The Salzburg Statement on Vaccination Acceptance.

Immunization represents one of the greatest public health achievements. Vaccines save lives, make communities more productive and strengthen health systems. They are critical to attaining the UN Sustainable Development Goals. Vaccination also represents value for investment in public health. It is undisputedly one of the most cost-effective ways of avoiding disease, each year preventing 2-3 million deaths globally. We the concerned scientists, public health professionals, physicians, and child health advocates issue this Salzburg Statement along with the International Working Group on Vaccination and Public Health Solutions, proclaiming our unwavering commitment to universal childhood vaccination, and our pledge to support the development, testing, implementation, and evaluation of new, effective, and fact-based communication programs. Our goal is to explain vaccinations to parents or caregivers, answer their questions, address their concerns, and maintain public confidence in the personal, family and community protection that childhood vaccines provide. Every effort will also be made to communicate the dangers associated with these childhood illnesses to parents and communities since this information seems to have been lost in the present-day narrative. While vaccine misinformation has led to serious declines in community vaccination rates that require immediate attention, in other communities, particularly in low-income countries, issues such as lack of access. and unstable supply of vaccines need to be addressed.

Guiding industry settlements of opioid litigation.

Background: The recent $270 million settlement of Purdue Pharmaceuticals and the State of Oklahoma on March 26, 2019 concerning the state's opioid litigation is a harbinger of industry settlements to come. Thousands of opioid-related cases with impending trial dates may stimulate opioid manufacturers, distributors, and retailers to seek new deals to escape historic liability. Objectives: Against a backdrop of massive damage potential of a two decade opioid epidemic, reaching appropriate settlements is key. Parties to opioid lawsuits must balance an array of factors to assure industry accountability while preserving access to opioids among legitimate patients seeking palliative care. Methods: We examined major bases for opioid litigation across the U.S. Thousands of cases have been filed against opioid manufacturers, distributors, pharmacies, pharmacy benefit managers, and others. Hundreds of these cases are consolidated in a federal district court in Cleveland, Ohio where trials are scheduled as early as October 2019. Grounds for litigation are highly varied. Results: Multiple factors underlying responsible settlements include (1) a primary focus on contemporary treatment and prevention strategies supplemented by research innovations; (2) primary access to life-saving treatments for at-risk individuals; (3) fair and equitable allocation of settlement resources; (4) dedication to lawful, efficacious interventions; (5) cross-sharing of industry data and practices to promote good faith compliance; and (6) continued assurance of access to palliative care for deserving patients. Conclusions: Negotiated settlements must align with highly effective public health priorities. Crafting wise settlement agreements is necessary to assign responsibility for huge public harms and ensure future treatments that are prudent and efficacious.

Medicare's Historic Prescription Drug Price Negotiations.

This Viewpoint evaluates the legal claims and policy implications of historic drug price negotiations possible with the Inflation Reduction Act of 2022.

The Model State Indoor Air Quality Act.

This Viewpoint discusses how poor indoor air quality can affect health and examines the Model State Indoor Air Quality Act, which provides science-based regulatory standards aimed at ensuring public indoor environments provide healthy air.

Legal Preemption and the Prevention of Chronic Conditions.

State and local legal innovations to address chronic conditions are an ongoing source of public health improvements. For decades, some of the most ingenious law and policy ideas to address the underlying causes of chronic conditions and their contributing factors have emerged from state or local public sector grassroots initiatives in diverse areas, including tobacco use, safe housing and transportation, and environmental hazards. These reforms, however, are susceptible to invalidation through the legal doctrine of preemption. Embedded throughout our constitutional system, preemption refers to how state or local laws may be averted, displaced, or negated by conflicting laws at a higher level of government. Preemption can be complex in concept and application, leading to considerable confusion among public health leaders seeking to generate meaningful policy proposals. The objective of this article is to unravel the legal concept of preemption, explain its use as a tool to both thwart or further public health interventions, and offer practical guidance for how to legally navigate around it to address factors underlying chronic conditions.

Legal Regulation of Sodium Consumption to Reduce Chronic Conditions.

In the United States, tens of thousands of Americans die each year of heart disease, stroke, or other chronic conditions tied to hypertension from long-term overconsumption of sodium compounds. Major strides to lower dietary sodium have been made over decades, but the goal of reducing Americans' daily consumption is elusive. The Food and Drug Administration (FDA) has been urged to consider stronger regulatory limits on sodium, especially in processed and prepared foods. Still, FDA categorizes salt (and many other sodium compounds) as "generally recognized as safe," meaning they can be added to foods when ingested in reasonable amounts. Legal reforms or actions at each level of government offer traditional and new routes to improving chronic disease outcomes. However, using law as a public health tool must be assessed carefully, given potential trade-offs and unproven efficacy.

The Promise (and Pitfalls) of Public Health Policy Surveillance.

Though public health policy surveillance is an integral tool in correlating the law to scientifically based public health law studies, drawing accurate legal conclusions from collected data can be challenging. Data may be of poor quality, inaccessible to law and policy makers, or inapplicable to other jurisdictions over time and place. As Burris et al. (2016) advocate, modern, sophisticated, and interactive data collection systems would render more precise legal analysis tied to public health improvements. Although policy surveillance is promising, public health officials, health care providers, attorneys, and researchers must be skilled and prepared to successfully navigate and resolve potential pitfalls for its benefits to be fully realized. Among the significant challenges related to policy surveillance are: (1) timing; (2) agenda setting; (3) predictable misuse; and (4) politics inherent in a federalist public health legal infrastructure. As public health data infrastructure is developed, better legal approaches must be simultaneously crafted to achieve optimal public health outcomes.

Assessing Impacts of "Anti-Equity" Legislation on Health Care and Public Health Services.

A deluge of state "anti-equity" legislative bills seek to reverse prevailing trends in diversity, equity, and inclusion; withdraw protections of LGBTQ+ communities; and deny access to gender-based care for trans minors and adults. While the political and constitutional fate of these acts is undetermined, profound impacts on patients and their providers are already affecting the delivery of health care and public health services.

"Out Like a Lion:" Terminating the COVID-19 National Public Health Emergency.

From its inception, the COVID-19 pandemic has been a disruptive force on U.S. health care and public health systems. President Biden's announced termination of the national public health emergency on May 11, 2023 portends a return to normalcy and relief for Americans from the greatest infectious disease scourge the nation has ever faced. In reality, closing out this pandemic presents a tempest of legal and practical complications.

Midterm Maelstrom: Public Health Legal Impacts of Election 2022.

Among the morass of critical issues impacting the results of the midterm elections in 2022 were core public health issues related to health care access, justice, and reforms. Collectively, voters' communal health and safety concerns dominated outcomes in key races which may shape national, state, and local legal approaches to protecting the public's health in the modern era.

Medicare Drug Pricing Negotiations: Assessing Constitutional Structural Limits.

A series of structural constitutional arguments lodged in multiple cases against Centers for Medicare and Medicaid Services' (CMS) authorities to negotiate prescription drug prices via the 2022 Inflation Reduction Act threaten the legitimacy of CMS program and federal agency powers.

Supreme Court Impacts in Public Health Law: 2022-2023.

In another tumultuous term of the United States Supreme Court in 2022-2023 a series of critical cases implicate instant and forthcoming changes in multiple fronts that collectively shift the national public health law and policy environment.