Unlocking the potential of law to prevent chronic disease


Project title: The role of public health law in preventing chronic disease

Start date: March 2015
Estimated end date: March 2018

What is the issue?

Public health law has delivered many of the most celebrated successes in health promotion globally including gun laws, mandatory seatbelt use in motor vehicles, excise taxes on alcohol and the plain packaging of tobacco.

Despite these successes, public health law remains an underutilised public health tool. One reason for this is that while governments have been able to employ effective legal responses to public health challenges, especially where interventions have clear measures of effectiveness (e.g. reduced smoking rates), there has been limited rigorous measurement and evaluation of the impact of the broad range of public health law affecting the health of populations.

Also, public health law comes in a number of guises including statute, government regulation, common law and ‘soft’ law, not all of which are well recognised. This means that policy makers often do not know what works in preventing chronic disease and which legal strategies have little, or unintended, effects. Consequently, policy makers lack the empirical evidence to justify significant public health policy changes.

How is the project addressing the issue?

This PhD project aims to develop methods and processes to facilitate the evaluation of public health law’s impact.

The project will:

  • Investigate the impact of case law on the regulation of alcohol availability in Australia
  • Conduct systematic reviews, into topics including the effectiveness of ‘soft law’ or alternative legal systems (e.g. community-led alcohol restrictions)
  • Use qualitative methods such as case studies and stakeholder interviews to evaluate public health law interventions in terms of effectiveness and implementation.

Relevance for practice

The project hypothesises that improving the generation and translation of evidence about public health law to cater for the complex needs of policy makers will help to garner the political support necessary to maximise the potential of powerful, acceptable and sustainable public health law in preventing chronic disease.

The project aims to develop empirical research tools that policy makers and researchers can use to identify deficiencies in existing public health law (in terms of power, effectiveness, acceptability and sustainability), and to inform the design of legislative reform. These tools will build the capacity of those invested in prevention to respond to the epidemic of chronic disease with innovative, tailored and practical policy models.

Through this work, the implementation of effective and cost-effective public health law holds the potential to strengthen national capacity, leadership and governance in area of disease prevention, particularly in addressing the health inequalities suffered by disenfranchised and disadvantaged populations.

What are the expected outcomes?

  • Identify who makes public health law in the area of chronic disease prevention (incorporating both formal and informal health governance forums)
  • Determine the strengths and weaknesses of various types of public health law in specific populations
  • Develop new methodological approaches to evaluating public health law, policy and regulation to provide fresh insights for policy makers and researchers in prevention
  • Translate the evidence generated by the project into clear and practical guidelines and a strategy for prioritising the use of public health laws in chronic disease prevention.

 

Project lead

Jan Shanthosh, PhD candidate, Prevention Centre, The George Institute for Global Health

Supervisors

This project was funded by the NHMRC, Australian Government Department of Health, NSW Ministry of Health, ACT Health and the HCF Research Foundation.

 

NHMRC, Australian Government Department of Health, NSW Government Health, HCF Research Foundation, ACT Government Health, hosted by Sax Institute

  • Four papers published, two more underway
  • Along with Alexandra Jones from the George Institute, made a submission to Deputy Secretary, Planning, Policy, Strategy and Governance of the NSW Department of Planning and Environment regarding the inclusion of health and wellbeing in the review of the NSW planning system
  • The paper, Judicial intervention in alcohol regulation: an empirical legal analysis, was referenced in a submission by the Western Sydney Local Health District Centre for Population Health regarding the Evaluation of the Community Impact Statement requirement for liquor licence applications (July 2017).

Publications

Shanthosh J, Angell B, Wilson A, Latimer J, Hackett ML, Eades AM, Jan S. Generating sustainable collective action: Models of community control and governance of alcohol supply in Indigenous minority populations. Int J Drug Policy. 2018;62:78-85. doi: 10.1016/j.drugpo.2018.09.011. [Epub ahead of print]

Muhunthan J, Angell B, Wilson A, Hackett M, Latimer J, Eades A-M, Jan S. Australia’s appointment to the UN Human Rights Council means it must deliver on Indigenous engagement in alcohol control. 2018. Aust N Z J Public Health. Online. doi: 10.1111/1753-6405.12799

Muhunthan J, Angell B, Wilson A, Reeve B, Jan S. Judicial intervention in alcohol regulation: an empirical legal analysis. Aust N Z J Public Health 2017;doi:10.1111/1753-6405.12666

Muhunthan J, Angell B, Hackett ML, Wilson W, Latimer J, Eades A-M, Jan S. Global systematic review of Indigenous community-led legal interventions to control alcohol. BMJ Open 2017;7:e013932. doi:10.1136/bmjopen-2016-013932

Muhunthan J, Eades A-M, Jan S. Neglecting preventive health threatens child rights in Australia. The Lancet. 2015.

Muhunthan J, Eades AM, Jan S. UN-led Universal Periodic Review highly critical of Australia’s record on human rights and health for Indigenous Australians. BMJ Glob Health 2016;1:e000018. doi:10.1136/bmjgh-2015-000018

Presentations

2017

How can public health law research methods strengthen the prevention agenda? Emerging Health Policy Research Conference 2017, Sydney, 27 July 2017

How do the world’s Indigenous communities use law, culture and collective action to reduce alcohol-related harm?,  ANU, Canberra, 10 August 2017,

2016

Emerging Health Policy Conference 2016, “How do Indigenous communities use public health law to control alcohol: a global systematic review”

Healthier Law: How rigorous public health law can strengthen prevention policy, The Australian Prevention Partnership Centre, University of Sydney

Judicial intervention in alcohol control, Menzies Centre for Health Policy, University of Sydney

The role of law in shaping a culture of health, The George Institute for Global Health

Effect of stroke and importance of driving in young survivors, The George Institute for Global Health

Public Policy and Alcohol Controls in Indigenous Communities, University of Sydney Masters of International Public Health Mental Disorders in Global Context

2015

Judicial intervention in alcohol control: an analysis of case law, Emerging Health Policy Research Conference, Sydney, Australia, 21 July 2015