CFP1

This project includes a mapping study analyzing the state of the law and the application of the law surrounding antimicrobial resistance; and a mechanism study to assess the empirical effect of current regulation on antibiotic resistance, including calculation of the effective patent life of antibiotics and empirically testing the patent holder waste hypothesis. Deliverables for this project include a proposed set of policy recommendations related to the two main approaches to reducing antimicrobial resistance; innovation and conservation. Dissemination will be via policy briefs and publications in journals such as Health Affairs, Clinical Infections Diseases, Lancet Infectious Diseases and New England Journal of Medicine.

This project will explore the relationship between non-medical exemption laws and variability in those state laws and disease rates. The project will employ mixed-effects hierarchical models at 3 levels (year, state, and region) of analysis for 5 vaccine-targeted diseases (measles, mumps, pertussis, varicella, andhepatitis B). We will use a longitudinal research design to examine state-level data from 51 jurisdictions over 8 years (2001-2008). Deliverables for this project include at least two publications for highly visible law and health journals, an Issue Brief to be distributed in the NCLS newsletter, the Forum for State Health Policy and to State Health Commissioners. The project staff also aims to present findings to the Institute for Medicine and in other legislative venues.

This project will develop and implement a streamlined alternatives assessment tool appropriate for use in a regulatory context. The alternatives assessment compares alternatives to lead and to one another across a variety of attributes, Research questions include: What existing uses of lead in the United States and the nature of their associated human exposures? Second, for selected uses of lead, are safer alternatives available or emerging? Third, for those alternatives, what are the barriers to diffusion, if any, and how can public health law be used to overcome those barriers. Deliverables for this project include: 1) Phase I Project Report and a shorter “policy brief” publication relating to lead use and exposure 2) Final Project Report and policy brief 3) Peer-reviewed formal papers for peer-reviewed academic journals and law reviews 4) A project white paper for federal and state policy makers, trade associations, and nongovernmental organizations focusing on the policy recommendations 5) Fact sheets for businesses, distributors, workers, trade associations and unions, and the general public summarizing the uses, exposures and hazards for relevant processes or products.

This project will evaluate the effectiveness of the establishment of the Lead Court in November 2002 in the City of Philadelphia under the Lead Abatement Strike Team Program of the Philadelphia of Public Health to determine if this type of innovative legal strategy was effective in enforcing the existing city health code, which would lead to improvement of children's health (by reducing exposure to lead in individual housing units) and improvement of the environment (by decreasing the number of properties with lead hazards). Quantitative analysis will look at data regarding the number of properties and details of their enforcement and Lead Court appearance history (such as documentation of non-compliance and time to compliance) and blood lead level history and trends of resident children, and their correlation with time to compliance. There will be comparisons of data from the pre-Court (1998-2002) and Court (2003-2008) time period. Deliverables for this project include journal articles, a final report, and oral and poster presentations to local, state and national legal, public health, environmental health, pediatric, and lead poisoning prevention conferences.