CHAPTER 5: Public Health, Law and Policy

Law

What government has the authority to do.

Policy

Determines what actions to choose to take.

Ethics

Helps public health officials decide what they should do.

Federal authority

national/interstate issues.

State authority

The Tenth Amendment, which reserves broad “police powers” such as education, criminal law, property law, and family law.

Federalism

The division of authority and responsibility for public health between federal and state governments, shaping policy, emergency response, and individual rights.

State police powers

the broad authority of U.S. states—rooted in the Tenth Amendment—to enact laws protecting public health, safety, morals, and general welfare.

Tenth Amendment

That powers not delegated to the federal government nor prohibited to the states are reserved to the states or the people, reinforcing the U.S. system of federalism.

Health in All Policies

Collaborative policymaking approach that integrates health considerations into decisions across all sectors—such as transport, housing, education, and finance—to improve population health and health equity.

Market justice

emphasizes freedom and efficiency through individual choice. They don’t want the government involved.

Social Justice

Emphasizes equity and fairness through collective action. The challenge for many societies is balancing both to achieve a system that is both efficient and just. They like the government to be involved as much as possible.

Individual right

limiting some individual freedoms to protect the health of the community, but these limits must be lawful, ethical, and proportionate to the threat.

Community well-being

emphasizes the active engagement of communities to improve health, equity, and quality of life through participatory, culturally sensitive, and sustainable approaches.

Public health ethics

1. focused on population & community

2. Population benefits & harms

3. Individual rights may need to be balanced with community well-being

Belmont principles

1. respect for persons—treat individuals as they have their own decisions

2. Beneficence—maximize benefits and minimize harm

3. Justice - distribute benefits and burdens fairly.

Informed consent

the voluntary, informed agreement of individuals to participate in health-related activities, grounded in respect for autonomy, transparency, and ethical standards, but adapted to the realities of public health’s collective nature.

IRBs

Independent committee that reviews, approves, and monitors research involving human participants to ensure ethical conduct and participant safety.