Civil rights march on Washington, D.C. Film negative by photographer Warren K. Leffler, 1963. From the U.S. News & World Report Collection. Library of Congress Prints & Photographs Division. Photograph shows a procession of African Americans carrying signs for equal rights, integrated schools, decent housing, and an end to bias. https://www.loc.gov/item/2003654393/

Structural Racism: The Root Cause of the Social Determinants of Health

By Ruqaiijah Yearby, J.D., M.P.H.

In 1906, W.E.B. DuBois noted that social conditions, not genetics, impacted the health of Blacks, causing racial disparities in mortality rates. In 2010, the federal government formally recognized that social conditions, specifically the social determinants of health (SDOH), were responsible for racial health disparities.

Racial health disparities, estimated to cost the United States $175 billion in lost life years and $135 billion per year in excess health care costs and untapped productivity, persist because of the failure to address their root cause: structural racism.

Structural racism describes the way our systems are structured to produce racial inequalities between whites and racial and ethnic minorities in the SDOH, leading to racial health disparities.

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Close-up Of Doctor's Hand Measuring Blood Pressure Of Male Patient.

Understanding the Role of Race in Health: A New Digital Symposium

By Craig Konnoth

In the 1980s, a vanguard of critical race theorists debated their contemporaries as to whether law could or should play a role in achieving equity — in particular, racial equity. Scholars such as Kimberlé Crenshaw and Patricia Williams argued that while legal discourse historically had been used to oppress Black, Indigenous, and people of color (BIPOC), history had shown that in the law also lay the seeds of empowerment. Conceptualizing BIPOC as persons endowed with legal rights, and as a community subject to heightened legal solicitude because of the historical injustices they have faced, has helped undergird their selfhood, dignity, identity and activism. Law could thus be a discourse of despair — but also one of hope.

Whether or not the years have proved those claims correct as to the law, today, a similar debate unfolds in the context of race, medicine, and health care. Today, medicine and the health care system embody discourses of power that rival the law. Will these discourses inevitably serve to oppress BIPOC — and if not, how can we harness their power to achieve justice? Those are the questions that this symposium seeks to answer.

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alcatraz, san francisco

The COVID-19 Pandemic and Efforts to Release People in Custody

By Phebe Hong

The first death of a federal inmate from COVID-19 occurred on March 28, at a prison in Oakdale, Louisiana. The inmate had been incarcerated for 13 years for a nonviolent drug charge. At least four other infected inmates have died at the same institution.

The COVID-19 pandemic is wreaking havoc on prisons and jails, where proper social distancing is nearly impossible to maintain.

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Pile of colorful pills in blister packs

Promises and Perils of Prescription Drug Monitoring Programs: Workshop Report

This piece was part of a symposium featuring commentary from participants in the Center for Health Policy and Law’s annual conference, Promises and Perils of Emerging Health Innovations, held on April 11-12, 2019 at Northeastern University School of Law. The symposium was originally posted through the Northeastern University Law Review Online Forum.

Promises and Perils of Emerging Health Innovations Blog Symposium

We are pleased to present this symposium featuring commentary from participants in the Center for Health Policy and Law’s annual conference, Promises and Perils of Emerging Health Innovations, held on April 11-12, 2019 at Northeastern University School of Law. As a note, additional detailed analyses of issues discussed during the conference will be published in the upcoming Winter Issue of the Northeastern University Law Review.

Throughout the two-day conference, speakers and attendees discussed how innovations, including artificial intelligence, robotics, mobile technology, gene therapies, pharmaceuticals, big data analytics, tele- and virtual health care delivery, and new models of delivery, such as accountable care organizations (ACOs), retail clinics, and medical-legal partnerships (MLPs), have entered and changed the healthcare market. More dramatic innovations and market disruptions are likely in the years to come. These new technologies and market disruptions offer immense promise to advance health care quality and efficiency, as well as improve provider and patient engagement. Success will depend, however, on careful consideration of potential perils and well-planned interventions to ensure new methods ultimately further, rather than diminish, the health of patients, especially those who are the most vulnerable.

In the final post of the Promises and Perils of Emerging Health Innovations blog symposium, Leo Beletsky and the team from Health in Justice Action Lab provide a summary of an event held in conjunction with the Center for Health Policy and Law’s 2019 annual health law conference. The Promises and Perils of Prescription Drug Monitoring Programs (PDMPs) workshop was held on April 13, 2019 and convened experts, practitioners, experts, and other stakeholders to brainstorm strategies with the goal to “maximize the benefits of PDMPs, while minimizing harms.” Visit the Health in Justice Action Lab website (linked below) for information on this and other projects underway. 

Promises and Perils of Prescription Drug Monitoring Programs: Workshop Report

By Health in Justice Action Lab

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gavel.

Denying the Insanity Defense: A Repudiation of Science and Justice

By Laura Karas

The Supreme Court this term faces a difficult question: Is it unconstitutional for a state to abolish the insanity defense? In the case before the court, Kahler v. Kansas, a plaintiff who suffered from multiple psychiatric disorders, including severe depression, shot and killed his wife, two daughters, and mother-in-law. He was denied the opportunity to present an insanity defense under Kansas law and was sentenced to death. Kansas is one of four states to have abolished the insanity defense, along with Idaho, Montana, and Utah.

The insanity defense in its modern form contains two prongs. First, a person is not responsible for his criminal conduct if he could not “conform his conduct” to the requirements of the law due to mental illness. This prong is sometimes referred to as the volitional prong of the insanity defense. Second, a person is not responsible for his criminal conduct if, due to mental illness, he could not appreciate the wrongfulness of his actions. Since the 1980s, many states have rejected the volitional prong of the insanity defense, and some states, such as Kansas, have gone so far as to abolish the insanity defense entirely. Read More

U.S. Supreme Court building

Health Law Cases in the Upcoming Supreme Court Term

By Alexa Richardson

The next Supreme Court term is shaping up to include a number of critical cases that will impact health law. From insurance, the Affordable Care Act, abortion access, and mental health, the decisions made this term could have significant impacts on public health moving forward. Here are some of the key health law cases upcoming this term to keep an eye on:

June Medical Services, LLC v. Gee

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Photo of a stethoscope, gavel, and book

Court Upholds Manslaughter Charge of Pregnant Mother For Death of Her Baby

By Alexa Richardson

A woman whose hours-old baby was dying admitted to her care providers that she had abused prescription and over-the-counter medications shortly before the birth. This summer, in United States v. Flute, 929 F.3d 584 (2019), the Eighth Circuit held that she could be charged with federal manslaughter for the death of her baby. While some states have charged pregnant people with manslaughter for drug use during pregnancy, Flute marks the first time that federal prosecutors have brought such charges. The decision, which reversed the district court decision dismissing the charge, opens the door for pregnant people to be criminally charged for a wide range of prenatal conduct — should it result in the baby’s death after birth — such as driving recklessly, receiving chemotherapy treatment during pregnancy, failing to obtain adequate prenatal care, or declining a medical recommendation.

Samantha Flute, an American Indian woman, gave birth at a Sisseton, South Dakota hospital on August 19, 2016. She told the medical staff that she had ingested Lorazepam, hydrocodone (possibly laced with cocaine), and cough syrup before coming to the hospital. Four hours after birth, Baby Boy Flute died. The autopsy revealed a full-term baby with no anatomical cause of death, and the pathologist determined the death to be the result of drug toxicity from the substances ingested prenatally by Flute.

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Call for Proposals: Addressing the Health Care Needs of Justice-Involved Populations

The Beazley Institute for Health Law and Policy at Loyola University Chicago School of Law and Annals of Health Law & Life Sciences invite original submissions for presentations at our Thirteenth Annual Health Law Symposium: Addressing the Health Care Needs of Justice-Involved Populations. The Symposium will take place at Loyola University Chicago School of Law on Friday, November 15, 2019 beginning at 9:00am.

The Symposium will explore legal barriers that justice-involved populations face in accessing health care, and address how those barriers can be alleviated. “Justice-involved populations” generally refers to individuals who are incarcerated in prisons, jails, immigrant detention centers, juvenile detention centers, on probation, or individuals who are otherwise involved with the U.S. justice system. Read More

Image of a man spurting out water from his mouth

Spitting at Science: The Unjustified Criminalization of Spitting While HIV-Positive

Saliva doesn’t transmit HIV. And no one has ever become HIV-positive because an HIV-positive person spit on them.

Yet a number of states, including Louisiana, Mississippi, Missouri, Nebraska, Ohio, Oklahoma, Pennsylvania, and Texas, either have laws that explicitly criminalize the act of spitting specifically if one is HIV-positive or in recent years have used the criminal law to prosecute and convict the act of spitting by an HIV-positive person. Read More

Image of the backs of two police officers

Security and Health: Police as Key Players in Public Health

For more than a decade, a variety of scholars and practitioners in public health, policing and the broader domain of security have been stoking a conversation about the links between their disciplines and the need to do a better job integrating the disciplines and practices.

This week, The Lancet published a special series on Security and Health. A global set of authors, myself included, make the case that military and police forces should be recognized as key players, rather than intruders, in public health, and therefore we need these relationships to be backed by investment in partnerships and reform. Take a look. You may even be inspired to put the next global Law Enforcement and Public Health Conference on your agenda, set for Edinburgh in October.