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A global health action agenda for the Biden administration
Get PDFJoe Biden will assume the US presidency at a time of unprecedented global health crises, with the COVID-19 pandemic and major setbacks in reducing poverty, hunger, and disease. The COVID-19 pandemic offers rare opportunities for the US President-elect to spearhead long-overdue structural changes and revitalise global health leadership. Building trust among global partners will be challenging, given the USA\u27s withdrawal from, and disruption of, international cooperation under the presidency of Donald Trump. The USA will have to lead in a different, more collaborative way. Here, we offer a Global Action Agenda for the Biden Administration
The Current Role of the Environment in Reinforcing Acts of Domestic Terrorism: How Fear of a Climate Change Apocalypse May Strengthen Right-Wing Hate Groups
Get PDFRight-wing extremist organizations, like white supremacists and nativists, are using the environment as a rallying cry to gain supporters of their anti-social agendas. Apocalyptic rhetoric about climate change and the lack of action to combat it has frightened some people into accepting the simplistic, violent worldview of these groups. Although the violence is new, the coupling of racism and anti-immigration rants with environmental goals is not—it is part of our cultural history. This Article provides some background on the threats of environmental and domestic terrorism facing our nation and describes how the present-day rhetoric of fear of an environmental Armageddon may be helping rightwing extremist organizations to gain supporters. The Article suggests that moderating the rhetoric and identifying actions individuals can take to change that future may not only have beneficial environmental results, but may also lessen the appeal of these groups
Injustice is an Underlying Condition
Get PDFRace, poverty, and zip code serve as critical determinants of a person\u27s health. Research showed the links between these factors and poor health and mortality before COVID-19, and they have only been amplified during this pandemic.
People of color experience higher rates of asthma, heart disease, diabetes, and other chronic conditions. People of color who live in poverty are even more likely to suffer from poor health; they face a “double burden” of health disparities associated with both racial and socioeconomic marginalization. Neighborhoods with concentrated poverty and with residents who are primarily people of color have even faced a life expectancy decades shorter than higher income, predominantly white neighborhoods. Now, a virus that does not itself discriminate is disproportionately infecting and killing people of color across the nation. Biology cannot explain either the longstanding disparities that COVID has spotlighted or the new disparities that have been framed as the “color of COVID.” The common underlying condition? Injustice.
The U.S. Centers for Disease Control and Prevention (“CDC”) and other health experts across the world recognize the powerful role that social determinants play in health. Social and economic conditions such as unemployment, housing instability, food insecurity, and unequal access to quality education, drive as much as 80% of a person\u27s health. These social determinants, and the racist legal structures that have furthered them, are at the root of the health disparities illuminated by COVID.
A growing body of “health justice” scholarship explores the role of law and policy in eliminating unjust disparities. A health justice approach requires as a fundamental first step a structural understanding of health disparities and the ways that social determinants of health drive those inequities. This article examines two major social determinants of health that drove disparities pre-COVID and are exacerbating them now: food insecurity and housing instability. With the pandemic and resulting recession, hunger is growing rapidly in the U.S., with dangerous impacts on health, especially for children. As unemployment escalates, millions of Americans find themselves unable to pay rent and on the brink of eviction and homelessness, both of which are associated with poor health outcomes. Low-income Americans are confined to homes with substandard conditions like mold and rodents that drive asthma and other respiratory diseases, at a time when those illnesses can make people more susceptible to complications from COVID.
