标题：Transitions in State Public Health Law: Comparative Analysis of State Public Health Law Reform Following the Turning Point Model State Public Health Act
摘要：Given the public health importance of law modernization, we undertook a comparative analysis of policy efforts in 4 states (Alaska, South Carolina, Wisconsin, and Nebraska) that have considered public health law reform based on the Turning Point Model State Public Health Act. Through national legislative tracking and state case studies, we investigated how the Turning Point Act's model legal language has been considered for incorporation into state law and analyzed key facilitating and inhibiting factors for public health law reform. Our findings provide the practice community with a research base to facilitate further law reform and inform future scholarship on the role of law as a determinant of the public's health. POLICYMAKERS, SCHOLARS, and public health officials have argued that state-based public health laws are ripe for reform. 1 , 2 Despite a burgeoning research agenda on the effect of law on the public's health, 3 , 4 few studies have examined the enabling statutes that create state and local public health agencies and empower them to prevent disease and promote health. 5 – 7 This gap in legal analysis was recognized in 2 recent Institute of Medicine reports, 8 , 9 increasing the interest of state public health officials in modernizing the statutory basis of their practice. Beginning in 2000, the Turning Point Public Health Statute Modernization Collaborative (Turning Point Collaborative)—part of a larger Robert Wood Johnson Foundation effort to strengthen public health infrastructures 10 —brought together state representatives with federal, tribal, and local public health partners and private sector actors (e.g., health professionals and institutions) to “transform and strengthen the legal framework for the public health system through a collaborative process to develop a model public health law.” 11 After 3 years of development, the Turning Point Collaborative released the final version of the Turning Point Model State Public Health Act (Turning Point Act) in September 2003, 12 proposing it as a template of key public health powers for state, tribal, and local governments considering public health law modernization. The effectiveness of the Turning Point Act as a catalyst for law reform has not yet been determined. 13 With the Turning Point Act serving as a basis for several state public health law reform efforts, we hypothesized that consideration of the act led to varied reform initiatives and responses according to distinct underlying policy conditions in each state. We believed that a comparative analysis would elucidate the approaches most likely to support modernization efforts and assist public health advocates and officials in framing future law reforms.
