PHAI Online - The Public Health Advocacy Institute
Archive for the ‘Publications’ Category
PHAI Attorney and Noted Univ of IL Economist Look at Applying Tobacco Taxation and Other Pricing Strategies to Reduce Obesity
Wednesday, March 31st, 2010
University of Illinois, Chicago Economist, Frank J. Chaloupka, and PHAI Senior Staff Attorney, Patricia A. Davidson, have published an article commissioned by the Tobacco Control Legal Consortium that explores the applicability of tobacco control taxation and pricing strategies to obesity prevention. Key points include:
- Tobacco consumption responds to price changes. Higher taxes reduce consumption and prevalence, especially among youth and the poor. Higher taxes also raise government revenue that may be dedicated to tobacco control or other public health initiatives.
- Most tax increases are justified on policy and economic grounds.
- The legality of tax increases is not generally a significant issue, unlike restrictions on advertising and marketing, which often spark First Amendment commercial speech debates.
- The tobacco industry, concerned with long-term profitability, has responded to tax increases with a variety of discounting practices. Tobacco control advocates could respond more aggressively to this strategy by adopting laws to restrict discount tools, such as coupons, multi-pack discounts, and other price discounts, including removing their protection under minimum pricing laws. Although the industry may argue that limits on discounts raise First Amendment issues, this argument should not be persuasive because laws pertaining to pricing and discount practices do not implicate the commercial speech doctrine. Such laws only need to be rationally related to a legitimate public health purpose (e.g., reducing consumption) to withstand a court challenge.
- Proposed taxes on sugar-sweetened beverages raise many of the same policy and legal issues as tobacco taxes. The food industry’s arguments against them are also similar to those of the tobacco industry. Tax increases, as well as any laws limiting industry discounting practices, do not implicate the First Amendment and are legally defensible as reasonable measures to reduce consumption.
- Higher taxes on sugar-sweetened beverages, at least as a first step, may currently be more politically palatable and justifiable than a potentially difficult to define and administer tax on snack foods.
- The successful strategy of dedicating a portion of tax increases to public health programs, including subsidies for healthier options, should be part of the legal policy model for taxing sugar-sweetened beverages or snack foods.
PHAI Publishes Case Study Examining Litigation Surrounding Atlantic City’s Needle Exchange Ordinace
Monday, March 29th, 2010
- PHAI Publishes Case Study Examining Litigation Surrounding Atlantic City’s Needle Exchange Ordinace (pdf)
PHAI documented Atlantic City’s 2004 passage an ordinance establishing a municipal needle exchange program. Atlantic City faced an HIV/AIDS public health crisis with one in forty residents infected and sixty percent of infections related to injection drug use.
The Atlantic City Department of Health and Human Services (“DHHS”), working in conjunction with Drug Policy Alliance of New Jersey (“DPA-NJ”), proposed a municipal needle exchange ordinance after the state legislature repeatedly failed to enact needle exchange legislation. The DHHS informed the Atlantic County Prosecutor and law enforcement of the proposed ordinance. The County Prosecutor told DHHS and the press that he believed the ordinance violated New Jersey’s criminal drug paraphernalia laws.
After consulting DPA-NJ, and with full support of the Mayor of Atlantic City and the head of the City Council, the ordinance was formally proposed and passed into law. The Atlantic County Prosecutor immediately filed suit to enjoin implementation of the ordinance, and the law was overturned in court. Despite the invalidation of the ordinance, Atlantic City’s bold action to address its public health crisis focused media attention on the HIV/AIDS issue and generated the political will necessary to successfully enact state-level needle exchange legislation in 2006.
- Funded by the Robert Wood Johnson Foundation’s Public Health Practice & Policy Solutions, PHAI used case study research methodology to investigate threats of litigation made during the proposal and passage of public health laws. The case studies examine this experience across a range of public health issues. Public health officials, attorneys and advocates provide insight into their decision-making and planning process in anticipation of and in response to legal challenges.
