Unlocking the potential of law to prevent chronic disease
Project title: The role of public health law in preventing chronic disease
This project is finished. Click on the image to read the Findings Brief.
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 did the project address the issue?
This PhD project developed methods and processes to facilitate the evaluation of public health law’s impact.
The project :
- Investigated the impact of case law on the regulation of alcohol availability in Australia
- Conducted systematic reviews into topics including the effectiveness of ‘soft law’ or alternative legal systems (e.g. community-led alcohol restrictions)
- Used 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 hypothesised that improving the generation and translation of evidence about public health law to cater for the complex needs of policy makers would 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 aimed 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 were the outcomes?
- We identified a number of cases where public health arguments failed and decisions were made in favour of industry.
- We found that public health evidence was largely discounted as there was no clear basis in law on which it could be used.
- Using case law to evaluate public health laws enabled us to uncover the scope of the problem, identify the legal issues underpinning it, and show a way forward to ensure legislation fulfils its intended purpose.
Jan Shanthosh, PhD candidate, Prevention Centre, The George Institute for Global Health
This project was funded by the NHMRC, Australian Government Department of Health, NSW Ministry of Health, ACT Health and the HCF Research Foundation.
- Five papers published, one under review.
- 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).
- 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 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
- Muhunthan J, Eades A-M, Jan S. Neglecting preventive health threatens child rights in Australia. The Lancet. 2015.
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,
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
Judicial intervention in alcohol control: an analysis of case law, Emerging Health Policy Research Conference, Sydney, Australia, 21 July 2015
- The Conversation: Bottleshops affect people’s health, so our laws need to reflect that
- ABC News: Communities losing ground in war against liquor giants: experts
- ABC News 24: Local communities are losing the battle against big alcohol retailers
- The Wire: Study reveals legal favour for alcohol industryhttp://thewire.org.au/story/study-reveals-legal-favour-alcohol-industry/
- Croakey: Just Justice concerns: making global news and hitting the election trail
- Interview with National Radio
- The Australian: Better health options in prison for Indigenous
Prevention Centre news
- Healthier law seminar (webcast), May 2016