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Understanding the Role of Legal Frameworks
in Shaping Public Health
A Book Brief on Legal Epidemiology: Theory and Methods
 

Author: Alexander C. Wagenaar, PhD

Epidemiology and related fields conducting scientific evaluations of the population health effects of public policies typically report studies with major limitations. Studies are often atheoretical, without a clear articulation of the underlying theory on the expected mechanisms of effect between a legal change and health outcomes.  When random assignment to treatment conditions is not possible, studies often do not include a full complement of other important research design elements available to strengthen causal inference. Finally, studies often pay little or no attention to measurement consistency, reliability and validity, especially for independent variables designed to measure changes in laws or policies.

 Legal Epidemiology: Theory and Methods, a new text published by Wiley, advances science by directly addressing the above limitations.   Edited by Alex Wagenaar, Rosalie Liccardo Pacula and Scott Burris, a team of 23 distinguished scholars from a diverse set of public health and social science disciplines deliver a thorough primer addressing issues that arise specifically in legal epidemiology—the scientific study and deployment of law as a factor in the cause, distribution, and prevention of disease and injury in a population.

Law is critical as a mechanism of influence on the public’s health, well-being, and equity. In shaping physical and social environments, and in shaping individual and social behaviors, law serves as a systemic intervention—one we saw clearly during the height of the recent COVID-19 pandemic. Law can also serve as a barrier to systemic interventions, as we have seen with harm reduction efforts related to opioids. A holistic consideration of legal environment therefore is important for addressing the ongoing challenges around the social determinants of health and most other areas of research in epidemiology. Law is at the root of most major public health advances, and yet we have historically not paid sufficient attention to improving its scientific assessment.

The book’s first two chapters provide a framework for situating the field of legal epidemiology within the broader field of public health. Then six chapters lay out theories relevant for understanding mechanisms of

legal effect from public health, sociology, criminology, social psychology, and economics, closing with a chapter integrating concepts and mechanisms from diverse disciplines. Part three of the book lays out specific practical steps for the measurement of legal variables, ensuring reliable and valid indicators required for high-quality scientific studies. The final major section of the book focuses on research design considerations that are central for making causal inferences concerning effects of law on the public’s health, including RCTs, controlled time-series trials and natural experiments, as well as qualitative and cost-benefit studies of public health policies.

The text is particularly helpful to PhD students, post-docs, and career scientists interested in the social determinants of health, and studying effects of regulations, laws and other public policies on population-level health outcomes.

Contents      

Foreword to the First Edition                                                                          

Michelle A. Larkin

Forward to the Second Edition

Sandro Galea                                                                                                              

Preface                                                                                                                        

Editors:

ALEXANDER C. WAGENAAR, PhD, is Research Professor at the Emory University Rollins School of Public Health and Professor Emeritus at the University of Florida College of Medicine.

ROSALIE LICCARDO PACULA, PhD, holds the Elizabeth Garrett Chair in Health Policy, Economics & Law in the Sol Price School of Public Policy at the University of Southern California.

SCOTT BURRIS, JD, is Professor of Law and Public Health at Temple University, where he directs the Center for Public Health Law Research, and Professor in Temple’s College of Public Health.          

PART ONE

Frameworks for Legal Epidemiology

1.

A Framework for Research in Legal Epidemiology
Scott Burris, Alexander C. Wagenaar, Jeffrey W. Swanson, Jennifer K. Ibrahim, Jennifer Wood, and Michelle M. Mello
 

2. Law in Public Health Systems and Services Research
Scott Burris, Glen P. Mays, F. Douglas Scutchfield, and Jennifer K. Ibrahim

PART TWO

Understanding How Law Influences Environments and Behavior

3. Perspectives from Public Health
Kelli A. Komro and Alexander C. Wagenaar
 
4. Law and Society Approaches
Robin Stryker
 
5. Criminal Theories
Wesley G. Jennings and Tom Mieczkowski
 
6.

Procedural Justice Theory
Tom R. Tyler and Avital Mentovich
 

7.

Economic Theory
Frank J. Chaloupka and Rosalie Liccardo Pacula
 

8.

The Theory of Triadic Influence
Marc B. Schure, Kazi Faria Islam, and Brian R. Flay
 

9.

Integrating Diverse Theories for Public Health Law Evaluation
Scott Burris and Alexander C. Wagenaar

PART THREE

Identifying and Measuring Legal Variables

10.

Picturing Public Health Law Research: The Value of Causal Diagrams
Jeffrey W. Swanson and Jennifer K. Ibrahim
 

11. Measuring Statutory Law and Regulations for Empirical Research
Evan D. Anderson, Sue Thomas, Ryan D. Treffers, and Alexander C. Wagenaar
 
12. Coding Case Law for Public Health Law Evaluation
Mark Hall

PART FOUR

Designing Legal Epidemiology Evaluations

13. Randomized Trials in Legal Epidemiology
Harold Pollack, Alida Bouris, and Scott Cunningham
 
14. Natural Experiments: Research Design Elements for Optimal Causal Inference Without Randomization
Alexander C. Wagenaar and Kelli Komro
 
15. Qualitative Research Strategies for Public Health Law Evaluation
Jennifer Wood
 
16.

Using Cost-Effectiveness and Cost Benefit Analysis to Evaluate Public Health Law
Rosalie Liccardo Pacula
 

17.

The Future of Research in Legal Epidemiology
Scott Burris, Rosalie Liccardo Pacula, and Alexander C. Wagenaar

References 

 

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