233164 Role of law in public health preparedness: Opportunities and challenges

Tuesday, November 9, 2010 : 12:50 PM - 1:10 PM

Helen Wu, PhD(c), MPhil, MS , Pardee RAND Graduate School, RAND Corporation, Santa Monica, CA
Peter Jacobson, JD, MPH , Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI
Jeffrey Wasserman, PhD , RAND Corporation, Santa Monica, CA
Benjamin E. Berkman, JD, MPH , Department of Bioethics (Clinical Center)National Human Genome Research Institute, National Institutes of Health, Bethesda, MD
Anda Botoseneanu, MD, PhD , Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI
Amy Silverstein, MPH , Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI
Daniel Rubin, MA, JD(c), PhD(c) , Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI
        
Background and aims: Legal preparedness is a foundational and multi-dimensional component of public health preparedness. This study assessed how law shapes public health preparedness. Specific objectives were to: 1) demonstrate the link between law and public health preparedness, 2) understand how public health practitioners interpret and respond to federal and state laws, 3) identify other factors affecting preparedness, and 4) generate policy recommendations. Methods: Data were collected from semi-structured interviews with 158 officials in public health and emergency management agencies at the federal, state, and local levels. Case studies of nine states were completed that compared interview responses with objective legal analysis of federal and state laws. Results: Key issues affecting public health legal preparedness included legal authority, organizational issues, financial structures, and ethical concerns. At the local level, officials often perceived law to be unclear or of minimal benefit, and reported that implementation guidance was lacking. Across all respondents, political and ethical concerns, as well as interpersonal relationships, were often emphasized over legal ones. A clear tension exists between how public health and emergency management officials perceive the law; respondents' views also diverged along state-local lines. Discussion: Legal preparedness is inconsistent across states, and no state studied was fully prepared across multiple domains of legal preparedness. A substantial gap exists between the objective legal environment and officials' perceptions. An adequate legal framework is the first step towards preparedness, but effective implementation will require better collaboration between federal, state, and local agencies in public health and emergency management.

Learning Objectives:
To describe study findings related to the role of law in public health emergency preparedness, compare approaches used by public health and emergency management disciplines, and identify opportunities for improvement in public health law.

Keywords: Law, Public Health Administration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the co-lead research assistant for this project and contributed to a major share of the project effort, including data analysis and preparation of the final report.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4164.1: Public Health and Policy