Digital Commons Network^™

Spending Health Care Dollars Wisely: Can Cost-Effectiveness Analysis Help?, Milton C. Weinstein

Center for Policy Research

Are we getting the most health improvement possible for our money. In other words, are all the things that we do in medicine really worth it? That is where cost-effectiveness comes in. As a nation, we have been unwilling, at least publicly, to look explicitly at the value, in terms of improved health outcome, that we get for our health care dollars. With advances in medical technology putting unsustainable pressure on health care costs, our historical reluctance to measure value for health care may have to change. I start this brief by describing cost-effectiveness analysis as a method of determining …

The Un And The Responsibility To Practice Public Health, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

From International Sanitary Conventions To Global Health Security: The New International Health Regulations, David P. Fidler

Articles by Maurer Faculty

In May 2005, the World Health Organization adopted the new International Health Regulations (IHR), which constitute one of the most radical and far-reaching changes to international law on public health since the beginning of international health cooperation in the mid-nineteenth century. This article comprehensively analyses the new IHR by examining the history of international law on infectious disease control, the IHR revision process, the substantive changes contained in the new IHR and concerns regarding the future of the new IHR. The article demonstrates why the new IHR constitute a seminal event in the relationship between international law and public health …

The Impact Of Privatization Of Primary Care Programs In Large County Health Departments In Florida, Arlesia Lynn Brock

USF Tampa Graduate Theses and Dissertations

Since the mid-1970s, top managers, politicians, and officials in both public and private institutions have promoted contracting-out services (privatization) as a means of increasing efficiency, flexibility, and quality. The privatization trend has occurred in many public sector organizations particularly in city services and prisons. Public health services are not immune to this trend. Today many county health departments have contracted the provision of public health services like womens health, primary care, and laboratory services. However, very few studies have analyzed the impact of these privatizations on cost, access, and health outcomes. Proponents favoring the private provision of these services argue …

Mandatory Recall Authority: A Sensible And Minimalist Approach To Improving Food Safety, Michael T. Roberts

ExpressO

No abstract provided.

Keeping Safe: Field Public Health Nurses' Perceptions, Karen Nielsen-Menicucci Phd, Ms, Rn, Phn

Dissertations

By the year 2005, there will be an estimated 1.25 million workers involved in providing nursing care to individuals in their homes (Bureau of Labor Statistics, 1997). There is limited empirical data available on the issue of safety of nurses within the context of home visiting or in the public health venue. Recent research on safety in home visiting has focused on home health rather than public health nursing. The purpose of this study was to explore and explain the perception of safety among field public health nurses. A purposive sample of 19 public health nurses employed in an official …

Is Fifra Enough Regulation? Failure To Obtain A Npdes Permit For Pesticide Applications May Violate The Clean Water Act, Rebecca E. Leintz

Chicago-Kent Law Review

In the summer of 1999, West Nile Virus, a mosquito-borne illness, appeared in the eastern United States and has since worked its way across the country. Thousands have been infected, and hundreds have died from the virus. Communities, struggling to protect their residents, have often been forced to employ widespread pesticide spraying to stop the virus' spread. Citizens and environmental groups, however, have expressed concern that pesticide spraying is damaging to the environment and contend that the law has been broken. They argue that when these pesticides are deposited onto water bodies, without first obtaining a permit, there is a …

Caught Between Paradise And Power: Public Health, Pathogenic Threats, And The Axis Of Illness, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

Legal Frameworks For Chronic Disease Prevention, Wendy Collins Perdue

Law Faculty Publications

Law is a tool that can be used to shape both private and government conduct so as to impact public health. There are at least seven different techniques of legal intervention, each of which has advantages and disadvantages. These techniques are: direct regulation through command and coercion; economic incentives to encourage private parties to behave in a particular way; indirect regulation through private enforcement such as tort law; altering the informational environment; directly providing services or infrastructure to the public; government acting as a "model citizen" with respect to its employees and facilities; and, inducing other levels of government to …

Vanishing Vaccinations: Why Are So Many Americans Opting Out Of Vaccinating Their Children?, Steve P. Calandrillo

University of Michigan Journal of Law Reform

Vaccinations against life-threatening diseases are one of the greatest public health achievements in history. Literally millions of premature deaths have been prevented, and countless more children have been saved from disfiguring illness. While vaccinations carry unavoidable risks, the medical, social and economic benefits they confer have led all fifty states to enact compulsory childhood vaccination laws to stop the spread of preventable diseases. Today, however, vaccines are becoming a victim of their success-many individuals have never witnessed the debilitating diseases that vaccines protect against, allowing complacency toward immunization requirements to build. Antivaccination sentiment is growing fast in the United States, …

Licensing Health Care Professionals: Has The United States Outlived The Need For Medical Licensure?, Gregory Dolin

All Faculty Scholarship

With an expanding market for what is now known as "complimentary and alternative" medicine (CAM), states are increasingly facing the issue of who can and who should be allowed to practice medicine. Of necessity, this question also concerns whom patients may see to treat their ailments.

