Local
The rapid growth of the immigrant Latino population in North Carolina and nationwide has led to immigration policies that may have a potentially profound impact on utilization of public health services. This study will evaluate whether a relationship exists between local immigration law enforcement and the utilization of public health services, especially prenatal care, by Latinos. The team will collect qualitative data in North Carolina on (1) Latinos' willingness to seek public health services as it relates to the threat of immigration enforcement, and (2) how attitudes and behaviors have changed since implementation of the immigration enforcement program. Using statewide prenatal care data from 2000 through 2009, the team will explore how immigration enforcement affects utilization of prenatal care among Latinas to determine trends and differences in: (1) the month of gestation for a first prenatal visit, and (2) the total number of prenatal visits.
Grant Number: 69701
Funding Date: Sun, 01/01/2012
Researching Institution: Wake Forest University
Researcher: Scott D. Rhodes, PhD; Mark A. Hall, JD
Americans saw more than 2.8 million foreclosures recent years, and the impacts on public health are largely unknown. The foreclosure process may impact health if it causes stress-related illnesses such as hypertension and diabetes, if it forces reallocation of household funds that are otherwise used for health care, if it occasions dislocation that impacts treatment relationships, or if it degrades health-related behaviors such as diet and exercise. The research team will draw a sample of 400 homeowners undergoing foreclosure in a median Zip code in Phoenix through an extensive recruitment effort. Data will be gathered on the foreclosure process, health, health care, insurance, and use of safety net benefits - all essential for understanding the impact of laws on health.
Grant Number: 69700
Funding Date: Sun, 01/01/2012
Researching Institution: University of Arizona
Researcher: Christopher Tarver Robertson, PhD, JD; Christina Cutshaw, PhD
The American Nonsmokers' Rights (ANR) Foundation will collect and code local tobacco control laws nationwide related to youth access to tobacco products, tobacco advertising, and conditional use permits. The final dataset is expected to include as many as 70 variables for the youth access laws (eg. vending machines, single cigarettes, and penalties), 20 variables for tobacco advertising laws (eg. location restrictions, point of sale requirements, and tombstone exemptions), and an undetermined number of variables for conditional use permit laws. The dataset of tobacco control laws, in combination with other existing data on public health behavior and outcomes, will enable researchers to determine the impact and value of such laws on public health.
Grant Number: 69741
Funding Date: Sun, 01/01/2012
Researching Institution: Americans for Nonsmokers' Rights Foundation
Researcher: Cynthia Hallett, MPH
Stakeholders in sports medicine have focused on decreasing the risk of repeated concussions among athletes. This study will use a random sample of high schools in Washington to determine the effect of the type of implementation of concussion-related laws on the risk of playing with concussive symptoms, the methods by which these return-to-play (RTP) laws are implemented, and the effect of those methods on concussion outcomes is unknown. Examination of this implementation can lead to a better understanding of the factors associated with the greatest impact on outcomes from RTP laws.
Grant Number: 6391
Funding Date: Tue, 11/15/2011
Researching Institution: University of Washington
Researcher: Frederick Rivara, MD, MPH
Unintentional fatalities because of prescription medications are an increasing problem in Utah and the United States. In response to this crisis of drug-related harm, the state government of Utah has undertaken several regulatory changes including promulgating guidelines for opioid prescribing and mandating that providers register to use the online portal for access to the Utah Controlled Substances Database (CSD), a registry of all filled prescriptions for schedule II-V drugs. This study aims to evaluate the impact of three regulations on prescribing patterns, use of the online system to access the CSD and adverse drug events.
Grant Number: 6369
Funding Date: Tue, 11/15/2011
Researching Institution: University of Utah
Researcher: Christina Porucznik, PhD, MSPH; Brian Sauer, PhD
Proactive policing has become a primary strategy for controlling violence and disorder in urban America. The key tactic is the widespread use of "Terry" stops, where police temporarily detain, frisk and perhaps search persons or their property when an officer has "reasonable suspicion" to suspect that "crime is afoot." This project will identify the effects of proactive policing on the mental and physical health of persons stopped. Law enforcement policies will be constructively informed by the identification of common practices that adversely affect the mental health of citizens.
