Category: Social Determinants of Health

Suboxone.

Five Opportunities to Use the Law to Address Persistent OUD Treatment Gaps 

Temple University Center for Public Health Law Research Leave a comment

By Jon Larsen and Sterling Johnson

People who need opioid use (OUD) treatment in the United States are often not receiving it — at least two million people with OUD are experiencing a treatment gap that prevents or hampers their ability to receive life-saving care and support. This reality reflects structural, policy, and legal misalignments common to the entire U.S. health care system, but that are especially present for behavioral health needs like substance use, and are exacerbated by other challenges related to stigma, lack of employment, and fragmented or nonexistent care coordination.  

With support from the Foundation for Opioid Response Efforts (FORE), public health law experts from Indiana University McKinney School of Law and the Temple University Center for Public Health Law Research at the Beasley School of Law recently embarked on a systematic review of U.S. drug policy using a whole-of-government (W-G) approach to assess where these misalignments are occurring among different agencies at the same level of government (referred to as horizontal W-G), and across different levels of government (referred to as vertical W-G). It ultimately provides a tool to address these misalignments directly. 

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City with trash in foreground and smokestacks producing smog in background.

The Privatization of Cancer

Daniel G. Aaron 2 Comments

By Daniel G. Aaron

Cancer is fearsome, unstoppable even. So the story goes. Yes, you can secure some extra time with loved ones, and — if you are lucky —  maybe your cancer is susceptible to drugs or surgery. But for most people, cancer sounds like a death sentence. The proper response is to throw drugs and radiation at it.

Cancer seems so unstoppable that many have started rifling through their cosmetic products and foods to eliminate all possible carcinogens. Despite the fact we have regulatory regimes to ensure our food, makeup, the air, and drinking water are free of carcinogens, people don’t trust them. There is an intuitive sense that products are not well regulated, leaving individuals to moderate their own cancer risk. In fact, the majority of Americans do not hold strong trust in our health agencies like FDA and CDC.

In my forthcoming article, I argue that our cancer regulatory regimes inadequately protect the public. I believe deregulation is one form of the “privatization of cancer.”

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AUSTIN, TEXAS, UNITED STATES - October 23, 2022: Shaquille O'Neal at round 19 of the 2022 FIA Formula 1 championship taking place at the Circuit of the Americas in Austin, Texas United States.

Shaq, Entrepreneurship, and Social Determinants of Health

Bobby Stroup Leave a comment

By Bobby Stroup 

If advocates working to address health disparities want to overcome seemingly insurmountable obstacles, perhaps they should adopt the mindset of people who do that on a daily basis: entrepreneurs.

Applying the entrepreneurial spirit to advocacy around the social determinants of health (SDOH) sounds like a potentially beneficial way to further the cause. But can we manufacture that attitude through public policy? Law is a tool we use to protect fundamental rights and empower social progress. But does that mean we should use it to make people care about SDOH innovation?

In this article, I will consider potential law and policy-based approaches to promoting entrepreneurial innovation in the realm of health equity. Read More

U.S. Supreme Court

Context Matters: Affirmative Action, Public Health, and the Use of Population-Level Data

wparmet Leave a comment

By Wendy E. Parmet, Elaine Marshall & Alisa K. Lincoln

Last June, in Students for Fair Admissions (SFFA), the Supreme Court ruled that universities could not consider race in admitting students. In support of that decision, the Court dismissed the relevance of data about the varied experiences of racial groups, insisting that admissions decisions must be based solely on the experiences and merits of individual applicants. The Court’s rejection of group-level data evinces a critical misunderstanding about the uses and limits of such data that, if applied more broadly, portends troubling implications for health equity and health policy.

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Wooden blocks with symbol of social equality concept on blue background.

Building a Disability Organization Rooted in Disability Justice

The Petrie-Flom Center Staff Leave a comment

By Dom Kelly

There’s a lot to say about the nonprofit sector and how it so often burns out, underpays, and devalues the humans who do the labor. There’s a pervasive narrative that this should just be accepted as a cost of doing good in the world. But for marginalized people who find themselves in this work for reasons that are connected to their identities, this kind of thinking ultimately pushes us out of the sector altogether.

