By Scott Burris
The main contests (a summary of previous posts):
A lot of people in public health practice seem to be (appropriately) concerned about our public health infrastructure – the agencies within public health systems where day to day work is done. Public health infrastructure tends to get taken for granted and neglected. Core prevention activities, from surveillance to restaurant inspection, easily become invisible. Health agencies become collateral damage in the war on government. Our challenge here is to get noticed and appreciated – and to deserve it by being demonstrably effective, efficient, smart. Legal infrastructure is a meaningful part of this, so there is work for legal academics both in institutional design and in helping health agencies use their legal authority effectively and creatively.
In public health law (and PHLR), most of us tend to be working on legal interventions. Public health work can be pretty straightforward and even popular when it has to do with preventing proximate and substantial harms, and this is true even when the legal intervention involves changing behavior. Law changes norms and expectations, so initial resistance often gives way to acceptance. The fact that sometimes the industry whose profits are implicated can fight back, and even win, defines the hard part of the game – and challenges our field to be more legally and politically effective.
Then there is a third game, in which public health (in a not altogether new or unprecedented way) has concerned itself with the structure of the healthy society, and (perhaps to an unprecedented extent) taken on distal contributors to complex, multi-factoral health threats, case in point obesity. I’m not sure we have an effective game plan for this. But in each case, there are things we are doing poorly – or that we should think about doing better.
Challenges and opportunities: