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Lazzarini Speaks About the Role of Law in
Public Health
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Lazzarini began by pointing out that there are several levels of causation and intervention in public health, from the individual level to the superstructural level, and argued that it is necessary to look at factors at the structural level, such as law, for both the causes of disease and potential interventions. She stressed that law plays an important role in health, both in concrete ways, such as whether it is possible to purchase clean needles, and in amorphous ways, such as the effect of Constitutional restrictions on the powers of public health workers.
To date, Lazzarini said, most research about law and public health has been focused on Constitutional limits and the parameters set by previously decided legal cases, with little focus on empirically based research that analyzes the impact of law on health. She argued that future research should integrate law and social epidemiology in studies which measure the direct and indirect impacts of law on health, and used a study she is working on to illustrate the possibilities of such research. The study analyzes multiple aspects of state HIV exposure/transmission laws, which criminalize the knowing exposure to or transmission of HIV. Aspects of the laws studied include the types of behavior criminalized, the penalties attached to violations of the laws, the frequency with which violations are prosecuted, the types of violations prosecuted, and attitudes about HIV risk behavior and the legal system among a survey group at high risk for HIV infection. The data generated by the study is used to analyze whether HIV exposure/transmission laws are effective in decreasing the number of cases of HIV exposure and transmission by the means the laws criminalize.
Lazzarini cautioned that it is necessary to examine “whether… [laws] have paradoxical effects,” explaining that because the HIV exposure/transmission statutes are based on knowingly exposing someone to HIV, it is possible that some people may avoid HIV testing in order to remain ignorant of their HIV status and thus incapable of knowingly exposing someone to the virus. In addition, she noted that laws may be prosecuted in ways not likely to produce the greatest health impact: of the 316 prosecutions of HIV exposure/transmission laws studied, 75 involved HIV exposures through biting, spitting and scratching, all of which are relatively unlikely ways to transmit the virus.
Lazzarini stayed well beyond the 45 minutes allotted for her talk to
field questions from her interested audience of approximately 35. The
lecture was part of the Brown Bag Lecture Series presented by the Global
Health Division.
-Story by Christy Gordon.
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