News & Insights

The United States remains in the grip of both COVID-19 and drug-related harm. Both are public health emergencies marked by tens of thousands of preventable deaths – and both disproportionately impact Black, Hispanic, Native, and other non-White people. Addressing the structural racism that drive inequality in access to economic opportunity, educational attainment, and other factors that ultimately drives health disparities must be a key public health priority – both during the dual COVID and overdose epidemics and beyond.  

The medications for opioid use disorder, methadone and buprenorphine, can reduce overdose deaths by over 50 percent. Unfortunately, many people who want to access these medications are unable to do so  because of federal and state legal restrictions, primarily the federal X-waiver, which a physician must obtain in order to prescribe these medications. While the requirement itself is statutory and can only be changed by Congress, the departments of Justice and Health and Human Services (HHS)  have a great deal of autonomy in determining its exact contours.

Earlier this year, New York legalized adult-use (recreational) cannabis with the Marijuana Regulation & Taxation Act.  While it’s now legal for adults to possess cannabis, there are no retail establishments permitted to sell adult-use cannabis. The State is in the process of developing regulations for this new industry and the adult-use market is expected to be operational in late 2022. While New York is focused on creating a safe and efficient industry, it is also incorporating social justice measures, including restorative justice and diversity, equity, and inclusion (DEI) policies into its new cannabis system.

Often a patient wants a health care provider to share her Protected Health Information (PHI) with a social service organization (SSO) for support that directly or indirectly relates to her health. A provider’s efforts to obtain written authorization to release PHI often delays a patient’s access to SSO support. That delay is compounded when the patient has to physically go to the provider’s office to sign the authorization, a challenge or even an impossibility for some individuals. This process to obtain patient authorization also takes precious clinical time from healthcare providers and their staff. What is often misunderstood is that sharing PHI for care coordination purposes does not require written authorization under HIPAA Privacy Rule.

There has been a well-publicized attempt across the nation to stop the teaching of “critical race theory” through state legislation, lawsuits, pressure by parents at school board meetings, and other means. A consequence of this legally imposed silence is that persistent, obvious, and consistent patterns of inequality are portrayed as random and individualized rather than resulting from a social system organized around racial and gender lines. This runs counter to a public health approach which is based on understanding how systems impact whole populations.

In the course of our work to provide legal resources and legal technical assistance to support an effective public health response to the COVID-19…

In the United States, millions of children live in poverty and are at a much greater risk of experiencing adverse health outcomes compared to their contemporaries in higher income households. Low-income children of color are disproportionately at risk of having health problems including but not limited to, dental, hearing, speech, and vision problems; elevated lead blood levels; early childhood trauma; and asthma. Social risk factors such as the lack of access to healthy food, quality educational opportunities, greater environmental hazard exposures, and inadequate housing significantly increase the likelihood that a low-income child will be in poor health.

Some of the public health law and policy issues in the headlines in recent weeks include Texas’ new abortion law, the Supreme Court’s decision on the federal eviction moratorium and states’ responses; challenges to Florida Governor’s ban on mask mandates; gaps in data concerning COVID-19 cases; accessibility of mental health care; and the growing suicide rate among communities of color.

Nearly half of the United States is experiencing abnormally dry conditions this year. The public health implications of drought cannot be underestimated: drought can lead to a lack of clean drinking water, food insecurity, poor air quality, water-borne diseases, mental health concerns, wildfire, and poor sanitation. Solutions that prevent non-essential uses of water, increase natural storage of water in the soil and aquifers, or maintain water and lake levels, may help limit the public health impacts of future droughts by increasing the overall supply of useable water.

Like many others, we recently recognized the 20th International Overdose Awareness Day, and we are especially somber, as we know that the past year has seen more people die from preventable overdose than ever before. The Biden administration acknowledged the gravity of this moment by issuing a proclamation declaring Overdose Awareness Week. Over 94,000 families, friends, co-workers, and neighbors in the United States lost someone they loved. Many more folks faced the trauma of experiencing an overdose, reversing an overdose, or witnessing an overdose.

Long existing health disparities in the U.S. have been further exasperated by the COVID-19 pandemic. States, cities, and counties are increasingly recognizing the role that structural racism plays in perpetuating and maintaining these disparities. A sampling of recent news articles highlights both the advances that are being made, as well as some of the challenges that remain.

During the 2020 election cycle, several states utilized voter initiatives to legalize medical and/or adult-use cannabis. While these policy changes align with the nation’s changing perception of cannabis, voter initiatives have met serious legal opposition. Three of these court  cases in particular emphasize the need to understand state constitutional restrictions on voter initiatives and the impact these restrictions can have on the success of an initiative.