Grant Number: 6379
Funding Date: Tue, 11/15/2011
Researching Institution: Trustees of Columbia University in the City of New York
Researcher: Jeffrey Fagan, PhD; Amanda Geller, PhD, MEng, BS
Public health law research usually focuses on the substantive laws that effect health, not the accompanying funding laws. This study addresses a question that permeates public health law research: Does the source and/or type of funding, not just the amount of funding, impact health outcomes? Of the 88 counties in Ohio, 44 counties have a dedicated local levy that provides flexible local child welfare funding. In 18 other counties, there is a waiver to provide flexible federal funding. This study will analyze 10 years of county level data provided by Public Children's Services Association of Ohio and help to identify key elements of successful funding strategies. The results of this study may help other jurisdictions to improve outcomes for children in state care.
Grant Number: 6388
Funding Date: Tue, 11/15/2011
Researching Institution: Research Foundation of State University of New York on behalf of University at Buffalo
Researcher: Susan Mangold, JD; Gregory Kapcar, MPA
This project aims to study whether laws that target reducing emissions from local polluting activities have distinguishable health impacts: What federal, state, and local regulations can reduce or shift electricity demand in New York City away from peak hours; how will local New York City power plants respond to that changing demand; and will those plant-specific responses have any significant health impacts for local populations?
Grant Number: 6371
Funding Date: Tue, 11/15/2011
Researching Institution: New York University
Researcher: Michael Livermore, JD; George Thurston, ScD
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.
The Problem:
Illicit drug use is a well-recognized public health problem. Overdose and other less acute harms are associated with the non-medical use of controlled substances. The policy response to illicit drug use in the United States has historically focused on a punitive model. Resulting high rates of incarceration have placed large numbers of non-violent offenders into correctional facilities. Life in prison exposes inmates to numerous health risks. High incarceration rates also strain families and communities particularly in areas already suffering from harms associated with low socioeconomic status. As a result, both illicit drug use and the prevailing policy response aimed at reducing it are sources of harm to population health. Reducing incarceration for non-violent crime – the majority of which involves use and trafficking of small amounts of illicit drugs – is widely recognized as an important policy objective. Congressional Research Service, GAO: Drug Courts.
The Law:
In response to growing evidence of the public health burden of over-criminalization and the failure of the traditional punitive approach to stem illicit drug activity, in the late 1980s, states and localities started experimenting with models aimed more at rehabilitation than retribution. Representing one form of what is often referred to as therapeutic justice, drugs courts emerged as a new model for dealing with minor drug-related crimes. These specialized courts aim to divert convicted drug-offenders into treatment rather than incarceration. Between 1989 and 2009, well over 2000 drugs courts were created in the United States. U.S. Department of Justice. Many drug courts are created though judicial rulemaking. Examples of laws creating drug courts can be found in Mississippi (M.S. Code § 9-23 et seq) and Illinois (730 ILCS 166.1 et seq).
The Evidence:
Wilson, et al., systematically reviewed studies assessing the effect of drug courts on recidivism. David B. Wilson, Ojmarrh Mitchell, And Doris L. Mackenzie, A systematic review of drug court effects on recidivism, Journal of Experimental Criminology (2006) 2:459Y487. The reviewers identified fifty studies that fit their inclusion criteria. Using meta-analytic techniques, the reviewers combined odds-ratios across the studies in a random effects model. The overall summary odds ratio – which was statistically significant – was 1.62. The reviewers’ interpretation of the results from the summary statistic and other correlates in the regression was that recidivism decreased by 26% for offenders in drug courts versus comparison groups. However, methodological weaknesses in the majority of the included studies were noted as a source of caution against this figure. A more conservative estimate of the effect was found when they limited their review to more methodologically sophisticated studies. Overall, however, the authors view the evidence as sufficient to support the effectiveness of drug courts in reducing recidivism.
The Bottom Line:
According to the authors of a peer-reviewed systematic review, there is sufficient evidence to support the effectiveness drug courts in reducing recidivism among individuals convicted of drug-related offenses.
© RWJF 2012
Contact Us |
Sitemap
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.