Abstract For years, in response to demand from the field, Centers for Disease Control and Prevention’s Office of Public Health Law Services (OPHLS) has partnered with outside organizations, including Temple University’s Center for Public Health Law Research and ChangeLab Solutions, to operate the Legal Epidemiology Learning Cohort (Learning Cohort). This year-long opportunity offers training and mentorship to health department practitioners and others from public health-adjacent settings on the practical steps of legal epidemiology, which includes collecting, mapping, and evaluating legal texts. Participants work in transdisciplinary teams to design and carry out the foundational work for completing projects on research questions relevant to local public health challenges. Throughout 2023, ChangeLab Solutions and OPHLS coordinated training sessions and provided technical assistance to seven Learning Cohort teams across the country. This paper provides an overview of the Learning Cohort’s background, approach, and lessons learned. It also spotlights three recent Learning Cohort teams who describe the projects they completed and the benefits and challenges they found in learning foundational legal epidemiology methods for their public health work. Featured projects demonstrate how legal epidemiology can be used to examine topics like water safety, Tribal access to public health data, and the intersection of state and local law.
Abstract The $850,000 price for the gene therapy Luxturna is often framed as a story of private profiteering from publicly funded science. This paper challenges that narrative. Pharmaceuticals are a hit-driven industry: most projects fail, so the few successes must earn revenues well in excess of their own direct costs if the portfolio as a whole is to attract investment. Precision medicine intensifies this logic through two core economic challenges: (1) the “sticker shock” of one-time cures, which compress decades of value into a single payment, creating a financing problem more than a value problem; and (2) the “targeting dilemma,” in which precisely targeting drugs to smaller patient groups shrinks the market, requiring higher rewards per treated patient to maintain incentives to innovate. Rather than simply controlling prices, the paper proposes a policy toolkit that includes amortizing payments over time, bundling diagnostics with drugs and insurance, and streamlining regulation to lower development costs. The aim is to preserve innovation while expanding patient access.
Antimicrobials form the backbone of modern medicine and represent a foundational pillar of economic productivity. Overuse and misuse have led to a rising trend of antimicrobial resistance (AMR), depleting the efficacy of existing antimicrobials, necessitating conservation through stewardship and renewal through innovation. Poor global access exacerbates these challenges. We introduce the concept of antimicrobial effectiveness (AME) as a system in which antimicrobials are clinically and microbiologically efficacious against infectious pathogens and accessible for appropriate use. We frame AME as a global economic infrastructure, demonstrating its role as a key input to health, social, and economic outcomes and driver of positive spillovers. We investigate the balance between capacity constraints imposed by AMR and the benefits of maximizing non-discriminatory sharing of AME, exploring how a sustainable management approach comprised of infection prevention, universal access, stewardship, surveillance, and innovation can conserve AME. We explore economic mechanisms such as internalized healthcare overheads and hypothecated taxes to align contributions with benefits, ensuring that patients, hospitals, and businesses who rely on AME help to conserve it. Through identifying social value, patterns of payoffs, and downstream beneficiaries of AME, infrastructure framing provides a coherent axis to structure action, align incentives, and mobilize investment across sectors and scales.
Legal epidemiology - the study of how laws influence health outcomes - is an emerging field with potential to inform policy and improve public health. Shortages of specialists who can commit the extensive time required for these analyses has hindered progress in this area. Features of laws make them ideal candidates for artificial intelligence and natural language processing (AI/NLP) to address these constraints: standardized format, defined terms, and common terminology. However, there are concerns regarding valid AI/NLP application, especially given current underreporting of legal research in published policy evaluation studies. Drawing on lessons learned from case deployments and recent literature, we review opportunities and challenges for methods using AI/NLP in scientific legal research: assessing the scope of legal documents and data, identifying and collecting primary legal data, developing and applying coding schemes, and implementing quality controls to ensure the validity of produced legal datasets. We highlight methodologic research areas and innovation in the application of AI/NLP for scientific studies regarding effects of law on health and indicate methodologic reporting elements that will be essential for the field's innovation. This review provides a method-focused research agenda for AI/NLP in scientific legal epidemiology studies that might accelerate the field's growth and effects on evidence-based policy.
In an increasingly contemptuous political environment as the nation prepared to celebrate its semisquicentennial on July 4, 2026, the US Supreme Court capped its 2025-2026 term, which included profound decisions on a series of cases raising significant controversies in health law and policy. As per and analyses below, major topics addressed by the Court this term include: (1) the scope and limits of presidential emergency authorities; (2) state debates over LGBTQ+ rights and discrimination in parental and sports-related settings; (3) First Amendment interests juxtaposed against states' rights to regulate medical professionals or require vaccinations; (4) expansion of Second Amendment rights to possess firearms; and (5) state-based product liability and other claims foreclosed via Congress.
