Evidence Briefs: Public Health Topics
State
Obesity Prevention Laws
By utilizing a collaborative and iterative search process, researchers at the Harvard School of Public Health created this comprehensive database of obesity-related legislation enacted in the 50 states between 2000-2007. The dataset contains over 100 variables reflecting a diverse array of law ranging from restrictions on competitive foods in school to mandated diabetes screenings. This dataset was created with funding from the National Program Office for Public Health Law Research. For more details about the project, please see What public health law approaches help prevent obesity?
Data to be posted in Fall, 2011.
Distracted Driving Laws
This database of laws provides a comprehensive view of the provisions of laws that restrict the use of mobile communication devices while driving for all 50 states and the District of Columbia between 1992, when first law was passed, through July 15, 2011. The dataset contains information on 22 dichotomous, continuous or categorical variables including, for example, activities regulated (e.g., texting versus talking, hands-free versus handheld), targeted populations, and exemptions.
In June 2011, an article was published in the American Journal of Preventive Medicine describing this study.
- Read the news release
- Read the AJPM article
- Access the data
- NEW: Watch our "Distracted Driving" Webinar!
This study aims to evaluate the comparative effectiveness of state laws restricting use of electronic devices while driving in reducing fatalities on public roads and examine the interrelationship between distracted driving, alcohol consumption and state law.
Grant Number: 6360
Funding Date: Tue, 11/15/2011
Researching Institution: University of North Texas Health Science Center
Researcher: Fernando Wilson, PhD
Prescription drug overdose deaths, mostly from opioid pain relievers, now outpace motor vehicle fatalities in most states. In about 35 states, electronic databases known as prescription monitoring programs (PMPs) are intended to reduce abuse of prescription drugs and overdose by tracking pharmacy dispensing and making data available to clinicians and law enforcement. This study will provide evidence-based information of effectiveness to administrators and inform policy decisions at the national level.
Grant Number: 6387
Funding Date: Tue, 11/15/2011
Researching Institution: University of North Carolina at Chapel Hill
Researcher: Nabarun Dasgupta, MPH; Corey Davis, JD, MSPH
The United States suffers from an epidemic of health care associated infections (HAIs) accounting for 1.7 million annual infections and 100,000 deaths. Many HAIs are preventable, but hospitals have limited incentives to prevent them. More than 20 states now have laws requiring hospitals to publicly report infection rates, and national reporting is coming. This study will explore whether reporting induces hospitals to reduce actual HAI rates, reported rates, or both, and whether infection experts and consumers use the reports. The study will also compare the effectiveness of different reporting schemes, and assess how public health agency choices in implementing these programs affect their success.
Grant Number: 6375
Funding Date: Tue, 11/15/2011
Researching Institution: Northwestern University
Researcher: Bernard Black, BA, MA, JD; David Hyman, BA, JD, MD
This study proposes to conduct a systematic review and gap analysis of state laws relating to foodborne illness surveillance and outbreak response (FISOR). Laws will be collected from legal databases, state agency websites, and direct contact with state food safety officials. This effort will be complemented by an online survey to be conducted with state food safety officials. Food safety stakeholders could use the database for research and analysis purposes; states may find the gap analysis useful in assessing how laws and regulations may be updated, and outbreak and response professionals may find the results important to improving the operational outbreak response environment.
Grant Number: 6356
Funding Date: Tue, 11/15/2011
Researching Institution: George Washington University
Researcher: Rebecca Katz, PhD, MPH; Stephanie David, JD, MPH
Two million people with serious mental illness (SMI) enter U.S. jails each year. Jail diversion is a legal practice in which people with SMI are diverted from the criminal justice (CJ) system and in to treatment. The project will assess how brief jail stays before initiating diversion versus immediate diversion: 1) increase participants treatment adherence and reduce use of crisis care; 2) reduce recidivism among participants, including violent crimes and drug offenses that impact public safety; and 3) increase cost-effectiveness, a critical measure of success for widespread implementation of jail diversion. This analysis will inform potential statutory change requiring brief incarcerations prior to diversion.
Grant Number: 6382
Funding Date: Tue, 11/15/2011
Researching Institution: Duke University
Researcher: Allison Robertson, PhD, MPH; Marvin Swartz, MD
The project aims to identify the impact of laws and regulations in the United States that allow and/or restrict harm reduction interventions, including syringe exchange programs (SEPs) and naloxone delivery on public health outcomes among injecting drug users (IDUs). Methods will include a review of state and local laws pertaining to SEPs, non-prescription sale of syringes, and naloxone delivery as well as a review of harm reduction programs, including, size, reach, and their scope of services. State laws and local regulations have a significant impact on the availability of sterile injecting equipment, thus influencing HIV and HCV spread among IDUs. Similarly, the accessibility of medicines to reverse or prevent lethal overdose is also controlled by legal statutes.
