and changes in society as a whole. Second, the committee urges government agencies to familiarize themselves with the toolbox of public health legal and policy interventions at their disposal. Also, the report discusses evidence of the effectiveness of legal and policy tools, as well as efforts to advance the science needed to inform policymaking to improve the public’s health. (The effectiveness of policy interventions is especially noteworthy against a backdrop of current and future economic exigencies and the high premium placed on efficiency and accountability.) Third, the committee encourages government and private sector stakeholders to explore and embrace HIAP for their synergistic potential. The consideration of health in a wide range of public- and private-sector policymaking will lead both to improvements in population health and to the achievement of priority objectives in other sectors, such as job creation and educational reform, and a more vibrant and productive society. The report offers 10 recommendations and a conclusion to address the challenges it identifies and enhance the use of law and public policy to improve population health.

RECOMMENDATIONS

Public health statutes—the laws that define the authorities and roles of federal, state and local public health agencies—were enacted when major population health threats were due to hygiene factors (water, food, sanitation), communicable diseases, public safety issues, maternal and child health challenges, and occupational injury and illness. The contemporary burden of disease has shifted increasingly to chronic conditions and injuries as infectious disease declined, but the evolving physical, social, and built environments have contributed new challenges. In addition to the health hazards of another era, older public health laws currently “on the books” were informed by the scientific standards of the day and the statutory context and constitutional jurisprudence of their time, including conceptions of individual rights. Some laws were enacted in piecemeal fashion in reaction to contemporary epidemics, leading to layers of statutory accretion rather than holistic or comprehensive legislation (Gostin et al., 2008).

Two major efforts to review and update public health law took place around the turn of the 21st century. These were the Turning Point Model State Public Health Act (1997–2003) and the Model State Emergency Health Powers Act (MSEHPA) (2001–2002). The Turning Point Model Public Health Act was a broad (though not comprehensive) model law composed of nine articles and incorporating two other model acts—a revised version of the MSEHPA in the article pertaining to emergency powers, and the Model State Public Health Privacy Act (Gostin et al., 2001, 2002). Despite the development and dissemination of these model acts, their use for widespread updating or modernization of public health statutes has been



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement