Do unfunded mandates regarding banning use of hand held cell phones in Texas school zones result in greater savings or cost for municipalities? In response to the Robert Wood Johnson Foundation's Public Health team question regarding variation in implementation of local/regional public health laws and their impact on health outcomes, policy and enforcement, this project will examine a Texas law prohibiting the use of hand held cell phones in active school zones. It explores the implications of this law in several municipalities utilizing data from law enforcement and municipal budgets. This study aims to identify the relative costs of banning hand-held cell phone use for municipalities and determine any association between enforcement costs and lives saved.
Click here for more information about Tondra L. Moore at the RWJF Web site.
Funding Date: Mon, 11/15/2010
Researching Institution: Texas State University – San Marcos
Researcher: Tondra L. Moore, M.P.H., Ph.D., J.D.
State and federal laws removing paint from gasoline and from the paint used in homes were put in place decades ago. Overall, they have been very effective in reducing the number children who are poisoned by lead. But there are still numerous “hot spots” where children (particularly low-income, minority children living in older neighborhoods) continue to be poisoned by lead at alarming levels. Those children simply have not been reached by the protections of the state and federal laws. In order to find out whether local laws can be an effective tool to reach these children we will take a close look at a local housing inspection law put into place in Rochester, New York in 2006, and will look as well at laws in several other cities, to see if and how local legislation can be used as a tool to more effectively to fill the gap. The results of the study will be available to lawmakers, community advocates, policy analysts and scholars interested in evaluating or enacting local laws in their own communities.
Grant Number: 68390
Funding Date: Mon, 11/15/2010
Researching Institution: University of Rochester Medical Center
Researcher: Katrina Korfmacher, M.S., Ph.D.; Michael Hanley, J.D.
Publication Date: 12/07/2009
The Problem:
Vaccine coverage for preventable disease is an essential public health goal. Low vaccine coverage rates enable otherwise avoidable outbreaks of harmful diseases. CDC: Vaccines and Immunizations.
The Law:
State vaccination laws require children to be immunized prior to entering school. National Vaccine Program Office: Immunization Laws. Subject to instances where exemptions apply, these laws require written proof of a child’s immunization status provided from a health provider. For examples of state vaccination laws, see Colorado (6 CCR 1009-2), Iowa (Iowa Administrative Code), Nebraska (173 NAC 3) and Massachusetts (105 CMR 220.000).
The Evidence:
In a systematic review, a Community Guide expert panel reviewed the evidence concerning the effectiveness of requiring vaccinations as a condition of matriculation into child care, secondary school or college. Briss PA, Rodewald LE, Hinman AR, et al. Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults. Am J Prev Med 2000;18(1S):97-140. The review identified nine studies in the U.S. and Canada that measure the impact of these requirements. Of the nine studies, seven examined the impact of school laws; one examined vaccination mandates for child care, and one looked at requirements for college attendance. Six studies measuring the effect of vaccination requirements on the incidence of specific diseases (e.g., measles) found an inverse relationship suggesting that laws reduce rates of the targeted diseases. Three studies also observed a positive relationship between mandated immunization programs and rates of vaccination among the target populations. On the basis of this evidence, the reviewers concluded that there is sufficient evidence that school vaccination requirements are an effective public health intervention aimed at increasing vaccination coverage and decreasing the incidence of certain diseases.
The Bottom Line:
In the judgment of a Community Guide expert panel, there is sufficient evidence supporting the effectiveness of requiring vaccinations as a condition for attending child care facilities and schools.
Additional Information:
The Centers for Disease Control and Prevention has compiled and provided online access to all state vaccination laws.
The Immunization Action Coalition also has online maps showing specific legal requirements for the fifty states.
Additional Resources: Centers for Disease Control and Prevention, Immunization Action Coalition
Publication Date: 12/07/2009
The Problem:
Youth violence is an enormous public health problem in the United States, standing as the second leading cause of death for people between the ages of 10 and 24. CDC, National Center for Injury Prevention and Control. WISQRS. Juvenile court systems have often been criticized for inadequately deterring and poorly preventing recidivism among violent youthful offenders. Steiner B, Hemmens C, Bell V. Legislative Waiver Reconsidered: General Deterrent Effects of Statutory Exclusion Laws Enacted Post-1979. Justice Quarterly. 2006;23(1):34-59.
The Law:
All states have adopted laws that allow judicial waiver of jurisdiction by the juvenile court system, which sends young offenders to adult criminal systems. Some states use a discretionary approach, giving deference to the juvenile court judge. Other states employ an automatic approach: jurisdiction is waived for specific violent offenses or when the offender has prior violent arrests. For examples of juvenile waiver laws, see RCW 13.40.110 (Washington), Fla Stat § 985.556 (Florida), and MN Stats 260B.101 (Minnesota).
The Evidence:
In a systematic review, a Community Guide expert panel reviewed seven studies evaluating the impact of six laws allowing juvenile transfer. McGowan A, Hahn R, Liberman A, et al. Effects on violence of laws and policies facilitating the transfer of juveniles from the juvenile justice system to the adult justice system: a systematic review. Am J Prev Med 2007;32(4S):S7–S28. Across the studies, the reviewers observed an overall negative effect. Notably, there was a 34 percent median increase in recidivism among youths processed though adult systems compared to those retained in the juvenile courts. In addition, transfer of youths led to an increase in pretrial violence, victimization and violence in adult facilities, and elevated suicide rates among the incarcerated youths. According to the expert panel, there was not enough evidence to determine the true effect of waiver as a deterrent.
The Bottom Line:
In the judgment of a Community Guide expert panel, there is sufficient evidence to conclude that processing youths through adult systems has a negative impact on public health.
Additional Resources: Heilbrun, et al. A National Survey of US Statutes on juvenile transfer: implications for policy and practice. Behavioral Sciences and the Law. 1998;15(2):125-149.
This project will assess the effectiveness of unified family courts, as implemented in North Carolina, on health and school outcomes of children aged zero to 7 and health of women aged 18 to 49, through their effects in reducing rates of domestic violence. The study will examine processes of family courts as they relate to domestic violence and abuse of adult women and children in the N.C. unified family court system and will analyze changes in school-absenteeism, dropouts, progression to next grade, and suspensions/expulsions. Deliverables for this project include 2 papers; one to be published in a policy and law journal and the other to be published in a health policy journal. The project aims to share findings with the N.C. Administrative Office of the Courts.
Grant Number: 67149
Funding Date: Tue, 12/01/2009
Researching Institution: Duke University
Researcher: Frank Sloan, Ph.D., Elizabeth Gifford, Ph.D.
Publication Date: 12/07/2009
The Problem:
In 2008, 968 children under the age of 15 died from injuries suffered during motor vehicle crashes and approximately 168,000 other children were injured. CDC: Child Passenger Safety Factsheet. The use of child safety seats has been found to substantially reduce the risk of mortality to infants in motor-vehicle accidents (70 percent) and in children ages 1 to 4 years (47 precent to 54 percent). Yet, each year children are injured and killed due to the nonuse or improper use of child safety seats. Zaza S, et al. Recommendations to reduce injuries to motor vehicle occupants increasing child safety seat use, increasing safety belt use, and reducing alcohol-impaired driving. Am J Prev Med. 2001;21(4S):16–22. It is estimated that universal proper child safety seat use could save roughly 160 lives and prevent 20,000 injuries each year. Zaza S, et al. Reviews of evidence regarding interventions to increase use of child safety seats. Am J Prev Med. 2001;21(4S):31-47
The Law:
Today, every state has a law requiring children to be restrained in federally-approved child safety seats while riding in motor-vehicles. These laws differ from state to state based on number of factors (e.g., age, height and weight of the children requiring safety seats). All current child safety seat laws allow for primary enforcement, meaning a police officer can stop a driver solely for a violation of such laws. Child restraint/belt use laws: The Insurance Institute for Highway Safety, Highway Loss Data Institute. For examples of child safety seat laws, see La. R.S. 32:295 (Louisiana), Tenn. Code Ann. § 55-9-602 (Tennessee), Ala. Code § 32-5-222 (Alabama) and N.J.S. 39:3-76.2a (New Jersey).
The Evidence:
In a systematic review, Zaza et al. reviewed nine studies that evaluated the effectiveness of child safety seat laws in reducing rates of childhood motor-vehicle injuries. Zaza S, et al. Reviews of evidence regarding interventions to increase use of child safety seats. Am J Prev Med. 2001;21(4S):31-47. The underlying studies focused on laws that were passed in every state in the United States between the years 1978 and 1986. The reviewers found a 35 percent median reduction in fatal childhood injuries and 17.3 percent reduction in overall motor-vehicle child injuries following the introduction and enforcement of child safety seat laws. The effects of additional requirements in particular states (for example, requiring a particular seating position or providing for harsher penalties) could not be determined from the available studies. The reviewers also identified a 13 percent increase in the use of child safety seat use subsequent to the adoption of child safety seat laws.
The Bottom Line:
There is strong evidence to support the effectiveness of child safety seat laws in substantially reducing injuries to children during motor vehicle crashes, according to a Community Guide expert panel.
Additional Resources: Insurance Institute for Highway Safety
Publication Date: 12/07/2009
The Problem:
Firearms are the second leading cause of injury deaths in the United States accounting for 30,896 deaths and 71,417 injuries in 2006. CDC: WISQUARS. Firearms are used in 84 percent of the homicides of persons between the ages 10 and 24. CDC: Youth Violence Fact Sheet.
The Law:
Child access prevention (CAP) laws are a relatively recent legislative intervention intended to prevent firearm injuries caused by children by limiting their access to firearms. CAP laws establish criminal penalties for owners who do not store their firearms appropriately (e.g., unloaded, in a locked compartment). It is a felony offense for an owner under some CAP laws if an injury results from a child accessing an unsecured gun. In 2008, 27 states and the District of Columbia had adopted CAP laws. Legal Community Against Violence: CAP Laws Brief. For examples of CAP laws, see F.S. § 790.174(Florida), Texas Penal Code Annotated § 46.13(Texas) and CGS §29-37i(Connecticut).
The Evidence:
In a systematic review, Hahn et al. reviewed three studies that measured the impact of CAP laws on juvenile unintentional firearm-related deaths. Hahn et al. Firearms laws and the reduction of violence: a systemic review. Am J Prev Med. 2005;28(2S1):40-71. One of the three studies examined the impact of CAP laws on firearm-related and non-firearm-related juvenile suicides and homicides. The second study evaluated the impact of CAP laws on overall violent outcomes (all homicide, aggravated assault, robbery, and rape) to test the hypothesis that CAP laws impede self-defense. The third study measured the impact of unintentional firearm-related deaths among juveniles under the age of 15 in states with felony CAP laws. The findings on juvenile homicide and violent outcomes were inconsistent and mostly lacked statistical significance. A few of the underlying studies found associations between CAP laws and juvenile violent outcomes in a few states. However, the reviewers did not view the available evidence as sufficient to establish the effectiveness of CAP laws as a public health intervention.
The Bottom Line:
Although CAP laws may represent a promising intervention for reducing gun-related morbidity and mortality among children, in the judgment of a Community Guide expert panel, there is currently insufficient evidence to validate their effectiveness as a public health intervention aimed at reducing gun-related harms.
Additional Information:
A new firearms research database launched by the Harvard School of Public Health makes scholarly articles more accessible to reporters, law enforcement, public health officials, policymakers, and the general public. The Firearms Research Digest provides summaries of articles gathered from social science, criminology, medical and public health journals and is written in clear, accessible language for use by those outside academia.
The website currently covers six years of research published between 2003 and 2008. The digest will be expanded over time to include articles from 1988 to the present.
Additional Resources: The Firearms Research Digest