PHSSR

PHLR and PHSSR Integration Article Published

"Moving from Intersection to Integration: Public Health Law Research and Public Health Systems and Services Research" was published this week in The Milbank Quarterly.

The article is a collaboration between leaders of the Public Health Law Research (PHLR) National Program Office and the National Coordinating Center for Public Health Systems and Services Research at the University of Kentucky, and it establishes a unified framework for the two fields and a shared research agenda built around three broad inquiries. The article was written by Scott Burris, PHLR Director; Jennifer K. Ibrahim, PHLR Associate Director; F. Douglas Scutchfield, Director of the National Coordinating Center for PHSSR at the University of Kentucky; and Glen P.  Mays, co-PI of the RWJF-funded National Coordinating Center for PHSSR at the University of Kentucky.

For three decades, experts have been stressing the importance of law to the effective operation of public health systems. In a 2011 report, the Institute of Medicine recommended a review of state and local public health laws to ensure appropriate authority for public health agencies; adequate access to legal counsel for public health agencies; evaluations of the health effects and costs associated with legislation, regulations, and policies; and enhancement of research methods to assess the strength of evidence regarding the health effects of public policies. These recommendations, and the continued interest in law as a determinant of health system performance, speak to the need for integrating the emerging fields of PHLR and PHSSR.

The article is available for free in full from Wiley Online Library.

Citation: Burris, S., Mays G.P., Scutchfield, F.D., Ibrahim, J.K. (2012). Moving from Intersection to Integration: Public Health Law Research and Public Health Systems and Services Research. The Milbank Quarterly, 90(2), 375-408.

Categories:
Building the Evidence: Creating a Framework for Assessing Costs and Impacts of Joint Use Agreements

This study will enumerate the costs, implementation barriers, facilitators, and the administrative and financial burden that joint-use agreements (JUAs) may impose on schools that in turn can impact children's access to recreational activity. Understanding the consequences and main drivers of JUAs is crucial to promoting their use and improving the terms of future agreements to balance risks between schools and communities. Findings will provide a foundation for future cost-benefit or cost-effectiveness analyses.

 

Funding Date: Thu, 11/15/2012

Researching Institution: Los Angeles County Department of Public Health

Researcher: Tony Kuo, MD, MSHS, and Ricardo Basurto-Davila, PhD, MSc

Public Health Agencies and Advocacy Under the Law

This project will explore how policies that govern public employees' participation in the policy process affect state health departments' effectiveness in advocating for sound public health laws and policies. By understanding how agencies and their employees participate in law and policy development, and how they interpret the rules pertaining to policy advocacy, these findings can better assist agency leaders and our public sector employees in maximizing the contributions of the public health infrastructure to advancing public health policies.

Funding Date: Thu, 11/15/2012

Researching Institution: Johns Hopkins University

Researcher: Shannon Frattaroli, PhD, MPH

Moving from Intersection to Integration: Public Health Law Research and Public Health Systems and Services Research

For three decades, experts have been stressing the importance of law to the effective operation of public health systems. This article sets out a unified framework for the two fields and a shared research agenda built around three broad inquiries: (1) the structural role of law in shaping the organization, powers, prerogatives, duties, and limitations of public health agencies and thereby their functioning and ultimately their impact on public health ("infrastructure"); (2) the mechanisms through which public health system characteristics influence the implementation of interventional public health laws ("implementation"); and (3) the individual and system characteristics that influence the ability of public health systems and their community partners to develop and secure enactment of legal initiatives to advance public health ("innovation"). Research to date has laid a foundation of evidence, but progress requires better and more accessible data, a new generation of researchers comfortable in both law and health research, and more rigorous methods.

Burris, S., Mays G.P., Scutchfield, F.D., Ibrahim, J.K. Moving from Intersection to Integration: Public Health Law Research and Public Health Systems and Services Research. The Milbank Quarterly, 90(2), 375-408.

