hand reaching for blue pills

Author Q&A: Reducing High-Dose Opioid Prescribing

Sara Heins, PhD
Sara Heins, PhD, Associate Policy Researcher, RAND Corporation

From 1999 to 2017, almost 218,000 people died in the United States from overdoses related to prescription opioids. Overdose deaths involving prescription opioids were five times higher in 2017 than in 1999, according to the CDC.

Previous research has indicated that patients who receive higher doses of prescription opioids have an increased risk of overdose and mortality. In response, several states have established Morphine Equivalent Daily Dose (MEDD) thresholds that convert opioid prescriptions to their equivalent dose in morphine and divides the total prescription by the number of days the prescription is intended to last, allowing for comparison among different opioid formulations and strengths. MEDD policies set thresholds for prescribers, which may only be exceeded in limited circumstances, such as when being prescribed to certain patient groups or as short-courses.

Sara Heins, PhD, an associate policy researcher at RAND Corporation, used policy surveillance to track MEDD policies through June 1, 2017 (data are available on LawAtlas.org). She published an article in Pain Medicine on March 13 that describes U.S. MEDD policies.

We asked Dr. Heins a few questions about her work and this recent publication. Read More

Author Q&A: “Association between State Minimum Wages and Suicide Rates in the U.S.”

Alex Gertner, BA
Alex Gertner,  University of North Carolina at Chapel Hill

As the suicide rate increases across the United States, researchers at the UNC Gillings School of Global Public Health approached the issue by considering the financial anxiety caused by low wages. Alex Gertner, Jason Rotter, and Paul Shafer used the LawAtlas minimum wage dataset to explore the associations between state minimum wages and suicide rates in the United States.

Their study was published in the American Journal of Preventive Medicine on March 21, 2019.

Temple University Center for Public Health Law Research spoke with Mr. Gertner about their study.

 

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Heatmap of the the U.S. from the Opportunity Atlas website

Opportunity Atlas Creates Opportunities for Legal Epidemiology

By Amy Cook

Public health experts know that the social determinants of health—the environments in which we live, work, learn, and play—all have important effects on our health and well-being. As further evidence of this, in October 2018, researchers from Opportunity Insights collaborated with the Census Bureau to unveil the Opportunity Atlas, an interactive tool tracking data from more than 20 million Americans from childhood through their mid-30s, across each of the country’s 70,000 census tracts. The Opportunity Atlas gives us crucial insight into the level of geography that can impact adult outcomes: beyond the state and city, the neighborhood matters, sometimes tremendously. Read More

Abortion rights protest following the Supreme Court decision for Whole Women's Health in 2016

Louisiana TRAP Law Challenge Could Leave Thousands of Women without Abortion Access

By Adrienne Ghorashi

UPDATE: Late Thursday, February 7, the Supreme Court granted Plaintiff’s stay application, meaning Louisiana’s TRAP law may not be enforced while the challengers file an appeal. The Supreme Court will then decide whether to hear the case or deny the petition, letting the Fifth Circuit’s ruling stand.

Justice Roberts sided with the Court’s liberal justices to grant the stay, while Justices Alito, Thomas, Gorsuch, and Kavanaugh would deny it. Kavanaugh also wrote a dissent, saying he would want to see the law go into effect before deciding whether the stay was necessary.

Although this is only a temporary win for the women of Louisiana, these actions could be a sign that a majority of justices have their doubts as to the law’s constitutionality in light of Whole Woman’s Health.

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Pennsylvania Not Alone in Denying Abortion Coverage for Low-Income Women

By Adrienne Ghorashi

Last week, a lawsuit was filed challenging Pennsylvania’s decades-old statute restricting the use of state Medicaid funding to pay for abortion services. The lawsuit, brought by a group of abortion providers in the state, claims the restriction discriminates against low-income women on the basis of sex, in violation of the Pennsylvania Constitution. Read More

Seeking out global patient safety research

By John Tingle

Unsafe health care is a problem of global proportions .The remedies and solutions to many patient safety problems are unlikely to be found in just one countries health care system. Health is one of the world’s great generics, it transcends countries borders, we are all dealing with the health of human beings which is the common denominator. Whilst country contexts may change the subject matter, the patient, remains constant. WHO state:

“Ensuring the safety of patients is a high visibility issue for those delivering health care – not just in any single country, but worldwide. The safety of health care is now a major global concern. Services that are unsafe and of low quality lead to diminished health outcomes and even to harm. The experience of countries that are heavily engaged in national efforts clearly demonstrates that, although health systems differ from country to country, many threats to patient safety have similar causes and often similar solutions (p.1).

