Health Law and Policy Commons^™

Dissecting The Heterogeneous Effects Of Opioid Prescribing Limit Laws On Pediatric Mortality: A Multidimensional And Negative Binomial Modeling Approach, Francine R. Vega

Dissertations and Theses (Open Access)

Opioid prescribing for children and adolescents continues to be a significant health crisis in the United States. Early naïve exposure to opioid prescriptions has been linked to later misuse, opioid use disorder, and death. In response to the crisis, many states have implemented opioid prescribing limit laws (OPLLs) aimed at reducing exposure to opioids. These laws vary widely in their approach, including differences in dosage restrictions, prescription duration limits, informed consent requirements, educational provisions, and whether they offer explicit protections specifically for minors. Despite their widespread adoption, there is limited understanding of how heterogeneity in legal regulations affects outcomes for …

Water Fluoridation: A Personal Perspective On The Effectiveness Of Community Water Fluoridation, William Chase Dds, Maom

The Journal of the Michigan Dental Association

This article offers Dr. William R. Chase's personal insights into community water fluoridation, emphasizing its effectiveness in preventing dental caries. It traces the discovery of fluoride's benefits back to Frederick McKay's 1901 observations and highlights the pivotal 1945 Grand Rapids Study, which demonstrated significant caries reduction, especially in younger age groups. Despite long-standing support from the American Dental Association, controversies regarding fluoride's safety persist, leading to recent state-level bans. Dr. Chase's experiences in countries without fluoridated water, where he observed severe decay and life-threatening cellulitis, underscore his belief in fluoride as a "miracle supplement" when properly utilized. The Michigan Dental …

For The Greater Good: Civil Commitment For Addiction Amid The Overdose Epidemic, Steven P. Meerschaert

Cleveland State Law Review

America is facing a reckoning born of its own duality. Our society is gradually embracing an increasingly permissive stance on recreational drug use, while at the same time we lament the human costs of addiction. What the media has dubbed the “opioid epidemic” has seen increases in drug addiction diagnoses and opioid-involved overdose deaths nearly every year since 1999. In a rush to designate guilty parties and to crown a “gold standard” for treatment options, we have focused on theoretically flawed approaches that fail to follow the science precisely. At the same time, we dismiss validated treatment modalities in their …

A Cancer Education Needs Assessment: Informing Middle-Aged Female Patients About The Relationships Between Obesity And Women’S Health Concerns In The Reproductive System, Breast, And Endometrial Health, Batul Mirza

MUSC Theses and Dissertations

Obesity significantly impacts women’s health, particularly among middle-aged women, by increasing the risk of hormone-sensitive cancers such as breast, endometrial, and reproductive system cancers. This study examines the educational needs of this demographic group regarding obesity-related cancer risks and explores effective intervention strategies. Obesity-induced mechanisms – hormonal imbalances, chronic inflammation, and insulin resistance – drive cancer susceptibility, emphasizing the need for targeted health education. The study employs a qualitative design, which includes interviews with subject matter experts (SMEs) and surveys of middle-aged women. The goal is to assess awareness, perceived barriers, and preferred learning methods. Findings suggest that with many …

Integrating Positive Psychology And Spirituality To Foster Meaning And Well-Being In Older Adults, Crystal Morris

Adultspan Journal

This perspective article explores the integration of positive psychology interventions (PPIs) and spirituality in therapy to foster meaning and well-being in older adults. It highlights exercises such as the positive introduction, positive legacy, character strengths, mindfulness, mindful-based yoga, and a manifestation prayer journaling. The interventions presented are tools to support older adults that may experience depression, difficult life transitions, and the search for renewed meaning. Therapists who integrate PPIs and spirituality into therapy can promote a holistic, non-pathological approach to treatment.

It's Time For Some Important Conversations About Fluoride, Jessica R. Bentoski D.D.S., M.S., F.A.A.P.D., Sam Blanchard Dds, Ms

The Journal of the Michigan Dental Association

The guest editorial by the Michigan Academy of Pediatric Dentistry's Drs. Jessica Bentoski and Sam Blanchard, addresses growing public debate surrounding community water fluoridation and emphasizes the vital role of dental professionals in providing evidence-based guidance to parents. As pediatric dentists, the authors highlight that fluoride remains a cornerstone in preventing childhood caries—still the most common chronic disease in children. They stress the need to understand and address parental beliefs, misinformation, and concerns through respectful, informed dialogue. Removing fluoridation could exacerbate oral health disparities and misperceptions about fluoride safety. The authors call on colleagues to initiate important conversations, advocate for …

The Affordable Care Act: Analyzing Rates Of Healthcare Claim Denial, Lauren Sitter

Political Science Theses and Capstones

The United States healthcare industry is an integral aspect of every American’s life. The Affordable Care Act (ACA) in 2010 reformed the healthcare system by expanding coverage to millions of Americans and eliminating claim denials due to pre-existing conditions. It requires participating states to submit transparency data. Despite these reforms, coverage denials continue and vary by plan category, metal level, and among different states. I analyze data from The Kaiser Family Foundation (2023) and The CommonWealth Fund to test the correlation between claim denial and a variety of variables, including state political culture, plan type, metal level, and out-of-pocket costs. …

Supreme Court Case Study: The Variation In Rates Of Miscarriage Management Care And Post-Abortion Care Across The Us Before And After The Supreme Court Decision, Ted Sibrian Jr.

MUSC Theses and Dissertations

The paper examines abortion care and the management of miscarriages following the Roe v. Wade decision in restrictive states that do not allow medical intervention due to the vague legal terms. This research evaluates the need to establish protocols for providers when faced with nonviable pregnancies requiring medical intervention. Additionally, the paper highlights the impact across the US on women’s health outcomes by emphasizing the care for miscarriage management. This multi-method paper reviews the current literature on miscarriage management and spontaneous abortion MarketScan® data from commercially insured individuals with an age range of 18-50 years old by regions across the …

Challenging Race-Based Health Care Discrimination: A New Private Right Of Action, Aaron Pinkett

Northwestern University Law Review

The Hippocratic Oath calls on doctors to “do no harm.” Yet we know from extensive public health research that clinicians repeatedly cause harm to Black patients by dismissing their medical concerns, misdiagnosing them, and undertreating their pain. These practices of differential treatment for Black patients have led to steadily increasing racial disparities in health care outcomes throughout the United States. Title VI of the Civil Rights Act of 1964 prohibits this type of disparate impact, but modern Supreme Court jurisprudence forecloses opportunities for affected parties to seek legal relief—despite the clearly established legislative intent of Title VI. However, another legal …

Stopping The Cirrhosis: An International Review Of Hep C Screening In Prisons And Jails From 2004-2023, Anastasia Sahu Bs, Jack Spurlock Ba, Mhs, Eliza Beal Md

Medical Student Research Symposium

Background: As of 2023, HCV prevalence in state prisons in the United States was 9 times higher than the general population¹. Without treatment, 20% of people with HCV will develop cirrhosis, and some estimate that 70% of hepatocellular carcinoma (HCC) cases arise from cirrhosis or advanced fibrosis². Despite the high prevalence in prisons, the US does not have nationally standardized Hep C screening in correctional facilities. The goal of this study is to investigate different models of existing programs in prisons internationally. Understanding these models will inform Hep C screening in US prisons on a state …

Addressing Gaps In Access: Examining Language Barrier Accommodations In Medicaid Member Handbooks, 2015-2019, Sanskruti Patel

Senior Theses

Objective: This study examines the linguistic accessibility of Medicaid Managed Care Organization (MCO) handbooks from 2015 to 2019 by analyzing the instructions provided to access interpreter and written translation services. Trends were compared over time, considering state and plan-level factors that impact equitable healthcare access for Limited English Proficiency (LEP) enrollees.

Methods: A systematic search using manual efforts and FOIA requests located all publicly available Medicaid handbooks from 2015-2019 (N=657) across 39 states with comprehensive MCO plans. These handbooks were coded by independent reviewers to assess the study outcome variables. Random mixed-effects logistic and linear regression models were conducted to …

Science And Politics In Public Health Regulation, Samuel R. Bagenstos

University of Michigan Journal of Law Reform

Much of American public discourse takes for granted a distinction between science and politics. People describe and understand that distinction in contradictory ways, however. And those contradictions themselves underscore how closely entwined science and politics actually are.

The Ethical Dilemma Of Social Media, Janet H. Southerland

New Orleans Dental Association News

Social media has transformed dentistry, enhancing communication, education, and patient engagement. However, ethical challenges, including privacy concerns and misinformation, pose risks. This article explores the benefits and challenges of social media in dentistry, emphasizing the need for ethical guidelines to uphold professional standards while leveraging digital advancements for improved care and education.