 

Author: 
Scott Burris
Glen P. Mays
F. Douglas Scutchfield
Jennifer K. Ibrahim
Publication Date: 
06/18/2012
Categories:
What is the association between local legal infrastructure and population health?

State and local governments make important decisions about how resources and services—including public health services--are provided to citizens.  Examples of these decisions include how much decision-making autonomy local governments are given by the state, or the powers of local boards of health to impose public health taxes, and whether the public health delivery system provides basic or comprehensive services to the community. This study will examine how these decisions impact population health.  Based on the findings, this study will make recommendations for state legislation that will position local public health systems for optimal impact on population health.

Grant Number: 68395

Funding Date: Mon, 11/15/2010

Researching Institution: University of Kentucky College of Public Health

Researcher: Julia Costich, M.P.A., J.D., Ph.D.; Dana Patton

Results

Julia F. Costich and Dana J. Patton.  Local Legal Infrastructure and Population Health. American Journal of Public Health: October 2012, Vol. 102, No. 10, pp. 1936-1941.

Paper alternatively available via SSRN: http://ssrn.com/abstract=2139566

Findings
The grantee explored the association between the legal infrastructure of local public health, as expressed in the exercise of local fiscal and legislative authority, and local population health outcomes. Through their analyses, they found that public health legal infrastructure, particularly reformed county government, had a significant effect on population health status as a mediator of social determinants of health. Because states shape the legal infrastructure of local public health through power-sharing arrangements, their findings suggested recommendations for state legislation that positions local public health systems for optimal impact.

What is the impact of local health department structure and policy on public health outcomes?

This study examines the policies and structures of local and state health departments, and how they impact public health. The study will focus on the structural arrangements of the local boards of health (such as whether the boards of health are elected or appointed) and the level of state health department centralization, and how they affect performance, fiscal health, innovation, collaboration, and strategic planning. In addition to contributing to the ongoing dialogue regarding health department accreditation, this study will provide a road map for policy makers, planners, administrators and individual citizens for years to come.

Grant Number: 68400

Funding Date: Mon, 11/15/2010

Researching Institution: University of Illinois

Researcher: Scott Hays, Ph.D.

What legal structures support national accreditation of public health agencies?

This project will use (1) a mapping study to assess the status of accreditation laws, policies and regulations in 20 states that have been identified as having or making progress towards accreditation, followed by (2) a mechanism study involving process tracing in six case study states to examine how and why states developed, adopted, and implemented a particular legal structure. The mechanism study will also utilize the conceptual framework of public health system and services research (PHSSR) to explore the impact that legal structure has on the organizational capacity, functions, and outputs of resulting accreditation programs. Deliverables for this project include a "legal supplement" to The Accreditation Road Map, a tool aimed at assisting states in the creation of a successful accreditation program. The legal supplement will be disseminated electronically to all study participants, states participating in the Multistate Learning Collaborative, and others to guide agency accreditation activities.

Grant Number: 67142

Funding Date: Tue, 12/01/2009

Researching Institution: University of North Carolina, North Carolina Institute for Public Health

Researcher: Edward L. Baker, M.D., M.P.H., Gene W. Matthews, J.D.

Results

Matthews, G., Markiewicz, M., and Beitsch, L. (2012). Legal Frameworks Supporting Public Health Accreditation: Lessons Learned from 10 States.  Journal of Public Health Management & Practice, 18(1), E8-E16.

Matthews, G. & Markiewicz, M. (2011). Legal Frameworks Supporting Public Health Department Accreditation: Key Findings and Lessons Learned from Ten States [Report].  Chapel Hill, NC: The North Carolina Institute for Public Health.

Matthews, G. & Markiewicz, M. (2011). Legal Frameworks Supporting Public Health Department Accreditation: Key Findings and Lessons Learned from Ten States [Executive Summary].  Chapel Hill, NC: The North Carolina Institute for Public Health.

Matthews, G. & Baker, E. (2010). Looking Back from the Future: Connecting Accreditation, Health Reform, and Political OpportunitiesJournal of Public Health Management & Practice, 16(4), 367-369.