Making the Case for Public Health Law as a Tool for Diverse Executives by Dawn Hunter, JD, MPH, CPH
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very week, my husband and I place a grocery order. Sometimes we order online and pick it up, sometimes we have it delivered, and sometimes we do the shopping ourselves. We often purchase our groceries without much thinking—if we order online, we are prompted to “buy it again” and even in person we tend to buy the same staples. Prices are higher online than in store. We live in a community where plastic bags are still an option, but we used to live in a community where plastic bags are banned. We shop at an employee-owned supermarket chain known for its workplace culture. Why am I sharing all of this? Nearly every aspect of our weekly grocery trip is shaped by the law. Laws impact food placement, packaging, expiration dates, and prices; employee wages and benefits; store location, hours, and accessibility; availability of rideshare drivers for delivery orders; and whether to choose paper or plastic. Law impacts the way we experience our everyday lives by establishing the framework in which we operate. The grocery store is just one example of how law can shape our decisions and, more importantly, our choices. It is because law shapes the resources and opportunities available to us that law is an important determinant of health.
Exploring the Landscape of Public Health Law What we think of as “law” can take many forms. It includes statutes, regulations, case law, organizational policy, and budgets and how they are interpreted and enforced. The law can be a set of requirements or prohibitions, establishing norms and expectations for our behavior as individuals, organizations, systems. The law can also be the processes and procedures associated with creating laws, making decisions, and interpreting existing laws. Public health law, specifically, is important as a field because it includes the laws that are designed to protect and promote the public’s health and that define the power of the government to act on our behalf. In fact, law is behind every public health success of the 20th century. In a 1999 issue of the Morbidity and Mortality Weekly Report, vaccinations,
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motor vehicle safety, safer workplaces, healthier moms and babies, and recognition of tobacco as a health hazard were listed among those successes. These achievements would not be possible without: • • • • • • • • • • •
School vaccination laws Helmet and seatbelt laws Speed limits The Occupational Safety and Health Administration Food fortification School lunch programs The Women, Infants, and Children (WIC) program Newborn screening The Tobacco Master Settlement Agreement Clean indoor air laws Many others
At the same time, these laws have not benefited everyone equally. In fact, they have often operated as a tool of racism and other forms of structural discrimination. The lesson here is that the law can create the conditions that lead to differences in health outcomes, but it can also create the conditions for equity.
Civil Rights Movements and Transformations in Public Health Legislation
One must look only to the civil rights movement to see the potential. As just one example, today’s robust network of Community Health Centers was born from the activism of the Black Panther Party, which established free health clinics in response to continuing discrimination in the healthcare system, as well as the work of H. Jack Geiger and Count D. Gibson Jr., who established the first community health centers in 1965. In fact, key legislation enacted during the civil rights movement led to significant, even if insufficient, improvements in health outcomes for Black Americans. For example, there is evidence that women’s suffrage, the Civil Rights Act of 1964, and the Voting Rights Act all led to improvements in premature mortality and infant mortality, among other benefits. Similar success was seen with the
