The Legal Foundation for U.S. Public Health Practice National Indian Health Board National Tribal Public Health Summit May 31, 2012. Office for State, Tribal, Local, and Territorial Support. Public Health Law Program.
The Legal Foundation for
U.S. Public Health Practice
National Indian Health Board
National Tribal Public Health Summit
May 31, 2012
Office for State, Tribal, Local, and Territorial Support
Public Health Law Program
The contents of this presentation have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy. This presentation is for instructional use only and is not intended as a substitute for professional legal or other advice. Nor is it an endorsement for the implementation of any specific legislation. While every effort has been made to verify the accuracy of these materials, legal authorities and requirements may vary from jurisdiction to jurisdiction. Always seek the advice of an attorney or other qualified professional with any questions you may have regarding a legal matter.
Who We Are
What We Do
To provide support to public health practitioners and their counsel using legal tools and strategies that when implemented improve public health outcomes.
Converging science, policy and law into specific strategies that are promising practices or best practices.
Using Law to Improve Public Health Outcomes
STLT Public Health Agencies and Practitioners
Legal Counsel to Public Health Practitioners
We provide consultation and technical assistance that is coordinated with multidisciplinary subject matter experts, focused on jurisdiction specific public health issues, and encourages a team approach between public health practitioners and their legal counsel.
An increasing need for legal clarification regarding the way public health programs are implemented on the state and local level:
Conducting routine, daily activities, such as public health surveillance, inspections, and enforcement
Investigating outbreaks: setting clear parameters
Responding to natural disasters and other public health emergencies
Federal legislation (e.g. ACA) and policy initiatives
It is important that AI/AN public health practitioners have a basic understanding of the role of law in U.S. public health practice in order to better:
Foster understanding among AI/AN communities and policymakers on the state and local level
Equip and empower interested participants in being a voice in public health law and policy making on the state and tribal governmental level
Demonstrate the critical role that law plays in advancing public health goals
Do you know how law contributed to these achievements?
Control of infectious diseases
Decline in deaths from coronary heart disease and stroke
Safer and healthier foods
Healthier mothers and babies
Fluoridation of drinking water
Recognition of tobacco use as a health hazard
One suggested definition:
“The legal powers and duties of the state to assure the conditions for people to be healthy, 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 protection or promotion of community health.”*
Public Health Laws
Two Fundamental Concepts
Federalism power is divided between a national government and smaller state governments
Police Powers Powers exercised by the states to enact legislation and promulgate regulations to protect the public health, welfare, and morals, and to promote the common good.
Federal government has exclusive power to regulate commerce with foreign nations.
Direct or indirect regulation by states that unduly burdens foreign or interstate commerce is unconstitutional.
The federal government may regulate:
Interstate commerce that crosses state borders.
Intrastate commerce that affects interstate commerce.
Most public health activities carried out by state and local governments
Federal government functions in public health carried out through regulatory (e.g., FDA) and non-regulatory (e.g., CDC) agencies
Federal government shapes state / local public health through funding and defunding
An Urgent Public Health Threat
Tribal Public Health Law:
“In the realm of public health… it’s the law that really does the work. That’s been demonstrated time and time again in areas ranging from mandating vaccinations; to requiring automobile seatbelts, to improving workplace safety; to the inspections of meat products; and fluoridation of water. Public health succeeds by making healthy choices the norm.”
- New York City Mayor Michael Bloomberg in an address at the Harvard School of Public Health, 2007
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