This paper will argue that the struggle to define who is and who is not licensed to practice medicine is rather fruitless and will always leave patients with less choice than they desire. Part II will review the history of licensure in the United States. Parts III and IV will focus on benefits and …

Smart Growth For Community Development, Wendy Collins Perdue

Law Faculty Publications

The built environment has a profound effect on public health. For instance, community transportation policy influences pollution levels, which in turn contribute to levels of illness and death. The panelists for this session elaborate on this concept with perspectives drawn from varied experiences.

Parks As Gyms? Recreational Paradigms And Public Health In The National Parks, Jay D. Wexler

Faculty Scholarship

When scholars and policymakers think about the relationship between public health and environmental law and policy, they likely think first about controlling pollution and other toxic substances. As other articles have amply demonstrated, water pollution, air pollution, and other environmental toxins can have significant deleterious effects on the public's health. Scholars rightly pay serious attention to these relationships, and policymakers wisely devise methods and strategies to ameliorate the public health risks posed by these polluting substances.

Although pollution control might be the most obvious and important intersection between environmental policy and public health, legal and policy decisions regarding the management …

Evaluating Utilization Of Beta -Blockers As Secondary Prevention For Post Myocardial Infarction In A Medicaid Population, Ancilla W. Fernandes

Graduate Theses, Dissertations, and Problem Reports (ETD)

Acute myocardial infarction (AMI) is associated with high mortality and costs to the US healthcare system. Beta-blockers are known to reduce mortality and re-infarction rates when used for long-term prevention following an AMI. They are recommended by the American College of Cardiology (ACC)/American Heart Association (AHA) guidelines in post-AMI patients. However, this therapy is both underused (error of omission in eligible patients) and misused (error of commission in ineligible patients). This study involved two phases. Phase one included evaluating utilization of beta-blockers in a Medicaid population and determining the effect of their utilization on patient outcomes such as mortality, morbidity, …

Public Health And The Built Environment: Historical, Empirical, And Theoretical Foundations For An Expanded Role, Wendy Collins Perdue, Lawrence O. Gostin, Lesley A. Stone

Law Faculty Publications

In 2000, the Center for Disease Control and Prevention's National Center for Environmental Health issued a report that explored some of the ways in which "sprawl" impacts public health. The report has generated great interest, and state health officials are beginning to discuss the relationship between land use and public health. The CDC report has also produced a backlash. For example, the Southern California Building Industry Association labeled the report "a ludicrous sham" and argued that the CDC should stick to "fighting physical diseases, not defending political ones."

In this environment, it is understandable if the CDC looks to such …

The Built Environment And Its Relationship To The Public's Health: The Legal Framework, Wendy Collins Perdue

Law Faculty Publications

Public health advocates can help shape the design of cities and suburbs in ways that improve public health, but to do so effectively they need to understand the legal framework. This article re- views the connection between public health and the built environment and then describes the legal pathways for improving the design of our built environment.

That Wonderful Year: Smallpox, Genetic Engineering, And Bio-Terrorism, David A. Koplow

Georgetown Law Faculty Publications and Other Works

The thesis of this Article is that the United States, Russia, and by extension, the world as a whole, are pursuing a fundamentally sound strategy in retaining, rather than destroying, the last known remaining samples of the variola virus. For now, those samples are housed in secure, deep-freeze storage at the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia and at the comparable Russian facility, known as Vector, near Novosibirsk, Siberia. But that basic decision is about the only correct move we are making at this time - and even it is animated by fundamental misapprehensions about …

Blinded By Bioterrorism: Public Health And Liberty In The 21st Century, George J. Annas

Faculty Scholarship

In Blindness, Nobel Prize laureate Jos6 Saramago chronicles the quarantining of the first victims of a plague of blindness.1 We meet many people who become blind in Saramago's novel, including an opthamologist, a one-eyed man with an eye patch, and a man born blind. Saramago reminds us that we are all blind in one way or another, and that there are many things about ourselves and our society that we can't or won't see. The quarantine itself turns out to be isolating, inhumane, and degrading; the interred blind being portrayed by themselves and others as pigs, dogs, and "lame crabs." …

