摘要：Growing concern that public health laws may be inadequate to the challenges that confront public health practitioners has led to adoption of a Healthy People 2010 objective for improved laws and policies. It has also led to concerted efforts to strengthen the legal foundation for public health practice. In this editorial, the authors present a framework for collaborative research, analysis, and development to strengthen public health laws, skill in applying laws, and law-related information resources. THE CENTERS FOR DISEASE Control and Prevention (CDC), responding to opportunities raised in 2 workshops it sponsored in 1999 and 2000, has created a new Public Health Law Program and cosponsors the Public Health Law Collaborative with partner organizations. Here we outline a conceptual framework for strengthening the legal foundation for public health practice and improving the understanding and use of law as a public health tool. The legal foundation for public health practice comprises at least 3 elements: legal authorities, skills to apply them, and information for those who design and implement public health laws. Legal authorities—constitutional and statutory laws, regulations, administrative rules, and case law—enable government health agencies and private health organizations to take defined actions. Healthy People 2010 (objective 23-15) recommends that public health laws be examined and improved to meet evolving health threats. 1 Three key groups need law-related skills: public health practitioners, elected and appointed government policymakers, and attorneys who counsel public health practitioners and who interpret and adjudicate legal issues. In addition, all 3 groups must have ready access to knowledge about the impact of laws on the health of the public and about “best practices” for translating laws into effective public health interventions. Applied research and development are needed to strengthen the legal foundation for public health practice. Standards should be developed for legal authorities, skills, and information resources. The CDC and its partners are working toward consensus standards for legal authorities—including a model state public health law—and for law-related competencies and information. Research and analysis will identify existing gaps. Finally, developmental work will fill these gaps through collaborative design of new authorities and training programs and dissemination of law-related information to interested individuals and organizations. Perhaps the most exciting outcome of discussions in this area is formation of the Public Health Law Collaborative. The vision of the collaborative—whose members are public health practitioners, members of the legal community, elected policymakers, educators, and researchers—is to identify public health's legal “pockets of need” and connect them with existing “nodes of expertise” in the legal, academic, and nonprofit communities. The Public Health Law Collaborative and the CDC's Public Health Law Program are working to strengthen the legal foundation for public health practice, using the approach outlined here. Among other early actions, the Association of State and Territorial Health Officers has surveyed its members to learn how they access and use legal information. The CDC supports the extramural Center for Law and the Public's Health in Baltimore, MD, and Washington, DC, and funds peer-reviewed research on the impact of laws. A national public health law conference will be held in Atlanta, Ga, on June 18 and 19, 2002. Additional work is planned in the areas outlined above, including the development of tools to assess existing legal authorities, training programs, and a spectrum of information resources. This editorial, like the framework it presents, is intended to stimulate dialogue and encourage collaboration toward the goal of building a modern and effective legal foundation for effective public health action in our states and communities.
