Wednesday, November 23, 2022

Our team was honored to be selected for 11 presentations at the American Public Health Association Annual Meeting this year in Boston. The CPHLR researchers presented on a variety of subjects, spanning the broad range of work we do at the Center each day: opioids and harm reduction, reproductive rights and abortion law, COVID-19 mitigation policies, firearm violence prevention, and strengthening public health authority and workforce capacity. Because not everyone has the privilege of attending APHA, we're bringing some of our presentations to you in a few installments. 

In previous blog posts, we discussed the presentations focused on sexual and reproductive health and firearms and intimate partner violence.  

Katie Moran-McCabe, Lizzy Platt, and Lindsay Cloud presented at APHA on various topics on public health authority.

Acting for Public Health: Tracking attempts to erode public health authority in the United States

Public health departments do a lot to keep the public safe from man-made crises, natural disasters, and outbreaks of disease. But as communities continue to grapple with COVID-19, more than half of US states have passed legislation that will undermine public health now and in the future. The ongoing backlash against public health authority significantly limits the ability of public health officials to do their jobs. 

Act for Public Health is a collaborative effort that aims to protect the authority of public health agencies across the nation by providing law and policy research, analysis and expertise to preserve public health authority and infrastructure. This session described the work of Act for Public Health.

Tracking laws limiting public health emergency orders in the United States using sentinel surveillance methods

Using sentinel surveillance methods, Katie presented the dataset which explores laws that limit the authority of a governor, state health agency, or state health official, regarding public health emergency orders.  

The longitudinal dataset covers all 50 states and the District of Columbia and includes laws that were enacted since January 1, 2021, and were effective on or before May 20, 2022.

 The grey bard graphs show movement in the states enacting public health emergency orders. In the May 20, 2022 column the following states are listed: AL, AK, AR, AZ, FL, ID, IN, KS, KY, LA , MT, NH, NJ, NY, ND, OH, SC, TN, TX, UT, and WY.

Some of the scope restrictions include:

  • Prohibiting state health officers from mandating use of face masks
  • Prohibiting mandates for individuals to receive COVID-19 vaccination
  • Prohibiting governors from inhibiting the gathering of people for any religious, civic, or commercial activity
  • Prohibiting a state disaster plan from compelling a private business to deny access to customers 

Laws that restrict the authority of governors or health officials to act in times of emergency could significantly impact public health by limiting their ability to respond in an effective and efficient manner. This dataset provides an overview of the legal landscape on this topic that can help policymakers and advocates in their efforts to address attacks on public health authority.

Creating a system for the on-going tracking of legislation limiting public health authority

On the same panel, Lizzy presented ongoing research tracking legislation limiting public health authority supporting Act for Public Health.

The legislative tracking dataset topics capture: 

  • Public health authority limits 
  • Public health authority shifts 
  • Federal law limits 
  • Public health preemption 
  • Public health measures 
  • Public health expansion 

Preliminary analysis of the data shows that there have been more than 1,500 individual bills tracked between January 1, 2021 and May 20, 2022, which will be included in the forthcoming dataset released to 186 of those bills were enacted into law into 43 states and the District of Columbia. State averages are 29 introduced bills and 5 enacted laws. The most bills were introduced in New York (113) and the most laws were enacted in Virginia (13). 

These bills not only threaten to impede the ability of public health officials to respond to COVID-19 and future disasters, but they also threaten to erode the future efficacy of public health agencies and further exacerbate health inequities. 

These data have not yet been finalized, but anyone interested in receiving an alert when they’re available should sign up for the Act for Public Health email list

Strengthening state and local workforce capacity for public health law

Lindsay presented evidence-based policymaking, which is the systematic use of findings from program evaluations and outcomes analyses to guide government policy and funding decisions, becoming increasingly recognized as an effective tool to improve public health outcomes. 

In partnership with ASTHO, CPHLR developed a 26-question electronic survey and sent it to senior deputies in state health departments across all 50 states and the District of Columbia. From May 19, 2021, to August 5, 2021, the team received 44 individual responses from 35 health departments. 

The key takeaways from the survey found: 

  • State health departments must identify, track, and evaluate law and policy to promote population health 
  • Policy tracking is often done by staff with no formal legal training 
  • Technical skills, law and policy expertise, staffing capacity, and coordination activities vary widely across state health departments 
  • Policy surveillance can be a useful policy tracking tool for staff to increase evidence-based policymaking efforts 
  • Staff lack the time and resources to institutionalize scientific mapping tools 
Work Area: