Law Commons^™

The Psychology Of Science Denialism And Lessons For Public Health Authorities, Brenna Moreno, Molly J. Walker Wilson

All Faculty Scholarship

As it wreaked tragedy on the world, the outbreak of COVID-19 helped expose a pandemic of a different kind, one steeped in distrust and contrarianism. This movement, termed science denialism, has been lurking and undermining public health efforts for decades. Specifically, it is “the employment of rhetorical arguments to give the appearance of legitimate debate where there is none, an approach that has the ultimate goal of rejecting a proposition on which a scientific consensus exists.” Unlike skepticism, which is “doubt as to the truth of something” and works to progress both science and society, denialism is characterized by individuals’ …

What Covid-19 Laid Bare: Adventures In Workers’ Compensation Causation, Michael C. Duff

All Faculty Scholarship

This essay performs a close analysis of workers’ compensation coverage of COVID-19 and arrives at the conclusion that it should not be “impossible” to prove in a legal sense that an employee’s COVID-19 was caused by work. Scientific proof is not the same as legal proof: workers’ compensation law has never required that claims must be supported by irrefutable scientific proof of workplace causation. Yet repeatedly one heard this suggestion during public discussion on workers’ compensation coverage of employees.

Still, there is good evidence that even when workers’ compensation undisputedly covers work-related disease employers seldom pay benefits (and states do …

Lessons Learned From The Hiv/Aids Pandemic And Access To Medicines For Covid-19 Treatment, Thalia Le

Independent Study Project (ISP) Collection

There is an imminent need to address the healthcare disparities in accessing all COVID-19 medicinal products in developing countries. While logistical issues like inadequate production facilities such as the lack of vaccines administration capacity, storage issues, gap between supply and demand as well as vaccine hesitancy can certainly play a part in impeding COVID19 medicines distribution, patent monopolies and intellectual property protection laws further exacerbated the problem, especially when vaccines were at its early stages of authorization. Historical and contemporary case studies of efforts to challenge patents on HIV AVRs treatment provide a useful lens through which we may glean …

The Intellectual Property Of Covid-19, Ana Santos Rutschman

All Faculty Scholarship

The response to COVID-19 is indissolubly tied to intellectual property. In an increasingly globalized world in which infectious disease pathogens travel faster and wider than before, the development of vaccines, treatments and other forms of medical technology has become an integral part of public health preparedness and response frameworks. The development of these technologies, and to a certain extent the allocation and distribution of resulting outputs, is informed by intellectual property regimes. These regimes influence the commitment of R&D resources, shape scientific collaborations and, in some cases, may condition the widespread availability of emerging technologies. As seen throughout this chapter, …

Covid-19 Employee Health Checks, Remote Work, And Disability Law, Elizabeth Pendo

All Faculty Scholarship

The Americans with Disabilities Act (ADA) prohibits discrimination against people with disabilities, about 61 million individuals in the U.S. The law’s protections in the workplace are especially important during COVID-19, which has worsened pre-existing disparities experienced by people with disabilities. The ADA also applies to new strategies to reduce the risk of COVID-19 infection in the workplace. This Chapter will focus on two strategies that impact individuals with and without disabilities – employee health screening, testing and vaccination policies, and new or expanded remote work programs.

FacebookʼS Latest Attempt To Address Vaccine Misinformation — And Why ItʼS Not Enough, Ana Santos Rutschman

All Faculty Scholarship

On October 13, 2020 Facebook announced the adoption of a series of measures to promote vaccine trust “while prohibiting ads with misinformation that could harm public health efforts.” In the post written by Kang-Xing Jin (head of health) and Rob Leathern (director of product management), the company explained that the new measures were designed with an emphasis on encouraging widespread use of this yearʼs flu vaccine, as well as in anticipation of potential COVID-19 vaccines becoming available in the near future.

