The Historic Role of Boards of Health in Local Innovation: New York City’s Soda Portion Case

Childhood and adult obesity pose major risks for cancer, diabetes, and cardiovascular disease, with the poor and racial minorities suffering from disproportionately high burdens of obesity and chronic disease. With current policies failing, cities and states have moved forward with creative prevention measures–-with boards of health driving policy innovation in many local jurisdictions. The New York City Board of Board of Health’s (NYCBH) soda portion limit pushed the boundaries of innovation, but was struck down on June 26, 2014 by New York State’s highest court, which held that the Board trespassed on the City Council’s authority. The Court’s decision ignored the critical role of local health agencies in responding to 21st century public health threats, including epidemics of obesity and chronic disease. The Court narrowly construed the NYCBH’s authority, characterizing its powers as administrative, and thus potentially stifling local innovation. The decision also obscured the fundamental truth that public health policymaking requires complex trade-offs and incremental action, as well as a multifaceted approach to reducing population weight gain. Policymaking often relies upon limited evidence, and agencies experiment with novel ideas while also transforming social norms and pushing the boundaries of public opinion. Although the portion rule would disproportionately affect disadvantaged individuals who drink the largest amount of soda, government’s failure to act represents a greater injustice. Enhancing opportunities to choose a healthy life path better serves the interests of justice, but the Court’s judgment takes us further away from realizing this social aspiration

Patchy Progress On Obesity Prevention: Emerging Exemplars, Entrenched Barriers, and New Thinking

Although there have been positive pockets of change, no country has yet turned around its obesity epidemic. Preventing an increase in obesity prevalence will require urgent actions from government as well as a broader spectrum of stakeholders than previously emphasized. In this paper, we review a number of regulatory and non-regulatory actions taken around the world to address obesity and discuss some of the reasons for the patchy progress. In addition, we preview the papers in this Lancet series, which each identify priority actions on key obesity issues and challenge some of the entrenched dichotomies that present obesity and its solutions in “either/or” terms. Although obesity is acknowledged as a complex issue, many debates about its causes and solutions are centered around overly simple dichotomies that present seemingly competing perspectives. Examples of such dichotomies explored in this series include: individual versus environmental causes of obesity, personal versus collective responsibilities for actions, supply versus demand explanations for consumption of unhealthy food, government regulation versus industry self-regulation, top down versus bottom up drivers for change, treatment versus prevention priorities, and under versus over nutrition focus. In the current paper, we explore the dichotomy of individual versus environmental drivers of obesity, which lay out two truths: people bear some personal responsibility for their health and environmental factors can readily support or undermine the ability of people to act in their self-interest. We propose a re-framing of obesity that emphasizes the reciprocal nature of the interaction between the environment and individual. Current food environments exploit people’s biological, psychological, social, and economic vulnerabilities, making it easier for them to eat unhealthful foods. This leads to preferences and demands for foods of poor nutritional quality, thus sustaining the unhealthful food environments. Breaking these vicious cycles will need regulatory actions from governments and greater efforts from industry and civil society

If Sugar Is Addictive…What Does It Mean for the Law?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97481/1/jlme.12038.pd

Mobilisation of Public Support for Policy Actions to Prevent Obesity

Public mobilisation is needed to enact obesity prevention policies and to mitigate backlash against their implementation. However, current approaches in public health focus primarily on dialogue between public health professionals and political leaders. Strategies to increase popular demand for obesity prevention policies include refining and streamlining public information, identifying effective frames for each population, enhancing media advocacy, building citizen protest and engagement, and developing a receptive political environment with change agents embedded across organisations and sectors. Long-term support and investment in collaboration among diverse stakeholders to create shared value is also important. Each actor in an expanded coalition for obesity prevention can make specific contributions to engaging, mobilising and coalescing the public. Shifting from a top-down to an integrated bottom-up and top-down approach would require an overhaul of current strategies and re-prioritisation of resources

Constitutional Foundations for Public Health Practice: Key Terms and Principles

This chapter introduces the structure of the government in the United States and the concept of “separation of powers among the federal, state, and local governments. It introduces core legal principles from the U.S. Constitution that frame the authority of the government to enact and enforce laws to protect and promote the public\u27s health. These Constitutional principles are essential for the health advocate and leader to understand because every federal, state, and local law must comply with them. The core principles include the enumerated powers of the federal government and the broad plenary powers of state and local governments—which we call “police powers —to promote and protect the health, safety, and welfare of the population. The chapter explores how these Constitutional principles affect healthy equity and the social determinants of health by analyzing landmark legal decisions that explain how the law ensures basic notions of justice and fairness for all people