Puppy Love: Bioterrorism, Civil Rights, And Public Health, George J. Annas

Faculty Scholarship

Florida has been the state humorists most like to make fun of since the 2000 presidential election, especially when it comes to politics. And humorists are almost the only commentators who can be counted on to tell us the truth about the state of American politics today. When Californians decided to recall their Governor, for example, Conan O'Brien observed: "Yesterday Arnold Schwarzenegger announced he would run for governor of California. The announcement was good news for Florida residents, who now live in the second-flakiest state in the country."' And when more than 200 people filed to run for Governor, Jay …

Public Health And National Security In The Global Age: Infectious Diseases, Bioterrorism, And Realpolitik, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

Treating Physicians As Expert Witnesses In Compensation Systems: The Public Health Connection, Brian C. Murchison

Kentucky Law Journal

No abstract provided.

The Federal Government's Role In Protecting Public Health, Ernie Fletcher

Kentucky Law Journal

No abstract provided.

The Changing Face Of Hiv/Aids: An Anthropological And Epidemiological Study Of The Baton Rouge Area, Erica Brooke Gibson

LSU Master's Theses

The Human Immunodeficiency Virus (HIV) and the resulting Acquired Immune Deficiency Syndrome (AIDS) became widespread in the early 1980’s. At the beginning of the epidemic, HIV/AIDS was affecting mainly gay men. As the disease began to spread, more diverse populations were affected. Now, two decades later, the face of HIV and AIDS has changed. In the year 2000, the Baton Rouge area (which includes the parishes of Ascension, East Baton Rouge, East Feliciana, Iberville, Pointe Coupee, West Baton Rouge, and West Feliciana) had the highest detected rate of HIV/AIDS cases in the state, and the 16th highest detected rate of …

Personal Privacy And Common Goods: A Framework For Balancing Under The National Health Information Privacy Rule, Lawrence O. Gostin, James G. Hodge Jr.

Georgetown Law Faculty Publications and Other Works

In this Article, we discuss how these principles for balancing apply in a number of important contexts where individually identifiable health data are shared. In Part I, we analyze the modern view favoring autonomy and privacy. In the last several decades, individual autonomy has been used as a justification for preventing sharing of information irrespective of the good to be achieved. Although respect for privacy can sometimes be important for achieving public purposes (e.g., fostering the physician/patient relationship), it can also impair the achievement of goals that are necessary for any healthy and prosperous society. A framework for balancing that …

Conceptualizing The Field After September 11th: Foreword To A Symposium On Public Health Law, Lawrence O. Gostin

Kentucky Law Journal

No abstract provided.

School Vaccination Requirements: Historical, Social, And Legal Perspectives, James G. Hodge Jr., Lawrence O. Gostin

Kentucky Law Journal

No abstract provided.

Public Health Versus Civil Liberties: Washington State Imposes Hiv Surveillance And Strikes The Proper Balance, Robin Sheridan

Seattle University Law Review

The article examines the controversy surrounding the Washington HIV surveillance system in light of a long-standing conflict between public health concerns and civil liberties. 7 Part I of the article briefly describes the inception of the AIDS epidemic. Part II focuses on AIDS legislation and the justifications for surveillance. Part III discusses the tension between public health and civil liberties. Part IV describes AIDS’s social stigmatization and deterrence. Part V addresses the nature of medical information and the potential for government misuse. Part VI describes the types of HIV surveillance available and the benefits and burdens which accompany both tracking …

Handling Cases Of Willful Exposure Through Hiv Partner Counseling And Referral Services, Lawrence O. Gostin, James G. Hodge Jr.

Georgetown Law Faculty Publications and Other Works

Cases of willful exposure reveal the existing and future risks to the public health (especially women) which may be presented by individuals who willfully expose others to HIV through unsafe sexual or needle-sharing behaviors. In response to a documented case of willful exposure, a PCRS counselor or other public health official may, in his or her professional judgment, decide to act to avert a legitimate public health threat to known or unknown persons in the community. Yet handling such cases raises difficult issues in law, ethics, and public health practice. Public health authorities may be unable or ill-equipped to successfully …

The Globalization Of Public Health: The First 100 Years Of International Health Diplomacy, David P. Fidler

Articles by Maurer Faculty

Global threats to public health in the 19th century sparked the development of international health diplomacy. Many international regimes on public health issues were created between the mid-19th and mid-20th centuries. The present article analyses the global risks in this field and the international legal responses to them between 1851 and 1951, and explores the lessons from the first century of international health diplomacy of relevance to contemporary efforts to deal with the globalization of public health.

Public Health In South Africa: Aids And Child Welfare, Peter Barron, Marian Jacobs

Macalester International

No abstract provided.