Strengthening Legal Frameworks And Patient Safety: A Narrative Review Of Medical And Dental Malpractice In Indonesia, Ghulam Mustafa, Ede Surya Darmawan

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Many cases of medical and dental malpractice in Indonesia are still related to patient safety and healthcare quality. This narrative review aims to identify solutions that can be implemented. The main focus is to compare the incidence of malpractice in clinical medical and dental practice, emphasizing legal implications, coverage, and internal organizational issues. A systematic literature search was conducted through databases such as Pubmed, ScienceDirect, Google Scholar, Springer, Garuda, and other online databases. Articles published no later than 2024. Eleven studies were selected that discussed the problem of malpractice in Indonesia. Independent screening and critical appraisal were carried out to …

Decriminalizing Disease: A Health Justice Approach To Infectious Diseases And Criminal Law, Sean E. Bland

Arkansas Law Review

Infectious diseases, also called communicable diseases, are largely a public health issue and should not be criminalized. This Article seeks to re-frame the discussion around the legal framework for infectious diseases in a way that moves beyond a punishment mindset and toward a health justice mindset. The focus in this Article is on health justice rather than traditional understandings of public health, defined as the science and practice of improving the health of people and their communities. The Article makes three novel contributions. First, it applies a health justice framework to the critique of infectious disease criminalization. Second, the Article …

The Healing Power Of Antitrust, Theodosia Stavroulaki

Northwestern University Law Review

Millions of Americans live in hospital deserts—communities where people lack geographic access to hospitals and primary care physicians. People living in these deserts often miss doctor appointments, delay necessary care, and stop adhering to their treatment. In this way, hospital deserts exacerbate the health disparities plaguing America. This Article demonstrates that hospital deserts are not inevitable but the result of several business strategies—including noncompete agreements and merging with competitors—and antitrust enforcers’ unwillingness to recognize these harmful practices as antitrust violations. To cure the issue of hospital deserts, this Article makes three proposals. First, antitrust enforcers and the courts should expand …

Medication Abortion And The Mails: The Ghost Of Anthony Comstock Rides Again?, Lars Noah

UF Law Faculty Publications

Mail-order dispensing of the prescription drug mifepristone has become the latest flashpoint in this country’s long-running debate over abortion access. It also has brought back from the dead one of the oldest federal statutes to address that contentious subject. In their fight to limit access to a drug approved by the FDA one quarter of a century ago, abortion opponents have rediscovered the Comstock Act. Although amended on several occasions since 1873, Congress never managed to repeal or clarify its ambiguous language relating to abortion. On its narrowest reading, this provision would have no impact whatsoever on access to mifepristone; …

The European Health Data Space As A Compass For Academic/Industry Collaborations, Gabriela Lenarczyk, Hannah Louise Smith, W. Nicholson Price Ii

Articles

Against the backdrop of a deepening funding crisis for academic research in the US, how and when can closer relationships between academia and industry better support the research enterprise? Spector-Bagdady (2025) explores this potential response, bringing insight from genetic data sharing between academia and industry—and the benefits and challenges that arise from that sharing. She calls for a response that aligns academic institutional policy to support the realization of any public good, recognizing the pitfalls and problematic incentives that shape individual responses. It’s a timely call, and an attractive one in a time of urgent uncertainty about funding and support. …

Cause Of Death? -- It's Probably Not What's Reported On The Death Certificate, Lauren R. Roth

Lewis & Clark Law Review

In the age of big data, this country has a data problem—inaccurate and incomplete information in death certificates. The problem has long been hidden by the numbers reported—as have the people whose deaths go uncounted, but the COVID-19 pandemic unveiled the scope of the issue. Since the beginning of the pandemic, “excess deaths” (i.e., any deaths above the number predicted by existing mortality models) have increased significantly. Most of these excess deaths are likely attributable to COVID-19 because the decedent was never tested for COVID-19 or it was one of multiple factors contributing to their death. Other deaths are uncounted …

Maternal Mortality According To State Abortion Legislative Climate Following The Us Supreme Court's Dobbs V. Jackson Women's Health Organization Ruling, Emily Nuss, Mari Iwasaki, Lindsay Robbins, Peggy Ye, Misa Hayasaka, George Saade, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

We aimed to evaluate how maternal mortality rates have evolved across US states following the Dobbs ruling, while accounting for the confounding influence of the coronavirus disease 2019 (COVID-19) pandemic.

Study Design

We conducted a retrospective analysis of publicly available data from the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER) database from January 2018 to December 2024. This study period was divided into three intervals: (1) pre-COVID (January 2018 to February 2020), (2) pandemic (March 2020 to September 2022), and (3) post-Dobbs (October 2022 to December 2024). Using the Kaiser Family Foundation …

Dirty Water, Breanna Booker, Michael S. Sinha

All Faculty Scholarship

Plastics are taking over. Every day, humans are exposed to plastic pollutants in a variety of ways. From the water we use to water crops in the field, to the water in our taps, to the liquids we drink from plastic containers, it can be found virtually anywhere you look. Not only is it everywhere in the environment, but it is also within us. It builds up in our bodies. Plastics have become a major public health concern; researchers estimate that the total healthcare cost related to plastic chemicals may be as much as $250 billion.[1]

Water has always …

Assessment Of Implementation And Enforcement Of Smoke-Free Laws And Policies Among Malaysian Smokers: A Mixed Method Approach, Gan Shiz Yee

Student Works (2020-2029)

Smokefree laws (SFL) and policies could deter smoking by strengthening anti-smoking norms, impacting cessation behaviour due to decreased social acceptability of smoking in public spaces. With socioeconomic status (SES) affecting smoking risk factors, disparities in health outcomes post-SFL implementation are likely. Furthermore, regional and international assessments show Malaysia’s poor performance due to ineffective smoking bans and enforcement. Local studies revealed inadequate SFL implementation and enforcement, leading to high secondhand smoke (SHS) exposure. Understanding these challenges and opportunities is crucial for improving policy implementation and enforcement to enhance public health outcomes. This study examined the association between SFL and quit intention …

Water Fluoridation: The Evidence Behind The Risk Of Fluoride Use, Margherita Fontana D.D.S., Ph.D., Carlos González-Cabezas D.D.S., M.S.D., Ph.D., Livia Tenuta D.D.S., M.Sc., Ph.D.

The Journal of the Michigan Dental Association

The debate surrounding fluoride use for caries control has intensified due to recent events, including a National Toxicology Program (NTP) report and a court ruling mandating EPA action on fluoride levels in tap water.

Despite concerns about fluoride's potential neurodevelopmental impact at high concentrations, current evidence shows no adverse effects at the recommended levels of 0.7 ppm in U.S. community water fluoridation programs. While studies in regions with endemic fluorosis suggest an association between high fluoride exposure and lower IQ, methodological limitations undermine causal conclusions.

Global and U.S. health authorities, including the WHO and ADA, reaffirm the safety and efficacy …

Introduction—Bioethics After Dobbs, James Toomey

Pace Law Review

No abstract provided.

Two Lives, Shruti Trehan Mbbs

Journal of Wellness

A busy oncologist makes a decision to leave her busy, thriving, community practice in the Mid-West and moves to a Veterans Affairs hospital in South Florida in the quest for a better work-life balance.

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …

The Status Of Abortion Care Training For Medical Providers Amidst The Current Abortion Access Crisis: A Literature Review, Leah Johnson

Theses and Graduate Projects

Background: While a common, safe, and essential aspect of reproductive healthcare, abortions have been subject to countless legal restrictions and bans in the United States, especially after the overturn of Roe v. Wade. This has also exacerbated the current shortage of abortion providers. Within this crisis of worsening abortion access, it is imperative to appropriately train future clinicians to provide abortion care. Purpose: This literature review will investigate the status of abortion training in medical schooling. It will explore physician-specific education in abortion and look specifically at the impact of recent legal threats on the availability of this training. Finally, …

How Should We Measure Effectiveness Of Medical-Legal Partnerships?, Prashasti Bhatnagar, Deborah F. Perry, Margaret E. Greer

HJA Scholarship

Medical-legal partnerships (MLPs) try to mitigate health inequity by uniting legal and health professionals to respond to legal determinants of patients’ health. While there is a long tradition of “patients-to-policy” work in MLPs, the current empirical evidence base has evaluated MLP effectiveness by assessing benefits to individual patients, clinicians, and hospital and legal systems. This article calls for future research to measure how community power, which includes shifting power to impacted communities to develop and lead equity-focused agendas, is built as both a process and an outcome of MLPs.

Mda Foundation Mission Of Mercy: Transforming Lives, Relieving Pain, Anne Berquist

The Journal of the Michigan Dental Association

The MDA Foundation's Mission of Mercy (MOM) dental clinic in Flint provided free dental care to 659 patients over June 14-15, delivering 6,678 procedures valued at $1,156,285. The 120-chair clinic, set up by volunteers, saw patients from 35 Michigan counties and neighboring states. Patients, many of whom queued overnight, received an average of ten procedures each. Volunteers, including retired dentists, performed a wide range of services, from cleanings to complex surgeries. Translators were available to assist non-English speakers, and patients were informed about ongoing free or reduced-cost care options. The event, supported by local donations and community services, will continue …