PHAI Publishes Case Study on Challenges to Pharmacy Tobacco Sales Ban in San Francisco County
Monday, March 29th, 2010
PHAI documented the ban on tobacco product sales in pharmacies located in the County of San Francisco in August 2008. Even when faced with the likelihood of litigation, San Francisco lawmakers moved forward with the ban. In September 2008, a large pharmacy chain filed a lawsuit claiming that ban violated its equal rights. The ban excluded grocery stores and big box stores that housed pharmacies. Later in September 2008, a tobacco manufacturer filed a second lawsuit claiming that the ban violated commercial free speech rights.
The decision to pass the ban despite the threat of litigation was undergirded by some key points. First, the harm caused by tobacco justified the ban. Second, proponents believed establishing new, effective tobacco control laws inevitably meant having to face the tobacco industry in court, given the industry’s aggressive use of litigation. Third, proponents felt that litigation would confirm the legality of pharmacy bans, and thus, establish legal precedent for other jurisdictions to follow. Third, an effort to thwart passage of the ban would generate public interest and awareness of the health effects of tobacco use. Fourth, several years of capacity building established a range of stakeholders who understood and supported the ban. Fifth, the ban represented a first step in a larger effort to reduce tobacco sales in San Francisco through a reduction of retail outlets. The pharmacy ban would be good, and somewhat safe first step towards that goal.
Funded by the Robert Wood Johnson Foundation’s Public Health Practice & Policy Solutions, PHAI used case study research methodology to investigate threats of litigation made during the proposal and passage of public health laws. The case studies examine this experience across a range of public health issues. Public health officials, attorneys and advocates provide insight into their decision-making and planning process in anticipation of and in response to legal challenges.
PHAI publishes Case Study on NYC Menu Labeling Litigation
Monday, March 29th, 2010
PHAI documented the successful passage of the nation’s first restaurant calorie disclosure law. In an effort to address increases in obesity rates and obesity-related health problems, the New York City Department of Health and Mental Hygiene (“DOHMH”) amended the City’s Health Code on December 5, 2006 and then again on January 22, 2008 to require that chain restaurants post the number of calories contained in standardized menu items. The disclosure appears close to each item on the menu or menu board. Restaurant patrons are more likely to see and act upon these disclosures, compared to information posted in less obvious locations in restaurants or on websites.
Although several public health practitioners and organizations supported the concept of the disclosure law, its legality was untested in the courts when DOHMH acted. DOHMH knew it would face an organized and well-funded opposition. DOHMH nevertheless passed the disclosure law and faced two lawsuits. The final outcome was that DOHMH established a version of the disclosure law that was more comprehensive than originally intended. (The first version applied only to restaurants that voluntarily agreed to post calorie information. The final version applies to most chain restaurants, regardless of whether they want to post calorie information.) Numerous states and municipalities have subsequently passed disclosure law in their jurisdictions.
The decision by DOHMH to proceed was under-girded by some key factors. First, the scope of the increase in obesity prevalence was (and remains) alarming. The problem had been documented in health surveillance data. Second, several public health organizations have recommended the concept of mandating clear disclosure of calorie information for restaurant meals at the point of purchase. Third, organizational changes at DOHMH allowed public health practitioners to identify and focus on environmental risk factors for obesity. Fourth, questions of legality were addressed early on through a comprehensive internal legal review and dialogue that included a well-informed consideration of the potential public health benefits.
Funded by the Robert Wood Johnson Foundation’s Public Health Practice & Policy Solutions, PHAI used case study research methodology to investigate threats of litigation made during the proposal and passage of public health laws. The case studies examine this experience across a range of public health issues. Public health officials, attorneys and advocates provide insight into their decision-making and planning process in anticipation of and in response to legal challenges.
