Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-10T07:00:06.003Z Has data issue: false hasContentIssue false

Maximizing Community Voices to Address Health Inequities: How the Law Hinders and Helps

Published online by Cambridge University Press:  01 January 2021

Abstract

This paper highlights the need to apply an equity lens when assessing the impact of preemption and related legal doctrines on community health. Community autonomy to set and pursue public health priorities is an essential part of achieving health equity. Unfortunately, the priorities of organized industry interest groups often conflict with health equity goals. These groups have a history of successfully using law to limit community autonomy to pursue public health measures, most notably through preemption and related legal doctrines. We examine this phenomenon using two examples. First, we look at dental association efforts to block the spread of dental therapists in Indian Country. Native dental therapists have been improving the oral health of native people in Alaska for over a decade; yet the national and state dental associations have sought with mixed success to leverage state and federal laws to hinder other tribal governments from utilizing these providers. We compare these efforts with a restaurant association-led movement to limit what municipal governments can do to address food-based health inequities, focusing on a “model” ALEC bill that started in Ohio. Finally, we discuss how municipalities and Tribes are fighting back and continuing to pursue health equity for their communities.

Type
Symposium Articles
Copyright
Copyright © American Society of Law, Medicine and Ethics 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

For definitions of health equity and health disparities, see Braveman, P., “What are Health Disparities and Health Equity? We Need to Be Clear,” Public Health Report 129, S2 (2014): 5-8.CrossRefGoogle Scholar
See Grassroots Change, “Preemption Watch,” available at <http://grassrootschange.net/issues/preemption/> (last visited January 4, 2017).+(last+visited+January+4,+2017).>Google Scholar
Public Health Law Center, “Preemption in Public Health,” available at <http://www.publichealthlawcenter.org/topics/other-public-health-law/preemption-public-health> (last visited January 4, 2017).+(last+visited+January+4,+2017).>Google Scholar
Phipps, K. R. and Ricks, T. L., “The Oral Health of American Indian and Alaska Native Children Aged 1-5 Years: Results of the 2014 IHS Oral Health Survey (2015),” available at <https://www.ihs.gov/DOH/documents/IHS_Data_Brief_March_2016_Oral_Health%20Survey_35_plus.pdf> (last visited January 4, 2017).+(last+visited+January+4,+2017).>Google Scholar
See, e.g., Amererican Public Health Association, “Support for the Alaska Dental Health Aide Therapist and Other Innovative Programs,” 2014, available at <https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/07/13/28/support-for-the-alaska-dental-health-aide-therapist-and-other-innovative-programs> (last visited January 4, 2017).+(last+visited+January+4,+2017).>Google Scholar
See 25 U.S.C. § 1601 et seq. (IHCIA) and 25 U.S.C.A. § 1616l (revision notes).Google Scholar
Alaska Dental Society et al. v. ANTHC et al., No. 3AN-06-04797CI (Alaska Super. Ct. filed January 31, 2006).Google Scholar
DeMarben, A., Dentist's Remarks Called Racist, Misinformed, Alaska Dispatch News, April 14, 2006, available at <http://www.adn.com/rural-alaska/article/dentists-remarks-called-racist-misinformed-41406/2012/04/05/> (last visited January 4, 2017).Google Scholar
Alaska Dental Society v. Alaska et al., No. 3AN-06-04797CI (Alaska Super. Ct. June 27, 2007).Google Scholar
25 U.S.C.A. § 1616l (d)(2)(B) and (d)(3)(A).Google Scholar
See National Congress of American Indians, An Introduction to Indian Nations in the United States, available at <http://www.ncai.org/about-tribes/indians_101.pdf> (last visited January 4, 2017).+(last+visited+January+4,+2017).>Google Scholar
Swinomish Indian Tribal Community Code, Tit. 15, Chptr. 11 (2015).Google Scholar
See Oregon Tribes Dental Health Aide Therapist Pilot Project, available at <https://public.health.oregon.gov/PreventionWellness/oralhealth/DentalPilotProjects/Pages/projects.aspx#100> (last visited January 4, 2017).+(last+visited+January+4,+2017).>Google Scholar
Cleveland City Record for April 6, 2011, at 36, Res. No. 257-11, <http://www.dln.com/cr/index2011/April62011.pdf> (last visited January 4, 2017).+(last+visited+January+4,+2017).>Google Scholar
Cleveland City Code § 241.42.Google Scholar
Ohio Department of Health, Cuyahoga County Assessment: Access to Supermarkets, Summary of Progress-to-Date, at 5 (December 2011), available at <http://cccfoodpolicy.org/sites/default/files/resources/cuyahoga_county_assessment_access_to_supermarkets_-_2011.pdf> (last visited January 4, 2017); County Health Rankings & Roadmaps, <http://www.countyhealthrankings.org/#app/ohio/2012/measures/factors/84/data> (last visited January 4, 2017).+(last+visited+January+4,+2017);+County+Health+Rankings+&+Roadmaps,++(last+visited+January+4,+2017).>Google Scholar
Bruckman, D. et al., Data Brief: Adult Diabetes in Cleveland (2005-2009); Data Brief: Hypertension in Cleveland (2005-2009); Data Brief: Obesity in Cleveland (2005-2009) (February 2012).Google Scholar
Ohio R.C. 3717.53 (2011), invalidated by Cleveland v. State of Ohio, 989 N.E.2d 1072 (Oh. Ct. App. 2013).Google Scholar
The 2012 model bill is available at <https://www.alec.org/model-policy/food-and-nutrition-act/> (last visited January 4, 2017).+(last+visited+January+4,+2017).>Google Scholar
ALEC, Strategic Plan 2016-2018 at 8, available at <https://www.alec.org/app/uploads/2016/06/ALEC-Strat-Plan-Final-051616.pdf> (last visited January 4, 2017).+(last+visited+January+4,+2017).>Google Scholar
Miss Code Ann. §75-29-901 (2016); S. 366 86th Gen. Assemb., Reg. Sess. (Kan. 2016).Google Scholar
See The State of Obesity, “Adult Obesity in the United States,” available at <http://stateofobesity.org/adult-obesity/> (last visited January 4, 2017).+(last+visited+January+4,+2017).>Google Scholar
See, e.g., Neff, R. et al., “Food Systems and Public Health Disparities,” Journal of Hunger & Environmental Nutrition 4, nos. 3-4 (2009): 282-314, at 283. See also Centers for Disease Control and Prevention, “CDC Health Disparities and Inequalities Report — United States, 2013,” Morbidity and Mortality Weekly Report 62, no. 3 (November 22, 2013): 20-26, available at <http://www.cdc.gov/MMWR/pdf/other/su6203.pdf> (last visited January 4, 2017).CrossRefGoogle Scholar
Cleveland v. State of Ohio, 989 N.E.2d 1072 (Oh. Ct. App. 2013).Google Scholar