Health justice scholars have called for major law and policy reforms to address disparities in these areas. However, existing legal rights in the areas of public benefits and housing law are under-enforced, with deleterious health effects. While we work towards a health justice revolution, this article argues for the full enforcement of laws already on the books to attack injustice and advance health. During the COVID recovery and beyond, justice is a requisite for a healthier nation
The Value Proposition of the Global Health Security Index
Get PDFInfectious disease outbreaks pose major threats to human health and security. Countries with robust capacities for preventing, detecting and responding to outbreaks can avert many of the social, political, economic and health system costs of such crises. The Global Health Security Index (GHS Index)—the first comprehensive assessment and benchmarking of health security and related capabilities across 195 countries—recently found that no country is sufficiently prepared for epidemics or pandemics. The GHS Index can help health security stakeholders identify areas of weakness, as well as opportunities to collaborate across sectors, collectively strengthen health systems and achieve shared public health goals. Some scholars have recently offered constructive critiques of the GHS Index’s approach to scoring and ranking countries; its weighting of select indicators; its emphasis on transparency; its focus on biosecurity and biosafety capacities; and divergence between select country scores and corresponding COVID-19-associated caseloads, morbidity, and mortality. Here, we (1) describe the practical value of the GHS Index; (2) present potential use cases to help policymakers and practitioners maximise the utility of the tool; (3) discuss the importance of scoring and ranking; (4) describe the robust methodology underpinning country scores and ranks; (5) highlight the GHS Index’s emphasis on transparency and (6) articulate caveats for users wishing to use GHS Index data in health security research, policymaking and practice
How medical-legal partnerships help address the social determinants of mental health
No full textConditions related to where you are born, live, learn, work, and age—the social determinants of health—account for more than half of overall health and well-being. Problems in these areas include food insecurity, unsafe and unaffordable housing, family violence and instability, employment discrimination, inadequate education, and lack of access to health insurance and care. Such problems negatively affect physical and mental health and contribute to the health disparities that disproportionately impact low-income and marginalized communities of color. Housing instability and homelessness, for example, can increase the risk of chronic illness, infectious disease, and death, and also have a profound impact on mental health, creating or exacerbating psychological distress, anxiety, and depression. Research indicates that even years after an eviction, mothers are more likely to be depressed and report feeling increased material hardship and parental stress. Many underlying social determinants of health implicate or raise legal issues that require advocacy to overcome. One patient might skip critical medical or psychiatric appointments because he is unaware of his legal rights in the workplace and is afraid of losing his job if he misses work. Another may suffer from severe depression even with significant counseling and medication management because of anxiety and stress associated with overwhelming debt or the threat of imminent family violence. Such “health-harming legal needs” create barriers to achieving good health and are major contributors to health disparities. Although nurses and other healthcare providers understand the significant impact social determinants have on health, they do not always draw connections between those determinants and the legal issues they raise. Nor do they generally think of law as a tool that can be prescribed to improve a patient\u27s health and well-being. Medical Legal Partnership (MLP) is an innovative healthcare model that fills that gap by bringing doctors, nurses, and other health professionals together with lawyers to address unmet legal needs that negatively impact health and well-being
Promoting Journalism as Method
Get PDFThe marketplace of ideas has been a centerpiece of free speech jurisprudence for a century. According to the marketplace theory, the vigorous competition of ideas, free from government interference, is the surest path to truth. As our metaphorical marketplace has moved online, the competition has never been so heated. We should be drowning in truth. Yet, in reality, truth has perhaps never been more elusive.
As we struggle to promote democratic debate and surface truth in our chaotic networked public sphere, we are understandably drawn to familiar frames and tools. These include the source of the marketplace of ideas theory—the First Amendment—as well the institutional press, once a key gatekeeper of that marketplace. Yet, both the institutional press and the First Amendment have limitations that hamper their ability to spark transformative change. Instead, this Article proposes that we look to journalism. Journalism is not the press or a journalist. Rather, it is a method and a practice—an evolving system for gathering, curating, and conveying information. Among its aims are accuracy and truth, the checking of power, and the creation of spaces for criticism and compromise.
