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Local Public Health Departments and their Authority to Improve Public Health

posted on Fri, Jul 8 2011 9:41 am by Andy Baker-White

Farmer's Market

This July the Public Health Accreditation Board (PHAB) released its PHAB Standards and Measures Version 1.0, a set of revised standards and measures for state and local health departments seeking accreditation. Many of the standards and measures fall under domains based on the 10 Essential Public Health Services. The essential services reflect the core functions of public health, describe activities that should be undertaken by public health agencies and provide a “guiding framework for the responsibilities of local public health systems.”

Public health law plays an important role in the essential services and accreditation standards and measures. For example, under PHAB’s domain 6, “Enforce public health laws,” one of the standards for public health agencies is the review of existing laws and working with governing entities and elected officials to update laws as needed to reflect current scientific knowledge.  This standard is partly measured through the agency’s evaluation of needed changes in the laws, thereby ensuring that the laws reflect current scientific knowledge and evidence-based public health practices.  Public health agencies should also inform governing entities and elected officials of needed changes to public health law and make recommendations for changes. For more information and resources on accreditation, visit the Network’s Web page on Accreditation and Shared Service Delivery.

Unfortunately, local public health agencies continue to lose their ability to enforce public health laws and regulations. For example, in the area of obesity prevention, one of the CDC’s Winnable Battles, local public health in Ohio recently faced setbacks through state preemption.

On June 30, 2011, Ohio’s governor signed the state’s budget bill and limited the legal tools local public health can use to address obesity, including restrictions on restaurant toy giveaways and the use of trans fats in cooking. Some local jurisdictions, such as Santa Clara County, California, require meals that come with toys to meet certain nutrition levels. Others, including New York City and Philadelphia, are addressing obesity by restricting restaurants’ use of cooking oils with trans fats. Local jurisdictions in Ohio are now unable to utilize these techniques and strategies.

The new Ohio law prohibits cities, towns and counties from “[e]nacting, adopting, or continuing in effect local legislation relating to the provision or nonprovision of . . . consumer incentive items” (i.e., toys, games, etc.) at restaurants. Local jurisdictions are barred from adopting laws regulating restaurants that are characterized as fast food restaurants. The new law also prohibits towns and counties from regulating restaurant operations “based on the existence or nonexistence of food-based health disparities.” Local public health in Ohio is not alone, as there is a trend in such laws being passed across the country.

Limiting the authority of local public health agencies and local governments to address public health issues through innovative legal approaches not only restricts one of public health’s essential services, such restrictions also limit our ability to discover which laws work and which ones don’t.

This information was developed by Andy Baker-White, assistant director for the Network for Public Health Law – Mid-States Region at the University of Michigan School of Public Health.

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 does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.

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