Act of 2002,1 as amended in April 2003,2 which sets forth liability protection for participants in the current national smallpox vaccination program.3 It explains to nonlawyers the state of liability protection as it stands in mid-2003. Section 304 (or “the Homeland Security Act” or “the Act”) has been controversial since its enactment—in part because liability protection could have been structured in a variety of ways. Some controversy was inevitable, though, as the issue of vaccine liability in the era of bioterrorism is new territory. Until now, national defense has never been a factor in a decision to vaccinate civilians. Theoretically, vaccination could reduce the anticipated rewards of a biological attack, possibly deterring the proliferation and use of a particular agent.4 But as will be discussed, the smallpox vaccination program has not progressed as initially anticipated, partially because of concerns about liability. The recent experience with the smallpox vaccine is therefore instructive for future vaccination programs. A brief description of the main approaches to vaccine liability is presented first, followed by an analysis of the liability protection provided under Section 304. The paper then concludes with a discussion of several key principles related to liability that policymakers should consider when vaccines are used to defend against bioterrorism. APPROACHES TO VACCINE LIABILITY