3320 research outputs found
Sort by
Health Inequalities
Get PDFThe vast health inequalities in the United States and beyond that COVID-19 makes glaringly evident are frequently masked by aggregate statistics, which for years had been showing health improvements. Yet these improvements were inequitably distributed, with benefits disproportionately going to wealthier – and in the United States, white – populations. Globally, vast health inequities also exist among and within countries. The inequalities, which have also helped fuel the rise of populism, extend far beyond health care, including to wealth and income. Disaggregated, granular data is critical to understanding these inequalities.
Addressing health inequities must extend far beyond universal access to quality health service to under-funded population-based public health interventions. Meanwhile, as any epidemiologist will tell you, the single biggest predictor of health outcomes is a person’s zip code, indicative of social determinants outside the health sector, including employment, education, housing, and transportation. Without explicit attention to these determinants, and the systematic, structural factors like racism that underlie their inequitable distribution, we can make little progress towards health equity, and will fail to meet the UN Sustainable Development Agenda pledge of leaving no one behind.
Equity solutions require dedicated, systematic, systemic, well-resourced plans – health equity programs of action. These would include explicit targets, costed actions, rigorous measurement, and accountability through a comprehensive national effort. The United States could choose to lead, which would be a powerful political commitment to health equity and justice. And an intangible yet powerful benefit would be to restore a sense of dignity for all of society and, in turn, act collectively to elect truthful, compassionate leaders who bring us together as a nation
The Dual Epidemics of COVID-19 and Influenza: Vaccine Acceptance, Coverage, and Mandates
No full textThe confluence of coronavirus disease 2019 (COVID-19) and seasonal influenza this fall and winter will result in considerable morbidity and mortality, stressing the health system. With more than 100 000 COVID-19–related deaths already, the US could see a second wave of disease later this year. In 2018-2019 (a “moderate” year for influenza), the US experienced 35.5 million influenza cases, with 490 600 hospitalizations and 34 200 deaths related to influenza.1 An effective COVID-19 vaccine is unlikely until 2021. Even though seasonal influenza vaccines have variable year-to-year effectiveness, they can significantly reduce morbidity and mortality, especially with high coverage.The health system, and wider society, must prepare for the likelihood of co-epidemics of COVID-19 and influenza. What are the most effective strategies for increasing influenza vaccine coverage across the population and particularly in schools, businesses, and hospitals? Should states or businesses require vaccinations? Influenza vaccination, moreover, could offer valuable lessons for ensuring vaccine acceptance and uptake when COVID-19 vaccines become available
Correlation and Constitutional Rights
Get PDFSkepticism among American scholars about the value of analytic legal positivism stems in part from the pervasiveness of private law in analytic jurisprudence. Wesley Hohfeld’s influential framework proves little different: although he claims that the jural relations apply to constitutional entitlements, he relies on private law for their exposition. Matthew Kramer’s scholarship clarifies and develops Hohfeld’s framework and draws greater attention to its application in the public realm. This chapter advances the discussion by examining the application of the Hohfeld-Kramer framing to constitutional law in particular, demonstrating the weaknesses in assuming that the private law model can be sustained without more careful exposition. Such entitlements are held in res publica, with the result that the entitlement-holder also bears a duty of non-infringement. It identifies a new category of ‘dignities’, which act as a shield for claim-rights and highlights the nature of ‘purported rights’, where the state, holding the power of enforcement, structurally lacks the impetus to prosecute (its own) constitutional breach
Is It Lawful and Ethical to Prioritize Racial Minorities for COVID-19 Vaccines?
Get PDFCoronavirus disease 2019 (COVID-19) has disproportionately affected racial minorities in the United States resulting in higher rates of infection, hospitalization, and death. With a limited supply after the initial approval of a safe and effective vaccine, difficult legal and ethical choices will have to be made on priority access for individuals. The National Academies of Sciences, Engineering, and Medicine (NASEM) has recommended prioritization of racial minorities who are “worse off” socioeconomically and epidemiologically. TheWorld Health Organization (WHO) similarly cautioned that “colorblind” allocation frameworks could perpetuate or exacerbate existing injustices. Both NASEM and WHO urge policy makers to allocate vaccines in ways that reduce unjust health disparities. The ethics and legality of race-based policies in the United States have been fraught with controversy. This Viewpoint considers how COVID-19 vaccine priority allocations could be implemented ethically and legally
Accelerating Deep Decarbonization in the U.S. Transportation Sector
Get PDFThe transportation sector includes light-duty vehicles, heavy-duty vehicles (trucks), off-road vehicles, buses, rail, shipping, and aviation. Reducing emissions in this sector is critical in order to achieve the pathways to zero carbon. Transportation emissions accounted for 37 percent of total CO₂ emissions from energy and industry in 2019. The principal strategy for decarbonizing transportation is electrification (including battery, plug-in hybrid, and hydrogen fuel cells) of all light-duty vehicles, urban-based trucks and buses, rail, much of long-haul trucking, and some short-haul shipping and aviation. For long-haul aviation and long-haul ocean shipping, advanced low-carbon biofuels and synthetic liquids or gases produced with renewable energy are the leading energy contenders. The second strategy builds on initiatives to reduce vehicle use and miles traveled while enhancing accessibility to health, education, jobs, and other services for the mobility disadvantaged. This transition will require a variety of actions by federal, state, and local governments as spelled out in detail in the report that follows
Tuberculosis, human rights, and law reform: Addressing the lack of progress in the global tuberculosis response
Get PDFIn 2018, the United Nations General Assembly convened the first-ever high-level meeting (HLM) on tuberculosis (TB). Since that time news on the world’s most lethal infectious disease is not good—the 2019 WHO TB report shows 1.2 million people died from TB, a number that has fallen just 11% since 2015, less than one-third of the way towards the End TB Strategy milestone of a 35% reduction (to about 850 million deaths) by 2020. The same number of people, 10.0 million, are estimated to have fallen ill with TB in 2018 as in 2017. The stubborn persistence of TB is attributable to glaring gaps in case detection and treatment. While case detection has increased in recent years, there is still a significant gap between the 7 million new cases reported and the 10 million incident cases estimated in the most recent WHO data—and treatment success continues to hover at only 85%.
There has long been a call for a shift toward a “human rights-based approach” in TB—building policies and programs explicitly on the norms and values set out in international human rights law, treating people with TB as rights holders in their interaction with the state and the health system, and working to overcome stigma and discrimination. Yet laws in high TB-burden countries (HBCs) have not been reformed to include basic rights protections. This helps explain the lack of progress, as individuals who fear discrimination and coercion may avoid diagnosis and treatment. Thus, TB stands in stark contrast to HIV/AIDS, for which the international community has moved far more decisively to recognize and protect key rights, even as more progress is needed. At the UN, heads of state committed to removing discriminatory laws and policies against people with TB, protecting and promoting their human rights and dignity, as a key part of a strategy to improve the TB response and end the epidemic. Here, we analyze key areas of law with particular importance for TB, focusing on five aspects of compulsory public health powers in law and on laws related to migration. We identify significant gaps between core human rights norms and existing legal environments
How We Talk About the Press
Get PDFIn 2017, the term “fake news” was so popular that it received the “Word of the Year” honor from the American Dialect Society. Since then, its popularity may have abated some, but its use persists. Most obviously, anti-press speakers weaponize the term fake news to undermine journalists and the press as an institution. Perhaps more surprisingly, however, the term is also in regular rotation among many who would seem to support a free and independent press, including scholars, teachers, and journalists themselves.
The continued and often-uncritical use of fake news should worry us. As thinkers across disciplines have recognized for centuries, the names we use matter. Names shape the very way we understand things. And this is especially true when it comes to the press.