Constitutional Foundations for Public Health Practice: Key Terms and Principles

This chapter introduces the structure of the government in the United States and the concept of “separation of powers among the federal, state, and local governments. It introduces core legal principles from the U.S. Constitution that frame the authority of the government to enact and enforce laws to protect and promote the public\u27s health. These Constitutional principles are essential for the health advocate and leader to understand because every federal, state, and local law must comply with them. The core principles include the enumerated powers of the federal government and the broad plenary powers of state and local governments—which we call “police powers —to promote and protect the health, safety, and welfare of the population. The chapter explores how these Constitutional principles affect healthy equity and the social determinants of health by analyzing landmark legal decisions that explain how the law ensures basic notions of justice and fairness for all people

Keynote Address

Marice Ashe and Elsie Hayford jointly delivered a keynote address for the 2021 conference. From the conference program: Marice Ashe is the Founder of ChangeLab Solutions where she served as CEO for nearly 25 years. At ChangeLab Solutions, she pioneered the use of law and policy to solve complex problems related to institutionalized inequities and poor community health outcomes. Leading a staff of 60 lawyers and other public health experts and working in all 50 states, she drove major health equity successes across a broad range of public health challenges. Under her direction, ChangeLab Solutions consulted with leadership from every level of government, health system and community health practice, and created a vast library of “how to” guides and model policies (found at www.changelabsolutions.org) that promote multi-disciplinary partnerships to empower leaders, improve outcomes and save money. Marice is currently a public health law and policy consultant and teaches Public Health Law at the University of California, Berkeley Law. She serves on the national advisory boards for the Center for the Redress of Inequity ThroughCommunity-Engaged Scholarship at the University of Virginia and the Institute for Health Policy and Leadership at Loma Linda University. Marice consults with public health leaders throughout the world. She is a graduate of the University of Notre Dame, and received her advanced degrees in public health and law from the University of California at Berkeley. Elsie Hayford is a Global Health Lawyer, Legal Consultant and Policy Analyst. Elsie is most passionate about using the law as a tool for health systems strengthening to bridge the health equity gap globally. She is also an Adjunct Assistant Lecturer at Accra College of Medicine in Ghana where she teaches Medical Law and Ethics and Global Public Health Law to medical students. Mrs Hayford is the founder of Lamèsè, a global health consulting firm committed to restoring dignity, accountability and tackling injustices in health systems through the use of legal, public health and change management tools. Since the inception of the pandemic, her work has been focused on legal protections for health workers and the legal frameworks that support emergency healthcare delivery globally as a consultant with Vital Strategies, New York. She holds a Bachelor of Laws degree from the University of Liverpool, an Executive Certificate in NGO Management from the Africa Centre for Capacity Building and a Master of Laws with distinction in Global Health Law from Georgetown University in Washington DC, USA where she was also a Global Health Law Scholar and a recipient of the Dean\u27s Award and the CALI Excellence for the Future Award

Keynote Address

Marice Ashe and Elsie Hayford jointly delivered a keynote address for the 2021 conference. From the conference program: Marice Ashe is the Founder of ChangeLab Solutions where she served as CEO for nearly 25 years. At ChangeLab Solutions, she pioneered the use of law and policy to solve complex problems related to institutionalized inequities and poor community health outcomes. Leading a staff of 60 lawyers and other public health experts and working in all 50 states, she drove major health equity successes across a broad range of public health challenges. Under her direction, ChangeLab Solutions consulted with leadership from every level of government, health system and community health practice, and created a vast library of “how to” guides and model policies (found at www.changelabsolutions.org) that promote multi-disciplinary partnerships to empower leaders, improve outcomes and save money. Marice is currently a public health law and policy consultant and teaches Public Health Law at the University of California, Berkeley Law. She serves on the national advisory boards for the Center for the Redress of Inequity ThroughCommunity-Engaged Scholarship at the University of Virginia and the Institute for Health Policy and Leadership at Loma Linda University. Marice consults with public health leaders throughout the world. She is a graduate of the University of Notre Dame, and received her advanced degrees in public health and law from the University of California at Berkeley. Elsie Hayford is a Global Health Lawyer, Legal Consultant and Policy Analyst. Elsie is most passionate about using the law as a tool for health systems strengthening to bridge the health equity gap globally. She is also an Adjunct Assistant Lecturer at Accra College of Medicine in Ghana where she teaches Medical Law and Ethics and Global Public Health Law to medical students. Mrs Hayford is the founder of Lamèsè, a global health consulting firm committed to restoring dignity, accountability and tackling injustices in health systems through the use of legal, public health and change management tools. Since the inception of the pandemic, her work has been focused on legal protections for health workers and the legal frameworks that support emergency healthcare delivery globally as a consultant with Vital Strategies, New York. She holds a Bachelor of Laws degree from the University of Liverpool, an Executive Certificate in NGO Management from the Africa Centre for Capacity Building and a Master of Laws with distinction in Global Health Law from Georgetown University in Washington DC, USA where she was also a Global Health Law Scholar and a recipient of the Dean\u27s Award and the CALI Excellence for the Future Award