Researchers See Laws As Health
Determinants And Define New Field Of “Legal Epidemiology”
Goal Is “Better
“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
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.
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
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
3. Lastly, policy surveillance is the monitoring,
assessment and circulation of information on laws and policy important
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
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