Public Health Law Program, Center for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention, Atlanta, Georgia.
J Public Health Manag Pract. 2022;28(Suppl 1):S27-S37. doi: 10.1097/PHH.0000000000001444.
This article outlines a pathway for public health departments and practitioners to incorporate law into their efforts to advance equity in health outcomes. We assert that examining and applying law can accelerate public health efforts to mitigate structural and systemic inequities, including racism. Recent events such as the COVID-19 pandemic and the community impacts of policing have brought into sharp relief the inequities faced by many populations. These stark and explosive examples arise out of long-standing, persistent, and sometimes hidden structural and systemic inequities that are difficult to trace because they are embedded in laws and accompanying policies and practices. We emphasize this point with a case study involving a small, majority Black community in semirural Appalachia that spent almost 50 years attempting to gain access to the local public water system, despite being surrounded by water lines. We suggest that public health practitioners have a role to play in addressing these kinds of public health problems, which are so clearly tied to the ways laws and policies are developed and executed. We further suggest that public health practitioners, invoking the 10 Essential Public Health Services, can employ law as a tool to increase their capacity to craft and implement evidence-based interventions.
本文概述了公共卫生部门和从业人员将法律纳入其工作以促进健康结果公平的途径。我们断言，审查和应用法律可以加速公共卫生部门努力减轻包括种族主义在内的结构性和系统性不平等。最近发生的事件，如 COVID-19 大流行和警察对社区的影响，使许多人群面临的不平等现象变得明显。这些鲜明而引人注目的例子源于长期存在、持续存在且有时隐藏的结构性和系统性不平等，这些不平等难以追踪，因为它们嵌入在法律以及相关政策和实践中。我们通过一个涉及阿巴拉契亚半农村地区一个黑人占多数的小型社区的案例研究强调了这一点，该社区近 50 年来一直试图接入当地公共供水系统，尽管周围都是水管。我们认为，公共卫生从业人员在解决这些明显与法律和政策制定和执行方式相关的公共卫生问题方面可以发挥作用。我们还进一步建议，公共卫生从业人员可以援引 10 项基本公共卫生服务，将法律作为一种工具，来提高制定和实施基于证据的干预措施的能力。