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Cottage Food and Food Freedom Laws – New LawAtlas data

The newest map on LawAtlas.org analyzes state laws governing the production, sale, and regulation of cottage food operations.

Typically, commercial food production is required to take place in certified commercial kitchens that are heavily regulated. Cottage foods laws regulate the production and sale of certain foods (foods less likely to cause foodborne illness, such as jams and baked goods) made in home kitchens, rather than a licensed commercial kitchen, and a person’s ability sell them in venues like farm stands or retail stores. Similar state laws, called “food freedom laws,” expand upon cottage food laws to include potentially hazardous products like meat and poultry.

These laws are quickly becoming an increasing area of debate at the state level.  Part of this debate centers on the economic rights of “small-batch” home bakers and cooks versus public health and safety concerns. These private bakers, canners, and cooks want the liberty to sell their products to consumers free from the onerous licensing requirements required of their larger commercial counterparts, restaurants and food processing plants, are subject to.  At the same time, there is concern that this individual economic interest is riding roughshod over existing regulations designed to protect consumers from foodborne illnesses that can be caused by improperly prepared foods.

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Maps Outlining State Fair Housing Laws, State Landlord-Tenant Laws, and City Nuisance Property Laws are Now Available on LawAtlas

Three new datasets covering housing related laws were published today on LawAtlas.org, the Center for Public Health Research website dedicated to empirical legal datasets. The three datasets are:

Each dataset is publicly available. You can explore the data using the site’s mapping tool that allows you to explore the elements of the law across jurisdictions or download the data as an excel spreadsheet without any cost. Each dataset is accompanied by a codebook, a research protocol, and a summary report.

State Fair Housing Protections

The federal Fair Housing Act, passed as part of the Civil Rights Act of 1968, prohibits discrimination in housing-related transactions for individuals who are members of a protected class — these include race, color, national origin, religion, sex, familial status, and disability. Forty-nine states and D.C. have adopted their own fair housing laws to expand upon these federal protections, such as prohibiting discrimination based on an individual’s sexual orientation, gender identity, or source of income. These laws regulate which protected classes are included, the types of discriminatory actions that are prohibited, and when discrimination is exempt under the law.

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Civil Commitment and the Opioid Epidemic: A Call for Research

By Scott Burris, JD

There is a lot of interest in civil commitment these days, as a possible tool to fight two big health problems. As we continue to watch the rates of opioid-related deaths climb, and in the wake of an unfunded emergency declaration by President Trump, some policymakers are looking to involuntarily commit overdose survivors for drug treatment. On the gun violence side, experts like Jeffrey Swanson have argued for applying gun-access restrictions that now cover people subject to long-term civil commitment to those subjected to short-term civil commitment.

With those kinds of ideas in the air, it is important to recognize how little modern data we have on commitment and its effects. In a recent article in the Washington Post discussing commitment for opioid treatment, Michael Stein and Paul Christopher emphasize how little we know. I entirely agree on the need for more research, and offer a couple of things to help.

The first is the Policy Surveillance Program’s LawAtlas dataset that maps civil commitment laws across all 50 states and the District of Columbia. If we’re going to examine these laws and their impact, this is the place to start. We also put out the call to anyone interested in studying this to work with us not only to update this data through 2017, but also to make sure we’re mining these laws and their characteristics for the right information in these circumstances — Are we asking the right questions? Read More

States Tackle Youth Sports Concussions – New Data!

By Benjamin Hartung, JD, Joshua Waimberg, JD, and Nicolas Wilhelm, JD

While brain injuries and studies associated with professional football get the majority of media attention, student athletes, especially young football and soccer players, are also at risk for similar brain injuries. Each year, as many as 300,000 young people suffer from traumatic brain injuries (TBIs), more commonly known as concussions, from playing sports.

State governments have responded to the problem of brain injuries in youth sports by adopting laws aimed at reducing the harm that comes from injuries that occur during team practices or events. Delaware was the first state to pass a regulation relating to youth TBIs in 2008, with Washington State following shortly after in 2009. In the years since, all states have passed youth TBI laws, many modeled after the Washington law, that mandate when student athletes are to be removed from the field, how parents should be notified in the event of a concussion, what training is required of athletic coaches, when a student athlete may “return-to-play,” and who may allow this return to the field. Read More