A Growing Body of Evidence can Help Make the Case for Public Health Laws to Mitigate the Impacts of COVID-19
January 27, 2022
It’s a cornerstone of public health law that laws created and implemented to protect the public’s health should be grounded in evidence and expertise. That principle has not been honored consistently during the COVID-19 pandemic. Nonetheless, a growing body of evidence demonstrates how certain public health interventions backed by law have been associated with improved health outcomes during the COVID-19 pandemic. As early as the spring and summer of 2020, a published report assessed some of the first community mitigation measures instituted to attempt to address COVID-19 in the United States, and a much-cited study compared COVID case rates in states with orders requiring members of the general public or certain employees to wear masks with states that had no masking requirements. Now, with the omicron variant of the novel coronavirus racing through the U.S. in the opening weeks of 2022 and legislatures in many states beginning their 2022 sessions, many public health officials and policy-makers are hungry for up-to-date analysis as public health knowledge and policy implementation have evolved.
Public health practitioners and attorneys need to know how to find, interpret, and talk about the latest evidence, including legal epidemiology. Legal epidemiology encompasses more than evidence about the effectiveness of face masks, vaccinations, restrictions on gatherings, and related measures in slowing the spread of infectious disease. It is rigorous, scientific analysis of the effectiveness of public health measures when required or encouraged by law. It also encompasses assessments of the impact of legal measures to address the social and economic effects of the pandemic, including both how law can exacerbate racial disparities and how law can provide support for compliance with related public health interventions and increase equity. By carefully crafting questions about key aspects of laws and policies and collecting and coding the answers across state or local jurisdictions, legal epidemiology can enable more nuanced comparisons of legal approaches and their associated health outcomes. In the context of the COVID-19 pandemic, legal epidemiology can also contribute to powerful messages about public health interventions such as school mask mandates and prohibitions of on-site dining in restaurants.
Those seeking publicly available legal datasets and surveys related to COVID-19 may find the following sources helpful:
Legal Datasets and Surveys
- State-Issued Prevention Measures at the State Level (CDC)
- State Issued Prevention Measures at the County Level (CDC)
- COVID-19 State Legislation Database (National Conference of State Legislatures)
- COVID-19 U.S. State Policies (Boston University School of Public Health)
- Sentinel Surveillance of Emerging Laws Limiting Public Health Emergency Orders (Law Atlas, Center for Public Health Law Research, Temple University Beasley School of Law)
- Lyu W, Wehby GL. Community use of face masks and COVID-19: evidence from a natural experiment of state mandates in the US. Health Affairs (June 16, 2020)., (See Online Appendix, The Signing and Effective Dates of State Orders For Face Mask Use for Public and Employees
- State COVID-19 Data and Policy Actions (Kaiser Family Foundation)
- COVID-19 Government Response Tracker (Oxford University, Blavatnik School of Government)
- ASTHO and the Big Cities Health Coalition compared implementation of 3 nonpharmaceutical interventions ( shelter in place orders, gathering restrictions, and mask mandates ) in states and large cities in the initial months of the pandemic
There isn’t space here to highlight every relevant assessment of legal responses to COVID-19, but online repositories where relevant research and analysis may be found include the following:
Legal Epidemiology and Public Health Evidence
- The CDC’s COVID-19 Publications Database includes over 1000 scientific articles and publications from the last 2 years. It is updated regularly and searchable by keyword and author name. Articles published in the CDC’s Morbidity and Mortality Weekly Report (MMWR) are included in the database.
- The Infectious Disease Society (IDS) has a Real Time COVID-19 Learning Network which has compiled relevant literature on a variety of topics, including Masks for the Public.
- Johns Hopkins University Bloomberg School of Public Health has compiled a Novel Coronavirus Research Compendium, and sends weekly updates on high quality and/or controversial studies.
- A team of researchers at Boston University has created a publicly available dataset of COVID-19 U.S. State Policies, and has collected research examining the outcomes of COVID-19 Prevention Policies, Economic Precarity Policies, and Policies Intended to Shape a Healthier and More Equitable Future.
Just as no single public health intervention has proven to be a silver bullet against COVID-19, evidence of improved outcomes associated with certain public health legal interventions is not likely to carry the day by itself. But funding and conducting more legal epidemiological research as part of an overall research agenda and incorporating the findings into policy discussions and public health communications should be one piece of the puzzle.
This post was developed by Jill Krueger, J.D., Region Director, Network for Public Health Law – Northern Region Office.
The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document do not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.
Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not represent the views of (and should not be attributed to) RWJF.