• A Scan of CDC-Authored Articles on Legal Epidemiology, 2011-2015

      Center for Public Health Law Research (Temple University Beasley School of Law) (2016-11-01)
      Objective: The Centers for Disease Control and Prevention (CDC) conducts research on legal epidemiology, the scientific study of law as a factor in the cause, distribution, and prevention of disease. This study describes a scan of articles written by CDC staff members to characterize the frequency and key features of legal epidemiology articles and their distribution across CDC departments and divisions. Methods: CDC librarians searched an internal repository for journal articles by CDC staff published from January 1, 2011, to May 31, 2015. Researchers reviewed and coded the abstracts to produce data on key features of the articles. Results: Researchers identified 158 CDC-authored legal epidemiology articles published in 83 journals, most frequently in Preventing Chronic Disease (14 publications), Journal of Public Health Management Practice (10 publications), and Morbidity and Mortality Weekly Report (9 publications). Most articles concerned the use and impact of law as a deliberate tool of intervention. Thirteen articles addressed the legal infrastructure of public health, and 3 assessed the incidental or unintended effects of nonhealth laws. CDC-authored articles encompassed policy making, implementation, and impact. Literature reviews and studies mapping laws across multiple jurisdictions constituted one-quarter of all publications. Studies addressed laws at the international, national, state, local, and organizational levels. Conclusion: Results of the scan can be used to identify opportunities for the agency to better support research, professional development, networking, publication, and tracking of publication in this emerging field.
    • Better Health Faster: The Five Essential Public Health Law Services

      Center for Public Health Law Research (Temple University Beasley School of Law) (2016-10-16)
    • Data Shop: Law as Data: Using Policy Surveillance to Advance Housing Studies

      Center for Public Health Law Research (Temple University Beasley School of Law) (2019-04-04)
      Within the large body of literature evaluating the role of various demographic, geographic, and economic factors in housing-related outcomes, law is often neglected as an influential variable. The growing field of legal epidemiology is popularizing the use of law as data in quantitative analysis. As with any other dataset, it is imperative that legal data are accurate and meet high quality control standards. To that end, a method known as policy surveillance was developed to ensure the reliability and reproducibility of legal data and can be used to evaluate the impact of law. Policy surveillance is a type of scientific legal research that produces robust, scientific data for empirical research by mapping, or tracking, laws and policies and their characteristics across jurisdictions and over time.
    • Health, Housing, and the Law

      Center for Public Health Law Research (Temple University Beasley School of Law) (2019-03-28)
    • Medicaid Prior Authorization Policies for Medication Treatment of Attention-Deficit/Hyperactivity Disorder in Young Children, United States, 2015

      Center for Public Health Law Research (Temple University Beasley School of Law) (2017-10-26)
      Objectives: In 2011, the American Academy of Pediatrics updated its guidelines for the diagnosis and treatment of children with attention-deficit/hyperactivity disorder (ADHD) to recommend that clinicians refer parents of preschoolers (aged 4-5) for training in behavior therapy and subsequently treat with medication if behavior therapy fails to sufficiently improve functioning. Data available from just before the release of the guidelines suggest that fewer than half of preschoolers with ADHD received behavior therapy and about half received medication. About half of those who received medication also received behavior therapy. Prior authorization policies for ADHD medication may guide physicians toward recommended behavior therapy. Characterizing existing prior authorization policies is an important step toward evaluating the impact of these policies on treatment patterns. We inventoried existing prior authorization policies and characterized policy components to inform future evaluation efforts. Methods: A 50-state legal assessment characterized ADHD prior authorization policies in state Medicaid programs. We designed a database to capture data on policy characteristics and authorization criteria, including data on age restrictions and fail-first behavior therapy requirements. Results: In 2015, 27 states had Medicaid policies that prevented approval of pediatric ADHD medication payment without additional provider involvement. Seven states required that prescribers indicate whether nonmedication treatments were considered before Medicaid payment for ADHD medication could be approved. Conclusion: Medicaid policies on ADHD medication treatment are diverse; some policies are tied to the diagnosis and treatment guidelines of the American Academy of Pediatrics. Evaluations are needed to determine if certain policy interventions guide families toward the use of behavior therapy as the first-line ADHD treatment for young children.
    • New and Recurrent Concussions in High-School Athletes Before and After Traumatic Brain Injury Laws, 2005–2016

