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Law, Government, and Public Health. Chapter 4. Learning Objectives. Understand the role of law and government in promoting the health of the public Identify different types of laws Identify functions of governmental agencies Apply this knowledge in solving public health problems.

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Learning objectives
Learning Objectives

  • Understand the role of law and government in promoting the health of the public

  • Identify different types of laws

  • Identify functions of governmental agencies

  • Apply this knowledge in solving public health problems


Why does public health need the law
Why does public health need the law?

  • Values

  • Authority

  • Decisions

  • Enforcement

  • Define the "unacceptable"


U s responsibility for public s health
U.S.:Responsibility for Public’s Health

  • U.S. Constitution (1787)

  • Powers reserved to states and people

  • General welfare

  • Regulate commerce

  • Implied powers



National v s tate g overnments k ey e vents
National v. public's health (mostly)State Governments:Key Events


Legal concepts
Legal Concepts public's health (mostly)

  • Police Powers

  • Limit the actions of individuals to protect society

Jacobsen v. Massachusetts, 1905


Your turn
Your turn public's health (mostly)

  • An athletic event (like the Olympics) is being held in your jurisdiction. The temperature is near 100 degrees. Events include tennis, running, cycling, etc. There are thousands of spectators. There may be heat-related illnesses.

  • Should you as the local health director ask the organizers to postpone the event or issue an order to postpone it or do nothing?


Legal concepts1
Legal concepts public's health (mostly)

  • Support the general welfare

  • Elizabethan Poor Laws

  • Should government provide health care for people who can't afford it? Why or why not?

  • Under what circumstances?


Structures and organization to support governmental public health
Structures and Organization to Support Governmental Public Health

  • Federal, state and local agencies evolved

  • States delegate authority to counties, cities, towns, districts

  • "Home rule" gives broad authority to locals

  • Variation in state and local structures


Preemption
Preemption Health

  • By legislative or regulatory action, a “higher” level of government (state or federal) eliminates or reduces the authority of a “lower” level over a given issue.

  • Under the Supremacy Clause of the U.S. Constitution, Congress and federal regulators have virtually unlimited authority – if they choose to exercise it – to preempt state and local health laws.

  • Airline Smoking Ban

  • http://publichealthlawcenter.org/topics/other-public-health-law/preemption-public-health


Types of law
Types of Law Health

  • Constitutional law

  • Legislative (statutory) law

  • Administrative law

  • Judicial law


Constitutional law
Constitutional Law Health

  • Establishes powers, duties and limits of government

  • Courts interpret the Constitution

  • Does the Constitution protect an individual's right to smoke?


Legislative statutory law
Legislative (statutory)law Health

  • Congress and state legislatures; city councils, etc.

  • Regulate behavior and distribute resources

  • Consistent with the U.S. Constitution

  • Selects policies

  • Delegates authority

  • Mandates activity

  • Establishes and funds programs


Administrative law
Administrative Law Health

  • Executive branch

  • Regulations more detailed than statutes

  • Implement, decide, enforce, and interpret

  • Extensive public process

  • Continuing oversight by legislature

  • Example: asbestos removal in schools


Judicial law
Judicial Law Health

  • Interpret constitutionality of laws/regulations

  • Interpret intent of laws/regulations

  • Decide “case law”


Structure federal agencies
Structure: Federal Agencies Health

  • http://www.hhs.gov/about/orgchart/


Structures state tribal and territorial agencies
Structures: Health State, Tribal and TerritorialAgencies

  • Variation

  • Centralized v. decentralized

  • Umbrella v. Stand alone


Structure local health departments
Structure: Health Local Health Departments

  • 3,000+ local health departments

  • Mostly county

  • Mostly small jurisdictions (<50,000)

  • Some consistency and variation in services

  • Public Health Accreditation

  • Websites?


The vaccine war
The Vaccine War Health

  • http://www.pbs.org/wgbh/pages/frontline/teach/vaccine/

  • Should government prohibit children from entering school without vaccinations?

  • If there are exemptions, on what grounds?

  • What are the underlying legal and other issues?


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