The changes focus mainly on the establishment of a multiprong informational campaign about the seasonal flu vaccine, which includes …

A Retrospective Analysis Of Sex Education Messages Received By Lgb Youth, Jacqueline Bible, Alejandra Kaplan, Lisa D. Lieberman, Eva Goldfarb

Department of Public Health Scholarship and Creative Works

Using focus groups, this qualitative study asked thirty-five gay, lesbian, and bisexual (LGB) young adults to reflect on messages they received about sex and sexuality around the time they first had sex. Focus groups were conducted, recorded, transcribed, and analyzed. Through thematic analysis, the authors identified two messaging sources identified by participants: (1) formal education sources (i.e., school and parents), and (2) informal education sources (e.g., internet, peers). Formal sources often included messages perpetuating heteronormative assumptions, emphasizing abstinence, pregnancy and HIV/STI prevention, or silence as a form of messaging. Informal sources consisted of LGB-specific information. These findings suggest informal sources …

Housing Stability And Diabetes Among People Living In New York City Public Housing, Sungwoo Lim, Sze Yan Liu, Melanie H. Jacobson, Eugenie Poirot, Aldo Crossa, Sean Locke, Jennifer Brite, Elizabeth Hamby, Zinzi Bailey, Stephanie Farquhar

Department of Public Health Scholarship and Creative Works

Public housing provides affordable housing and, potentially, housing stability for low-income families. Housing stability may be associated with lower incidence or prevalence and better management of a range of health conditions through many mechanisms. We aimed to test the hypotheses that public housing residency is associated with both housing stability and reduced risk of diabetes incidence, and the relationship between public housing and diabetes risk varies by levels of housing stability. Using 2004-16 World Trade Center Health Registry data, we compared outcomes (housing stability measured by sequence analysis of addresses, self-reported diabetes diagnoses) between 730 New York City public housing …

Laws Restricting Access To Abortion Services And Infant Mortality Risk In The United States, Roman Pabayo, Amy Ehntholt, Daniel M. Cook, Megan Reynolds, Peter Muennig, Sze Yan Liu

Department of Public Health Scholarship and Creative Works

Objectives: Since the US Supreme Court′s 1973 Roe v. Wade decision legalizing abortion, states have enacted laws restricting access to abortion services. Previous studies suggest that restricting access to abortion is a risk factor for adverse maternal and infant health. The objective of this investigation is to study the relationship between the type and the number of state-level restrictive abortion laws and infant mortality risk. Methods: We used data on 11,972,629 infants and mothers from the US Cohort Linked Birth/Infant Death Data Files 2008–2010. State-level abortion laws included Medicaid funding restrictions, mandatory parental involvement, mandatory counseling, mandatory waiting period, and …

Laws Restricting Access To Abortion Services And Infant Mortality Risk In The United States, Roman Pabayo, Amy Ehntholt, Daniel M. Cook, Megan Reynolds, Peter Muennig, Sze Yan Liu

Department of Public Health Scholarship and Creative Works

Objectives: Since the US Supreme Court′s 1973 Roe v. Wade decision legalizing abortion, states have enacted laws restricting access to abortion services. Previous studies suggest that restricting access to abortion is a risk factor for adverse maternal and infant health. The objective of this investigation is to study the relationship between the type and the number of state-level restrictive abortion laws and infant mortality risk. Methods: We used data on 11,972,629 infants and mothers from the US Cohort Linked Birth/Infant Death Data Files 2008–2010. State-level abortion laws included Medicaid funding restrictions, mandatory parental involvement, mandatory counseling, mandatory waiting period, and …

Association Between Racial Discrimination And Health‐Related Quality Of Life And The Impact Of Social Relationships, Sze Yan Liu, Genevieve Bergeron, Nneka Lundy De La Cruz, L. Hannah Gould, Amber Levanon Seligson

Department of Public Health Scholarship and Creative Works

Purpose: Interpersonal racial discrimination is associated with poor health. Social relationships may moderate the impact of discrimination and represent modifiable behaviors that can be targeted by public health interventions. We described citywide associations between self-reported racial discrimination and health-related quality of life among the overall New York City (NYC) adult residential population and by four main race/ethnicity groups and explored whether social relationships moderated health effects of discrimination.