      Center for Public Health Law Research (Temple University Beasley School of Law) (2017-11-08)
      Objectives. To examine the trends of new and recurrent sports-related concussions in high-school athletes before and after youth sports traumatic brain injury laws. Methods. We used an interrupted time-series design and analyzed the concussion data (2005–2016) from High School Reporting Injury Online. We examined the trends of new or recurrent concussion rates among US representative high-school athletes participating in 9 sports across prelaw, immediate-postlaw, and postlaw periods by using general linear models. We defined 1 athlete exposure as attending 1 competition or practice. Results. We included a total of 8043 reported concussions (88.7% new, 11.3% recurrent). The average annual concussion rate was 39.8 per 100 000 athlete exposures. We observed significantly increased trends of reported new and recurrent concussions from the prelaw, through immediate-postlaw, into the postlaw period. However, the recurrent concussion rate showed a significant decline 2.6 years after the laws went into effect. Football exhibited different trends compared with other boys’ sports and girls’ sports. Conclusions. Observed trends of increased concussion rates are likely attributable to increased identification and reporting. Additional research is needed to evaluate intended long-term impact of traumatic brain injury laws.
    • Pandemic Legislation In The European Union: Fit For Purpose? The Need For A Systematic Comparison Of National Laws

      Center for Public Health Law Research (Temple University Beasley School of Law) (2017-09-20)
      Sound governance is central to effective pandemic management. Key international legal instruments governing pandemic management in the European Union (EU): the International Health Regulations (2005) and Decision 1082/13 require EU Member States to develop national plans and invite them to establish national legal frameworks to support compliance with this international legislation. Although Member States may design the legal framework as they choose, the strongest instrument of pandemic governance is national legislation.Sound governance is central to effective pandemic management. Key international legal instruments governing pandemic management in the European Union (EU): the International Health Regulations (2005) and Decision 1082/13 require EU Member States to develop national plans and invite them to establish national legal frameworks to support compliance with this international legislation. Although Member States may design the legal framework as they choose, the strongest instrument of pandemic governance is national legislation.
    • Public Health Implications of Housing Laws: Nuisance Evictions

      Center for Public Health Law Research (Temple University Beasley School of Law) (2018-08-10)
    • Reducing Traumatic Brain Injuries in Youth Sports: Youth Sports Traumatic Brain Injury State Laws, January 2009–December 2012

      Center for Public Health Law Research (Temple University Beasley School of Law) (2013-07)
      Objectives. I sought to describe current state-wide youth sports traumatic brain injury (TBI) laws and their relationship to prevailing scientific understandings of youth sports TBIs, and to facilitate further research by creating an open-source data set of current laws. Methods. I used Westlaw and LexisNexis databases to create a 50-state data set of youth sports TBI laws enacted between January 2009 and December 2012. I collected and coded the text and citations of each law and developed a protocol and codebook to facilitate future research. Results. Forty-four states and Washington, DC, passed youth sports TBI laws between 2009 and 2012. No state’s youth sports TBI law focuses on primary prevention. Instead, such laws focus on (1) increasing coaches’ and parents’ ability to identify and respond to TBIs and (2) reducing the immediate risk of multiple TBIs. Conclusions. Existing youth sports TBI laws were not designed to reduce initial TBIs. Evaluation is required to assess their effectiveness in reducing the risk and consequences of multiple TBIs. Continued research and evaluation of existing laws will be needed to develop a more comprehensive youth TBI-reduction solution.
    • State Law Approaches to Facility Regulation of Abortion and Other Office Interventions

      Center for Public Health Law Research (Temple University Beasley School of Law) (2018-03-07)
      Objectives. To compare the prevalence and characteristics of facility laws governing abortion provision specifically (targeted regulation of abortion providers [TRAP] laws); office-based surgeries, procedures, sedation or anesthesia (office interventions) generally (OBS laws); and other procedures specifically. Methods. We conducted cross-sectional legal assessments of state facility laws for office interventions in effect as of August 1, 2016. We coded characteristics for each law and compared characteristics across categories of laws. Results. TRAP laws (n = 55; in 34 states) were more prevalent than OBS laws (n = 25; in 25 states) or laws targeting other procedures (n = 1; in 1 state). TRAP laws often regulated facilities that would not be regulated under OBS laws (e.g., all TRAP laws, but only 2 OBS laws, applied regardless of sedation or anesthesia used). TRAP laws imposed more numerous and more stringent requirements than OBS laws. Conclusions. Many states regulate abortion-providing facilities differently, and more stringently, than facilities providing other office interventions. The Supreme Court’s 2016 decision in Whole Woman’s Health v. Hellerstedt casts doubt on the legitimacy of that differential treatment.
    • Taking Opportunity Costs Seriously in Public Health Law

      Center for Public Health Law Research (Temple University Beasley School of Law) (2018-03-07)
    • Toward Healthy Drug Policy in the United States — The Case of Safehouse

      Center for Public Health Law Research (Temple University Beasley School of Law) (2020-02-02)