For the Public's Health Revitalizing Law and Policy to Meet New Challenges (2011) / Chapter Skim
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3 Law and the Public's Health: Law as a Tool for Improving Population Health
3 Law and the Public's Health: Law as a Tool for Improving Population Health
Pages 57-72
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From page 57... ...
Below, the committee discusses the major ways in which laws enacted by federal, state, and local legislatures, regulations promulgated by the Executive Branch and its agencies, and to a lesser extent, litigation through the judicial system may be used as public health interventions. The committee provides examples of some prominent areas for policymaking, and explores the roles of public health agencies (and associated boards of health or other government executives)
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From page 58... ...
Using the Law to Achieve Population Health Objectives The principles that form the basis for legal interventions by public health agencies and others in government to protect and improve the public's health include discharging the statutory duty to protect from harm and promote health and safety. In many cases, this is done by intervening to attenuate externalities -- negative side effects of individual actions such as speeding, addressed by imposing speed limits, and of business sector actions such as emitting air pollution, addressed by setting and enforcing air quality standards.
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From page 59... ...
The Highway Safety Act of 1966 required that states enact and enforce motorcycle helmet laws to receive highway funding. By 1975, 47 states and the District of Columbia had done so.
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From page 60... ...
Smoking presents a threat to the health of others through environmental tobacco smoke, and an economic threat to businesses, which face higher medical care costs and losses in productivity, and to society in general (CDC, 2005; Musich et al., 200) .1 Similarly, the consumption of unhealthy foods -- whether containing trans fatty acids (shown to increase the risk factors for heart disease [Mensink et al., 2003]
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From page 61... ...
OTHER EXAMPLES OF LEGAL AND POLICY TOOLS Policy Interventions on the Informational Environment Unhealthy foods and beverages may be targeted from different angles, including compelling or requiring manufacturers and retailers to take or avoid certain actions and modifying the informational environment. Industry packaging, labeling, and multimedia advertising of such products are based on market research, and the results are highly attractive products often accompanied by confusing or misleading information (Gostin, 2010b; Mello et al., 2006; Pomeranz, 2011)
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From page 62... ...
, several of them public policies, to improve population health, specifically by reducing mortality and morbidity due to its use. It is important to note that the anti-tobacco campaign illustrates that the laws enacted at the federal, state, and local levels include a variety of taxes on tobacco products, bans on indoor smoking (first in workplaces, and later in restaurants and bars)
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From page 63... ...
For example, the Government Accountability Office recently concluded that unlike the FTC, which can require companies to provide evidence in support of their advertising claims, "FDA bears the burden of proving that a structure/function claim is false or misleading without having the authority to compel companies at the investigation stage to produce the evidence that the companies assert as support for their advertising claims" (GAO, 2011, p.
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From page 64... ...
Indirect regulation through litigation has been successfully employed by tobacco control programs. The Master Settlement Agreement with 46 state attorneys general who had brought litigation against tobacco companies was the major event in the tobacco battles.
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From page 65... ...
In addition to using the tool of direct and indirect regulation described above, requiring industry to make certain changes to their products or requiring consumers to operate within certain limits, the government may use the influence of its "bully pulpit" to motivate shifts in how privatesector entities operate with regard to products that are known to have the potential to harm health. One example comes from the United Kingdom, where the government has used a policy of collaboration and the incentive of public reporting to engage the food industry in taking voluntary steps to meet or exceed government-set guidelines for sodium levels in food.
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From page 66... ...
. The National Institute for Health and Clinical Excellence commissioned an economic model to measure the potential effects on cardiovascular disease risk factors of enacting legislation to eliminate trans fats or reduce dietary salt con sumption by 3 grams per day.
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From page 67... ...
The committee believes that policy interventions can be effective and of high value in addressing major causes of death, disease, and disability at the population level. The committee's belief is based on evidence reviews of the effectiveness of public policies aimed at injury prevention, tobacco control and prevention of environmental tobacco smoke, prevention of excessive alcohol consumption, and requirement of immunization for school entry (Elder et al., 2010; Hopkins et al., 2001; Task Force on Community Preventive Services, 2009; Task Force on Community Preventive Services et al., 2005)
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From page 68... ...
One study examined "costs and outcomes of 84 injury prevention interventions for the United States and found that an alcohol tax of 20 percent of the pretax retail price offered net cost savings (i.e., the savings outweigh the costs) even after taking into account the adverse economic impact of reduced alcohol sales," and the other study examined the cost-effectiveness of alternative policies to address excessive alcohol use and "found that taxation was the most effective and cost-effective intervention in populations with a 5 percent or greater prevalence of heavy drinkers" (Elder et al., 2010, p.
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From page 69... ...
2010. The effectiveness of tax policy interventions for reduc ing excessive alcohol consumption and related harms.
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From page 70... ...
2008. Effect of the California tobacco control program on personal health care expenditures.
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From page 71... ...
2010. Giving liberty its due, but no more: Trans fats, liberty, and public health.
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