Methods: We analyzed cross-sectional survey data from 2335 adults weighted to be representative of the NYC population. We measured exposures to lifetime interpersonal racial discrimination in nine domains using a modifed version …

The Problem With Relying On Profit-Driven Models To Produce Pandemic Drugs, Ana Santos Rutschman

All Faculty Scholarship

The longstanding problems of relying on a market response to a pandemic are becoming readily apparent in the United States, which has quickly become the epicenter of the COVID-19 outbreak. The problems are particularly pronounced in pharmaceutical markets, where we are pinning our hopes for both cures and vaccines. In previous work we have shown how characteristics of healthcare markets in the United States create a divergence between the private incentives of for-profit companies and public health needs, leading to sub-optimal health outcomes in what is a uniquely market-driven healthcare system. In this Essay, written as the COVID-19 pandemic unfolds, …

Reviving Focused Scrutiny In The Constitutional Review Of Public Health Measures, Robert Gatter

All Faculty Scholarship

This article re-examines the "focused scrutiny" standard proposed by Prof. Scott Burris in 1989 and argues for its application particularly during an infectious disease emergency such as the COVID-19 pandemic. Focused scrutiny seeks to tie judicial review of the constitutionality of public health measures closely to the facts of the particular disease and to evidence of the efficacy of each governmental action to prevent the spread of that disease, even when courts adopt rational basis testing.

Medicaid's Vital Role In Addressing Health And Economic Emergencies, Nicole Huberfeld, Sidney Watson

All Faculty Scholarship

Medicaid plays an essential role in helping states respond to crises. Medicaid guarantees federal matching funds to states, which helps with unanticipated costs associated with public health emergencies, like COVID-19, and increases in enrollment that inevitably occur during times of economic downturn. Medicaid’s joint federal/state structure, called cooperative federalism, gives states significant flexibility within federal rules that allows states to streamline eligibility and expand benefits, which is especially important during emergencies. Federal emergency declarations give the secretary of Health and Human Services temporary authority to exercise regulatory flexibility to ensure that sufficient health care is available to meet the needs …

The Reemergence Of Vaccine Nationalism, Ana Santos Rutschman

All Faculty Scholarship

This short essay explores the reemergence of vaccine nationalism during the COVID-19 pandemic. The essay traces the pre-COVID origins of vaccine nationalism and explains how it can have detrimental effects on equitable access to newly developed vaccines.

Mapping Misinformation In The Coronavirus Outbreak, Ana Santos Rutschman

All Faculty Scholarship

The coronavirus outbreak has sent ripples of fear and confusion across the world. These sentiments—and our collective responses to the outbreak—are made worse by rampant misinformation surrounding the new strain of the virus, COVID-2019. In this post, I survey some of the most pervasive areas of tentacular coronavirus-related misinformation that has proliferated online -- as well as the responses of social media companies like YouTube, Facebook, Pinterest and TikTok that may ultimately prove inadequate given the magnitude of the problem.

The Case For Face Shields: Improving The Covid-19 Public Health Policy Toolkit, Timothy L. Wiemken, Ana Santos Rutschman, Robert Gatter

All Faculty Scholarship

As the United States battles the later stages of the first wave of COVID-19 and faces the prospect of future waves, it is time to consider the practical utility of face shields as an alternative or complement to face masks in the policy guidance. Without face shields specifically noted in national guidance, many areas may be reluctant to allow their use as an alternative to cloth face masks, even with sufficient modification.

In this piece, we discuss the benefits of face shields as a substitute to face masks in the context of public health policy. We further discuss the implications …

Comments On The Preliminary Framework For Equitable Allocation Of Covid-19 Vaccine, Ana Santos Rutschman, Julia Barnes-Weise, Robert Gatter, Timothy L. Wiemken

All Faculty Scholarship

On September 1, 2020 the National Academies released a draft framework for Equitable Allocation of a COVID-19 Vaccine. In this response, we analyze the proposed framework and highlight several areas.

Among the proposed changes, we highlight the need for the following interventions. The final framework for distribution of COVID-19 vaccines should give a higher priority to populations made most vulnerable by the social determinants of health. It should incorporate more geography-based approaches in at least some of the four proposed phases of vaccine distribution. It should address the possibility of a vaccine being made available through an emergency use authorization …

Why The Government Shouldn't Pay People To Get Vaccinated Against Covid-19, Ana Santos Rutschman

All Faculty Scholarship

As several pharmaceutical companies approach the Food and Drug Administration (FDA) seeking authorization to bring COVID-19 vaccines to market, concerns about vaccine mistrust cloud the prospects of imminent vaccination efforts across the globe. These concerns have prompted some commentators to suggest that governments may nudge vaccine uptake by paying people to get vaccinated against COVID-19. This post argues that, even if potentially viable, this idea is undesirable against the backdrop of a pandemic marked by the intertwined phenomena of health misinformation and mistrust in public health authorities. Even beyond the context of COVID-19, paying for vaccination is likely to remain …

Protecting The Rights Of People With Disabilities, Elizabeth Pendo

All Faculty Scholarship

One in four Americans — a diverse group of 61 million people — experience some form of disability (Okoro, 2018). On average, people with disabilities experience significant disparities in education, employment, poverty, access to health care, food security, housing, transportation, and exposure to crime and domestic violence (Pendo & Iezzoni, 2019). Intersections with demographic characteristics such as race, ethnicity, gender, and LGBT status, may intensify certain inequities. For example, women with disability experience greater disparities in income, education, and employment (Nosek, 2016), and members of under-served racial and ethnic groups with disabilities experience greater disparities in health status and access …

Covid-19 And The Conundrum Of Mask Requirements, Robert Gatter, Seema Mohapatra

All Faculty Scholarship

As states begin to loosen their COVID-19 restrictions, public debate is underway about what public health measures are appropriate. Many states have some form of mask-wearing orders to prevent the spread of COVID-19 infection. Public health guidance from the Centers for Disease Control and Prevention and the World Health Organization has conflicted. From a public health point of view, it is not clear what the right answer is. In the absence of directives, individuals are also making their own choices about mask use. At a time when public health measures, like shelter-in-place orders and social distancing, are being used to …

Inequitable Chronic Lead Exposure: A Dual Legacy Of Social And Environmental Injustice, Tamara Leech, Elizabeth A. Adams, Tess D. Weathers, Lisa K. Staten, Gabriel M. Filippelli

Department of Public Health Scholarship and Creative Works

Both historic and contemporary factors contribute to the current unequal distribution of lead in urban environments and the disproportionate impact lead exposure has on the health and well-being of low-income minority communities. We consider the enduring impact of lead through the lens of environmental justice, taking into account well-documented geographic concentrations of lead, legacy sources that produce chronic exposures, and intergenerational transfers of risk. We discuss the most promising type of public health action to address inequitable lead exposure and uptake: primordial prevention efforts that address the most fundamental causes of diseases by intervening in structural and systemic inequalities.

Historical Differences In School Term Length And Measured Blood Pressure: Contributions To Persistent Racial Disparities Among Us- Born Adults, Sze Yan Liu, Jennifer J. Manly, Benjamin D. Capistrant, M. Maria Glymour

Department of Public Health Scholarship and Creative Works

Introduction
Legally mandated segregation policies dictated significant differences in the educational experiences of black and white Americans through the first half of the 20th century, with markedly lower quality in schools attended by black children. We determined whether school term length, a common marker of school quality, was associated with blood pressure and hypertension among a cohort of older Americans who attended school during the de jure segregation era.
Methods
National Health and Nutrition Examination Survey I and II data were linked to state-level historical information on school term length. We used race and gender-stratified linear regression models adjusted for …

Improving Sexuality Education: The Development Of Teacher-Preparation Standards, Elissa M. Barr, Eva Goldfarb, Susan Russell, Denise Seabert, Michele Wallen, Kelly L. Wilson

Department of Public Health Scholarship and Creative Works

BACKGROUND: Teaching sexuality education to support young people’s sexual development and overall sexual health is both needed and supported. Data continue to highlight the high rates of teen pregnancy, sexually transmitted diseases, including human immunodeficiency virus (HIV) infections, among young people in the United States as well as the overwhelming public support for sexuality education instruction. In support of the implementation of the National Sexuality Education Standards, the current effort focuses on better preparing teachers to deliver sexuality education. METHODS: An expert panel was convened by the Future of Sex Education Initiative to develop teacher-preparation standards for sexuality education. Their …

Sexuality Information Needs Of Latino And African American Ninth Graders: A Content Analysis Of Anonymous Questions, Francisca Angulo-Olaiz, Eva Goldfarb, Norman A. Constantine

Department of Public Health Scholarship and Creative Works

This study used qualitative content analysis to examine anonymous questions about sex and sexuality submitted by Latino and African American adolescents in Los Angeles, California, classrooms. The majority of questions asked about sexuality and sexual behavior, or anatomy and physiology, with fewer questions about pregnancy and pregnancy prevention, sexually transmitted infections, and condoms. Overall, a notable mix was found of questions implying exposure to or awareness of a wide range of sexual activities, together with questions demonstrating fundamental misunderstandings or confusion about some of the most basic aspects of sex and sexuality. Gender differences emerged across topics, subtopics, and question …

Area Specific Self-Esteem, Values, And Adolescent Sexual Behavior, Michael Young, Joseph Donnelly, George Denny

Department of Public Health Scholarship and Creative Works

This study examined area-specific self-esteem scores by sexual behavior relative to adolescents' values concerning participation in sexual intercourse as an unmarried teenager. The sample consisted of 332 students in grades 7–12 from a Southern rural school district. Students were asked if they had ever had sexual intercourse (yes/no) and if they had participated in sexual intercourse in the last month (yes/no). Respondents also indicated on a 4-point scale their response to the statement “It is against my values to have sex as an unmarried teenager.” Data were analyzed using a 2 × 4 (behavior x values) analysis of variance for …

Sexuality Education, Eva Goldfarb, Norman A. Constantine

Department of Public Health Scholarship and Creative Works

Sexuality education comprises the lifelong intentional processes by which people learn about themselves and others as sexual, gendered beings from biological, psychological, and sociocultural perspectives. It takes place through a potentially wide range of programs and activities in schools, community settings, religious centers, as well as informally within families, among peers, and through electronic and other media. Sexuality education for adolescents occurs in the context of the biological, cognitive, and social-emotional developmental progressions and issues of adolescence. Formal sexuality education falls into two main categories: behavior change approaches, which are represented by abstinence-only and abstinence-plus models, and healthy sexual development …

A Lesson On Homophobia And Teasing, Eva Goldfarb

Department of Public Health Scholarship and Creative Works

Homophobia and gay-related teasing are already present among young children. This lesson introduces the term “prejudice” and places the concept of homophobia within the context of bullying and teasing with which 8–11-year-olds are already familiar. The lesson builds empathy as children think about and discuss how they have felt when they have been teased or called a name and how they think people in gay or lesbian families would feel. The lesson celebrates the lives of gay and lesbian people as it celebrates diversity among all people and families. Children are encouraged to think about the diversity within their own …

Recently Arrested Adolescents Are At High Risk For Sexually Transmitted Diseases, Christopher Salvatore, Steven Belenko, Richard Dembo, Doris Weiland, Matthew Rollie, Alexandra Hanlon, Kristina Childs

Department of Justice Studies Faculty Scholarship and Creative Works

Adolescent offenders may be at high risk for sexually transmitted diseases (STDs). With previous research and interventions focused on incarcerated adolescents, data are needed on STD prevalence and risk factors among newly arrested youth released to the community, a far larger subgroup.Participants were recruited from all arrested youth processed at the Hillsborough County, Florida Juvenile Assessment Center during the last half of 2006 (506 males, 442 females). Participants voluntarily providing urine samples for drug testing as part of standard protocol were also consented to having their specimens split and tested for chlamydia and gonorrhea, using an FDA-approved nucleic acid amplification …

Need For Cognition And Message Complexity In Motivating Fruit And Vegetable Intake Among Callers To The Cancer Information Service, Pamela Williams-Piehota, Judith Pizarro, Stephanie A. Navarro Silvera, Linda Mowad, Peter Salovey

Department of Public Health Scholarship and Creative Works

This field experiment examined the impact of an individual's need for cognition (NFC; the tendency to enjoy thinking deeply about issues), complex versus simple messages, and the interaction of NFC and message type on encouraging fruit and vegetable consumption. Callers to the Cancer Information Service of the National Cancer Institute (N = 517) were asked to participate in the experiment at the end of their call. Individual NFC was assessed, and participants were assigned randomly to receive a telephone message promoting fruit and vegetable consumption that was either complex and multifaceted or simple and straightforward. Similarly constructed brochures were …