Disability organizations are no exception to this.

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Health visitor and a senior woman during home visit.

Caring for Patients with Serious Illness: Insights from Kristofer Smith

The Petrie-Flom Center Staff Leave a comment

Kristofer Smith, MD, MPP is the Chief Medical Officer of Landmark Heath, where he oversees efforts to establish a high-quality and clinically effective home-based medical care model for patients with serious illness.

We sat down with Dr. Smith to discuss his experience caring for patients with serious illness and developing programs to provide health care at home, among other topics. The following interview has been edited and condensed. Read More

Cover image of Ashley Shew's book, Against Technoableism.

Symposium Introduction: Addressing Technoableism: Reforming Infrastructure and Disability Representation

The Petrie-Flom Center Staff Leave a comment

By Ashley Shew

Far too often, when people write and talk about technology and disability, stories are deeply shaped by ableism. Often when devices are painted as “solving the problem of disability” or “empowering disabled people,” they suggest that being disabled is itself a problem, and that people should try to be as nondisabled as possible. But pretending to be nondisabled is not a great way to live — to be in hiding or denial, to not give your body and mind the rest they deserve, to hurt yourself trying to live up to expectations and infrastructure sometimes literally designed to keep you out. Technology itself gets painted as heroic and important — and, please, investors, throw more money at the tech industry — when any disability is mentioned. Disability is often appealed to as a justification for technological development, and as a moral imperative toward investment in technological research. This is technoableism as I describe it in my book, Against Technoableism: Rethinking Who Needs Improvement. 

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Large and diverse group of people seen from above gathered together in the shape of two intersecting circles.

An Intersectional Analysis of Proposed Fertility Leave in England and Wales

The Petrie-Flom Center Staff Leave a comment

By Elizabeth Chloe Romanis and Sabrina Germain

For people in England and Wales needing access to fertility treatment, economic barriers can be a huge hurdle. There are the direct costs of the treatment (some, but not all, of which are covered by the National Health Service). But there are also the less visible indirect costs associated with accessing these treatments. These include needing time off work to attend appointments, funding travel to and from fertility clinics, and having access to spaces at work to store and administer medication and take private phone calls. Indirect costs limit access to fertility treatment for structurally disadvantaged individuals in England and Wales. It is for this reason that a Private Member’s Bill currently being debated in the House of Commons, the Fertility Treatment (Employment Rights) Bill, which seeks to introduce fertility leave in the UK, should be welcomed (see earlier posts in this symposium by Dafni Lima and Manna Mostaghim).

Introducing a formal entitlement to “allow employees to take time off from work for appointments for fertility treatment; and for connected purposes” is a step in the right direction. We offer an intersectional reading of the Fertility Treatment (Employment Rights) Bill and consider how the benefits offered are likely to be stratified along class, race, sexuality, and gender lines. The Bill is well-meaning and highlights the critical issue of indirect barriers to fertility treatment in the workplace, but it is inattentive to structural issues affecting marginalized people experiencing infertility.

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figurine with a void shape of a child and family of parents with a child. Surrogacy concept.

Forced Gifting: English Surrogacy, Gestational Labor, and the Inequality of Choice

The Petrie-Flom Center Staff Leave a comment

By Lucas Taylor

Surrogacy, the practice in which one party (the surrogate) gestates a fetus on behalf of another pair/person (the intended parent/s or IPs), has sparked academic debates regarding gender equality and bodily integrity in the face of both commercial and altruistic agreements. I re-engage with this topic by challenging how the capacity of the surrogate to choose may be restricted under English and Welsh law. This post does not seek to argue against the practice of altruistic surrogacy. Instead, it seeks to highlight, through the lens of Social Reproduction Theory, that central to the legal framework is a highly gendered devaluation of labor which undermines the potential for surrogates to fully exercise choice in relation to their gestational labor.

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