Grant Number: 6367
Funding Date: Tue, 11/15/2011
Researching Institution: amfAR, The Foundation for AIDS Research
Researcher: Chris Collins, MPP; Don Des Jarlais, PhD
American Journal of Preventive Medicine, June 2011
Background
State laws limiting the use of mobile communications devices (MCDs) by drivers are being enacted at an accelerating pace. Public health law research is needed to test various legislative models and guide future legal innovation.
Purpose
To define the current state of the law, facilitate new multi-state evaluations, and demonstrate the utility of systematic, scientific legal research methods to improve public health services research.
Methods
Westlaw and Lexis–Nexis were used to create a 50-state, open-source data set of laws restricting the use of any form of MCD while operating a motor vehicle that were in effect between January 1, 1992, and November 1, 2010. Using an iterative process, the search protocol included the following terms: cellphone, cell phone, cellular phone, wireless telephone, mobile telephone, text, hands-free, cell! and text! The text and citations of each law were collected and coded across 22 variables, and a protocol and code book were developed to facilitate future public use of the data set.
Results
Thirty-nine states and the District of Columbia have at least one form of restriction on the use of MCDs in effect. The laws vary in the types of communication activities and categories of driver regulated, as well as enforcement mechanisms and punishments. No state completely bans use of MCDs by all drivers.
Conclusions
State distracted-driving policy is diverging from evidence on the risks of MCD use by drivers. An updatable data set of laws is now available to researchers conducting multistate evaluations of the impact of laws regulating MCDs by drivers. If this data set is shown to be useful for this public health problem, similar rigorously developed and regularly updated data sets might be developed for other public health issues that are subject to legislative interventions.
Ibrahim, J. K., Anderson, E. D., Burris, S. C., Wagenaar, A. C. (2011). State Laws Restricting Driver Use of Mobile Communications Devices: Distracted-Driving Provisions, 1992–2010. American Journal of Preventive Medicine, 40(6),659-665.
The Problem:
Tuberculosis is a classic public health scourge. Globally, there are over 9 million new cases of TB each year. World Health Organization: Tuberculosis Fact Sheet. The risks associated with TB have increased with the emergence of more virulent and drug-resistant strains of the disease. In the United States, the rate of TB incidence and associated mortality declined precipitously for most of the 20th century. In 1900 TB was the second leading cause of mortality accounting for over 10% of deaths; by 1980s deaths attributed to TB were in the hundreds. CDC: MMWR: Achievements in Public Health: Infectious Disease. In the early 1990s, however, incidence of TB began to increase again due to the HIV/AIDS epidemic and the synergistic risks of co-infection. Although these increases appear to have leveled off in the last few years, the risks associated with drug resistant strains continue to make TB an important public health challenge. CDC: MMWR: Trends in Tuberculosis.
The Law:
There are numerous legal measures for controlling the spread of TB. Law authorizes surveillance and specifies treatment requirements like Directly Observed Therapy (DOT). The most extreme and controversial legal measures involve the involuntary detention of individuals who are suspected or known to have infectious TB. In the United States, state statutes (Ca. Health & Safety Code § 121366) and regulations (New Jersey, N.J. Admin. Code § 8:57-5.7 et seq) define the procedural and substantive requirements for detaining an individual who presents a putative risk to the community as the carrier of an infectious disease. A sizable body of case law has also developed providing guidance about how and when an individual can be detained against their will to protect the public from disease. One of the seminal cases interpreting state power over coercive tuberculosis control measures is Green v. Edwards, 263 S.E. 2d 661 (1980).
The Evidence:
Coker systematically reviewed studies assessing the effect of detention of individuals with TB on public health. R.J. Coker. Public Health Impact of Detention of Individuals with Tuberculosis: Systematic Literature Review. Public Health (2003) 117, 281–287. Twenty-two studies fit the inclusion criteria. One of the studies employed a molecular finger printing design and found evidence that removing some infected individuals from the population would significantly decrease population incidence. Other modeling studies, however, suggested that the presence of coercive measures might increase transmission by decreasing the proportion of infected individuals that seek treatment. Observational and case control studies were few and small. According to Coker, there is insufficient evidence to sustain inferences about the effects of detention on population health.
The Bottom Line:
According to the author of a peer-reviewed systematic review, there is insufficient evidence at this time to conclude that detention of individuals with infectious tuberculosis improves population health.
© RWJF 2012
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Public Health Law Research is a national program of the Robert Wood Johnson Foundation. It is housed at the Temple University Beasley School of Law.