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Researchers See Laws As Health Determinants And Define New Field Of “Legal Epidemiology”

Doctoral Programs Proposed

Goal Is “Better Health Faster”

“Every item on the Centers for Disease Control and Prevention’s (CDC) list of great public health achievements of the twentieth century can be attributed in part to legal interventions.” This striking CDC conclusion is highlighted in a recent article entitled “A Transdisciplinary Approach to Public Health Law: The Emerging Practice of Legal Epidemiology” by Temple University researcher Scott Burris and colleagues in the Annual Review of Public Health.

 In it the authors describe the rich history of public health law for over a century, but note “Four major Institute of Medicine (IOM) reports over 25 years have lamented the state of public health laws, the practice of law, the training of public health officials in law, and the access of health officials to quality legal advice.”

Why the neglect?


Despite the continued and growing importance of the field, many of those who practice public health law have an entrenched, antiquated view of its scope - seeing the field only as applying legal knowledge to regulate health agencies, according to Burris and colleagues. They add, another important dimension of public health law has developed through the  rigorous, scientific study of how public health laws affect public health. However, scientists and even lawyers engaged in this type of research have not historically classified the work as “public health law”.

Burris et al. argue “The view that public health law is the province only of lawyers misses the fact that public health laws are commonly conceived, promoted, administered, and evaluated by public health professionals and others without JD degrees.” Further, a lack of unification between public health law and the study of public health will inevitably lead to gaps in health policy.

Solutions and Definitions

The proposed solutions for this neglect?

To remedy the situation, the authors propose a multidisciplinary conceptual model of public health law consisting of two branches - public health law practice and legal epidemiology. They define legal epidemiology as “the scientific study of law as a factor in the cause, distribution and prevention of disease and injury in a population.

In this model, public health law practice remains defined as it has been historically - applying professional legal skills to develop health policy through counsel, representation and research.

However, also included within this model are three components of legal epidemiology: legal prevention and control, legal etiology, and policy surveillance.

1. Legal prevention and control is the study of the effect of legal interventions on public health. Research in this area is critical to insure that public health laws actually increase positive health outcomes and do so efficiently.

2. Legal etiology in turn studies how laws can themselves be the causes of disease or have unintended health consequences.

3. Lastly, policy surveillance is the monitoring, assessment and circulation of information on laws and policy important to health.

Training Needs

While the growth of JD/MPH programs is producing more public health minded lawyers, according to the authors, they believe “future public health practitioners and researchers need a solid grounding in legal epidemiology.” MPH graduates will need improved legal training not restricted simply to a cohort of legal specialists within the field of public health. The goal of this training they argue should be to have all social and behavioral researchers willing and prepared to study the law as a factor affecting health. As such, they suggest the development of JD/PhD programs to train researchers that can take the lead in further growing the field of legal epidemiology.

Better Health Faster

Ultimately, a transdisciplinary approach linking public health law and legal epidemiology would connect research, advocacy and practice so that the transition from innovation or new findings to adoption or into public health practice can move faster and more smoothly. In short, the new model has the potential to produce “better health faster,” say the authors.

Links to articles:

CDC (Cent. Dis. Control and Prev.). 1999. Ten great public health achievements—United States, 1900– 1999. MMWR 48:241–43

Burris S, Anderson E. 2013. Legal regulation of health-related behavior: a half century of public health law research. Annu. Rev. Law Soc. Sci. 9:95–117

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