PHAI Publishes “Managing and Conducting Public Health Inspections: A Selected Bibliography and Topical Outline (1988)”
Friday, July 31st, 2009
In 1988, Dr. Anthony Robbins and his colleagues at Boston University School of Public Health created this document reviewing inspection-based enforcement in public health programs. Because of new interest in regulation, we are posting the document. When recently uncovered, it existed only in a paper and ink version, thus the document here was created by optical character recognition software after scanning the original. It may contain formatting errors due to the conversion.
Download the document here (pdf).
PHAI Publishes Issue Briefs on Tobacco Industry’s Corporate Makeover
Friday, May 8th, 2009
YEAR ONE – CORPORATE MAKEOVER
The Public Health Advocacy Institute, supported by the American Legacy Foundation, has completed a year of research on the tobacco industry’s attempted corporate makeover, and has created five issue briefs on the topic. A 60 minute Webinar was broadcast on May 11, 2009 and is archived HERE. They highlight various aspects of the tobacco industry’s use of corporate social responsibility rhetoric and tactics to attempt to rehabilitate its image and fend off tobacco control activism. These briefs each contain issues, the evidence and possible messages for State Tobacco Control Programs to use in their interventions and counter-marketing campaigns, and to generate support for future interventions. The issue briefs can be used effectively to denormalize the tobacco companies and better understand the motives behind their corporate makeover attempts.
- Download Webinar Archive (approximately 1 hour – requires Windows Media Player)
Issue Brief Topics:
- Corporate Social Responsibility Overview
- Manipulating Science
- Manipulating the Press
- Manipulating the Public and Regulators
- Youth Smoking
All briefs are in PDF format. 
Off the Map: Extracurricular School Food
Monday, April 6th, 2009
The two issue briefs and legal notes published under the theme Off the Map: Extracurricular School Food provide an overview of and legal and policy approaches to improving the extracurricular school food areas of school stores, concessions, fundraisers, and open campus lunch. These extracurricular environments are unique parts of the school food environment, because they are often outside the control of school food services and often involve parties outside the school.
The issue briefs and legal notes broaden our work in Mapping School Food: A Policy Guide, which provides tools to navigate the legal and policy complexities of school food. While the issue briefs and legal notes can be read modularly as stand-alone sections or pieces, we do recommend utilizing the issue briefs, legal notes, and Mapping School Food: A Policy Guide in conjunction with one another.
Download the issue brief on Open Campus Lunch [PDF].
Download the issue brief on School Stores, Concessions, and Fundraising [PDF].
Daynard and Gottlieb publish Op/Ed in Boston Globe: “How to fight America’s obesity epidemic”
Tuesday, February 10th, 2009
The article, published on January 8, 2009, addresses some of the 47 policy recommendations that were discussed at our September, 2008 conference and appear in our report to the Obama administration.
PHAI Sends Obama Transition Team Obesity Policy Recommendations
Monday, November 24th, 2008
NEW FEDERAL APPROACHES TO OBESITY EPIDEMIC NEEDED:
Public Health Advocacy Institute at Northeastern University School of Law Provides Obama Transition Team with Legal and Policy Recommendations
BOSTON (Nov. 24– President-elect Barak Obama’s Health and Human Services Transition Team today was presented with a series of nearly 50 legal and policy recommendations designed to combat the nation’s obesity epidemic.
The document, developed by the Public Health Advocacy Institute (PHAI) at Northeastern University’s School of Law, was sent to the Transition Team by Richard Daynard, a professor at the law school and president of PHAI.
Download PHAI Obesity Policy Recommendations to Obama Transition Team
“Public health, unlike some other national assets, cannot be ‘rescued’or ‘bailed out,’” Dayard wrote in a cover letter. “A sophisticated and aggressive federal approach to obesity is desperately needed.
“Such an approach could save countless lives and reduce the devastating consequences of this epidemic while meaningfully connecting with healthcare, agriculture and energy policies,” said Mark Gottlieb, Executive Director of the Institute.
“A failure of federal obesity policy would have untenable public health andeconomic consequences.”
The report from PHAI, a non-profit law and policy research organization, was based on recommendations developed by a group of leading national and international experts at a conference at Northeastern on stopping the obesity epidemic earlier this fall.
The conference, co-sponsored by Public Health Law & Policy (PHLP) of Oakland, CA, brought together legal scholars, health policy advocates, and government officials.
The recommendations (www.phaionline.org) include such areas as the economic and social aspects of dietary behavior, ensuring equal access to healthy food and physical activities, food marketing regulations, and menu labeling laws.
Download PHAI Obesity Policy Recommendations to Obama Transition Team (pdf)
PHAI Publishes Presentation Slides from Fifth Conference on Public Health, Law and Obesity
Thursday, October 16th, 2008
The Public Health Advocacy Institute held its Fifth Conference on Public Health, Law, and Obesity on September 19-21, 2008. It was entitled “A Time for Action: An Obesity Agenda for the Next Administration” and was co-sponsored by Public Health Law and Policy.
Many of the speakers have permitted us to release the slides they presented to the conference attendees. In the list of panel topics and speakers below, click on the links to that speaker’s slides. Note that you must have a “PDF” reader in order to view these slides.
Overview of the Public Health/Nutrition Picture:
- Marion Nestle, PhD, MPH – NYU Dep’t Nutrition, Food Studies & Public Health [slides-12mb]
Overview of the Legal and Policy Picture:
- Marice Ashe, JD, MPH – Public Health Law and Policy [slides-3mb]
Overview of Important Disparity Issues:
Presidential Candidates’ Statements on Obesity and Discussion
- Mark Gottlieb, JD – Public Health Advocacy Institute [slides]
Economic and Social Aspects of Dietary Behavior: Discussion of adjusting social norms about food choice and consumption through changing cultural norms, and pricing strategies.
- Jamie Chriqui, PhD – University of Illinois at Chicago [slides -1mb]
- Michel Chauliac, MD – French Ministry of Health [slides]
- Kathryn Henderson, PhD – Rudd Center for Food Policy and Obesity, Yale Univ. [slides]
- Jason Smith, JD, MTS – University of Connecticut, School of Medicine [slides]
Federal Food/Nutrition Initiatives and Implications for Food Reform: Discussion of the recently reauthorized Farm Bill, including strategies to adjust the NSLP and implementation and future reauthorizations to address the obesity. Included will be a Q&A on nutrition standards and food system options.
- Kenneth Hecht, JD – California Food Policy Advocates
- Susan Roberts, JD, MS, RD – Food and Society Policy Fellows Program [slides]
- James Weill, JD – Food Research & Action Center [slides]
Marketing: Examination of food marketing and potential regulatory strategies both in the US and abroad.
- Kathy Baylis, PhD – University of Illinois at Chicago [slides]
- Amandine Garde, PhD – Centre of European Legal Studies, University of Exeter [slides-13mb]
- Neville Rigby – International Obesity Task Force, London [slides-1mb]
- Emily York – Advertising Age [slides]
Menu Labeling: Effective Menu Labeling Strategies from both the East and West Coast.
- Jane McKenzie, JD – Prosecutor’s Office, King County, WA [slides]
- Lynn Silver, MD – New York City Department of Health and Mental Hygiene
- Paul Simon, MD, MPH – Los Angeles County Department of Public Health [slides]
Physical Activity and the Transportation Bill Reauthorization: Policy issues and solutions to increasing physical activity in children and adults through transportation policy, zoning, school policy adjustments, and regulation.
- Angie Cradock, ScD – Harvard School of Public Health
Policy Implications of Childhood and Adult Obesity: Allocating policy focus between childhood and adult obesity.
- Lori Dorfman, DrPH – Berkeley Media Studies Group [slides]
- David Ludwig, PhD, MD – Children’s Hospital Boston [slides-1mb]
- Kevin Ryan, JD, MA – Arkansas Center for Health Improvement