Although conventional wisdom is that press power and freedom spring primarily from the First Amendment, in reality, the doctrine is that the press has no greater rights than any other speaker. Press power and freedom are derived in large part from customs and norms. And those customs and norms draw sustenance from the positive language of the courts, other institutions, and the public about how the press serves the democratic functions of truthful educator, trusted proxy, and fair watchdog.
Press power is, in great part, rhetorical power.
This rhetorical power is especially fragile in our networked information sphere. As we are coming to understand, when labels or narratives are decontextualized and amplified, we begin to internalize and adopt them, sometimes regardless of their accuracy or how savvy we believe ourselves to be. Moreover, what is blunt and vitriolic generally scales further and faster than what is nuanced or measured. As a label, fake news is arguably becoming so entrenched and normalized that it might ease the way for other terms that rhetorically marry the press to falsity, bias, and laziness—like “pink slime journalism”—to slip into our everyday discourse.
If protecting the press was the only goal of curbing anti-press rhetoric that would be enough. But there is another reason to do it. How we talk about the press plays into how we tackle one the biggest challenges of our networked age—stemming information pollution. Fundamental to this effort is separating accurate information from false, trusted sources from manipulated ones, and journalism from propaganda and marketing. If we use labels that conflate these categories, we make a daunting task harder. For these reasons, it is increasingly important that we take care in how we talk about the press
Conclusion: A Way Forward
Get PDFWhere do we go next? I have three suggestions. One is to enlarge the frame of our work on poverty and race, including a focus on the ever-widening chasm of inequality, and all of it pressing toward the center stage of national attention. A second is to consolidate our work about income, jobs, and cash assistance into a unified frame, which I call a three-legged stool. And the third is to think from a perspective of place, and what that tells us about our antipoverty work.
We need a banner, a message, a theme, a politics for ending poverty. The substance of ending poverty is complex, but making it a top national priority requires finding a unifying concept. Experience tells us that poverty by itself is not enough to achieve center stage
When does a major outbreak become a Public Health Emergency of International Concern?
Get PDFThe process of determining whether a Public Health Emergencies of International Concern (PHEIC) exists and should be declared has drawn increasing criticism over the past few years with allegations that it is more political than technical. Delaying declaration, where appropriate, means that the opportunity of garnering international solidarity and necessary resources in the early phases of epidemics, when public health measures may be more effective, is lost. A reform agenda aimed at enhancing WHO/Emergency Committee transparency and objectivity for the PHEIC declaration process is required
Restoring the Historical Rule of Lenity as a Canon
Get PDFIn criminal law, the venerated rule of lenity has been frequently, if not consistently, invoked as a canon of interpretation. Where criminal statutes are ambiguous, the rule of lenity generally posits that courts should interpret them narrowly, in favor of the defendant. But the rule is not always reliably used, and questions remain about its application. In this article, I will try to determine how the rule of lenity should apply and whether it should be given the status of a canon.
First, I argue that federal courts should apply the historical rule of lenity (also known as the rule of strict construction of penal statutes) that applied prior to the 1970s, when the Supreme Court significantly weakened the rule. The historical rule requires a judge to consult the text, linguistic canons, and the structure of the statute and then, if reasonable doubts remain, interpret the statute in the defendant’s favor. Conceived this way, the historical rule cuts off statutory purpose and legislative history from the analysis, and places a thumb on the scale in favor of interpreting statutory ambiguities narrowly in relation to the severity of the punishment that a statute imposes. As compared to the modern version of the rule of lenity, the historical rule of strict construction better advances democratic accountability, protects individual liberty, furthers the due process principle of fair warning, and aligns with the modified version of textualism practiced by much of the federal judiciary today.
Second, I argue that the historical rule of lenity should be deemed an interpretive canon and given stare decisis effect by all federal courts. If courts consistently applied historical lenity, it would require more clarity from Congress and less guessing from courts, and it would ameliorate some of the worst excesses of the federal criminal justice system, such as overcriminalization and overincarceration