Seeding and propagating journalism could have numerous benefits. It could help to provide some of the norms desperately needed for our new information environment. It might inject democratic values into an information ecology that is driven by profit-seeking. It could create friction where speed and scale now reign. Finally, it could help reinvigorate and even repopulate an institutional press in desperate need of reinforcement
The 2020 Vertical Merger Guidelines: A Suggested Revision (March 26, 2020)
Get PDFThe FTC and DOJ requested comments on their draft Vertical Merger Guidelines in January 2020. This article is a complete alternative set of suggested Vertical Merger Guidelines that reflects and supplements the approach explained in the comments submitted by the author along with Jonathan. Baker, Nancy Rose and Fiona Scott Morton, as well as their other comments, and might be read in conjunction with those comments. This suggested revision of the Agencies’ draft expands the list of potential competition harms and provides illustrative examples. It expands and unifies the discussion and treatment of potential competitive benefits. It deletes the quasi-safe harbor and suggests the circumstances under which competitive harms raise lessened concerns on the one hand and heightened concerns on the other
The Trouble with Identity and Progressive Origins in Defending Labour Law
Get PDFDebate about labour regulation is not new. What is new is the urgency with which labour law reform is promoted as an important fix to economic woes. In recent years, calls for reform resound in poor and rich countries alike. The economic crisis in the United States and in Europe has intensified these debates, making labour regulation a prime target for reform. In several US states public sector unions have been under attack, depicted as a privileged class that drains public funds with high wages, cosy benefits, and retirement privileges that no other workers enjoy. Several European countries have introduced austerity measures that target labour regulation and other foundations of the welfare state as sources of economic waste that they can no longer afford. Moreover, it is argued that “rigid” labour regulation hampers job creation, which can be strengthened through a program of labour flexibilisation
The Legal Determinants of Health: How Can We Achieve Universal Health Coverage and What Does it Mean?
Get PDFHow can we keep people – wherever they live – healthy and safe? Among all global health initiatives, Universal Health Coverage (UHC) has garnered most political attention. But can UHC (as important as it is) actually achieve the two fundamental aspirations of the right to health: keeping people healthy and safe, while leaving no one behind? There is a universal longing for health and security, but also a deep-seated belief in fairness and equity. Can UHC achieve both health and equity, or what I have called, “global health with justice.”?
What makes a population healthy and safe? Certainly, universal and affordable access to health care is essential, including clinical prevention, treatment, and essential medicines. But beyond medical care are public health services, including surveillance, clean air, potable water, sanitation, vector control, and tobacco control. The final and most important factor in good health are social determinants, including housing, employment, education, and equity.
If we can provide everyone with these three essential conditions for good health (healthcare, public health and social determinants), it would vastly improve global health. But we also need to take measures to leave no one behind. To achieve equity, we need to plan for it, and here I propose national health equity programs of action. Society’s highest obligation is to achieve global health, with justice
Gerrymandering Justiciability
Get PDFAs illustrated by its 2019 decision in Rucho v. Common Cause, the Supreme Court has gerrymandered its justiciability doctrines in a way that protects the political power of white voters. Comparing the Court’s willingness to find racial gerrymanders justiciable with its refusal to find partisan gerrymanders justiciable reveals a lack of doctrinal constraint. That gives the Court the discretionary power to uphold or strike down particular gerrymanders by deeming them racial or partisan in nature. Such discretion is problematic because, when the Supreme Court has exercised discretion in a racial context, it has historically done so to protect the interests of the white majority. And that appears to be what the Court is now doing again in allowing white Republicans to dilute the political power of minority Democrats.
Part I of this Article describes the Supreme Court’s current justiciability rules for gerrymandering claims. Section I.A explains how the Court finds partisan gerrymandering claims to be nonjusticiable political questions. Section I.B explains how the Court finds racial gerrymandering claims to be justiciable. Part II inverts the Court’s justiciability rules, showing how they can be applied in a way that produces the opposite of the results that the Court found them to produce. Section II.A explains how partisan gerrymandering claims can be found justiciable. Section II.B explains how racial gerrymandering claims can be found nonjusticiable. Part III argues that the Court’s gerrymandered justiciability decisions create a sphere of unconstrained judicial discretion that the Court will end up exercising in a way that protects white electoral advantage from the threat of equalization through either partisan or racial gerrymandering. Section III.A argues that the Court’s decisions have the effect of diluting minority votes and reducing minority voting strength. Section III.B argues that such protection of white interests is consistent with the role that the Supreme Court has played throughout the history of race relations in the United States. The Article concludes that neither political nor judicial efforts are likely to secure electoral equality for either political or racial minorities, because the Supreme Court will not compel the mathematical proportionality that offers the only realistic hope of ever achieving the equality needed for genuine democratic self-governance