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Laws and policies are critical determinants of health and well-being. They can encourage positive behaviors and discourage harmful behaviors, and they can enhance or worsen health, health equity, health disparities, and health literacy. Recognizing their contribution to conditions in the environments in which people are born, live, learn, work, play, worship, and age, and people's experiences of these conditions, the US Department of Health and Human Services considered the roles of law and policy throughout its development of Healthy People 2030. Laws and policies often interrelate, but they have different purposes. A law is an established procedure, standard, or system of rules that members of a society must follow. A policy is a decision or set of decisions meant to address a long-term purpose or problem. Healthy People 2030 offers an opportunity for users in diverse sectors and at all levels to use laws and policies to support or inform the initiative's implementation, address health disparities and health inequities, and improve health and well-being in this decade. Introducing new laws and policies or rescinding existing ones to achieve Healthy People 2030 goals offers a chance to rigorously assess outcomes and weigh the balance of good outcomes against unintended consequences., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc.)

Each decade since 1979, the Healthy People initiative establishes the national prevention agenda and provides the foundation for disease prevention and health promotion policies and programs. Law and policy have been included in Healthy People objectives from the start, but not integrated into the overall initiative as well as possible to potentially leverage change to meet Healthy People targets and goals. This article provides background on the Healthy People initiative and its use among various stakeholder groups, describes the work of a project aiming to better integrate law and policy into this initiative, and discusses the development of Healthy People 2030 - the next iteration of health goals for the nation. Lessons from the preliminary stages of developing Healthy People by the HHS Secretary's Advisory Committee (Committee) on National Health Promotion and Disease Prevention Objectives for 2030 and a Federal Interagency Workgroup will be included. Efforts by the Committee focused on the role of law and policy as determinants of health and valuable resources around health equity are also shared. Finally, the article discusses ways that law and policy can potentially be tools to help meet Healthy People targets and to attain national health goals.

Objective: This study assesses how the nation's preeminent health promotion and disease prevention initiative, Healthy People, is utilized by key stakeholders., Methods: A Web-based survey was administered to assess awareness and use of Healthy People among state, local, tribal health organizations and other key stakeholder groups. Follow-up interviews were conducted with a subset of respondents., Results: Awareness and use of Healthy People have remained high among state, local, and tribal stakeholders. Healthy People 2020 is most frequently used as a data source. The Leading Health Indicators (LHIs) are an important element of the initiative, and nearly 90% of organizations that use the LHIs found them valuable. Awareness and use of other tools and resources are more limited., Conclusions: Healthy People continues to be a valued resource among public health stakeholders; however, continued outreach is needed to promote the use of tools and resources available on healthypeople.gov for this decade and beyond. Healthy People is a national initiative used most frequently as a data source by state and local health departments, tribal organizations, and other public health practitioners.

The Healthy People 2020 (HP2020) Midcourse Review (MCR) presents an opportunity for professionals in the disability and health field to contemplate preliminary progress toward achieving specific health objectives. The MCR showed notable progress in access to primary care, appropriate services for complex conditions associated with disability, expansion of health promotion programs focusing on disability, improving mental health, and reducing the unemployment rate among job seekers with disabilities. This commentary presents potential considerations, at least in part, for such progress including increased access to health care, greater awareness of appropriate services for complex conditions, and opportunities for societal participation. Additional considerations are provided to address the lack of progress in employment among this population -- a somewhat different measure than that for unemployment. Continuing to monitor these objectives will help inform programs, policies, and practices that promote the health of people with disabilities as measured by HP2020., (Published by Elsevier Inc.)

To improve health in the twenty-first century, to promote both access to and quality of health care services and delivery, and to address significant health disparities, legal and policy approaches, specifically those focused on civil rights, could be used more intentionally and strategically. This review describes how civil rights laws, and their implementation and enforcement, help to encourage health in the United States, and it provides examples for peers around the world. The review uses a broad lens to define health for both classes of individuals and their communities--places where people live, learn, work, and play. Suggestions are offered for improving health and equity broadly, especially within societal groups and marginalized populations. These recommendations include multisectorial approaches that focus on the social determinants of health.

The U.S. population is facing an obesity crisis wrought with severe health and economic costs. Because social and environmental factors have a powerful influence over lifestyle choices, a national obesity prevention strategy must involve population-based interventions targeted at the places where people live, study, work, shop, and play. This means that policy, in addition to personal responsibility, must be part of the solution. This article first describes the emergence of and theory behind the obesity prevention movement. It then explains how government at all levels is empowered to develop obesity prevention policy. Finally, it explores eight attributes of a promising state or local obesity prevention policy and sets the obesity prevention movement in the context of a larger movement to promote healthy communities and prevent chronic disease.

Objectives: An apparent increase in violent deaths among children and adolescents in Detroit, MI in 2002 prompted a coordinated epidemiologic investigation involving federal, state and local organizations., Methods: A descriptive analysis of cases and violent deaths (homicide, suicide or firearm-related) among juveniles <17 years was conducted, along with a case-control study using records from the medical examiner, police, schools and social service agencies., Results: Twenty-nine cases were identified. Median age was 10 years (range 1 day-16 years), and 15 (52%) were male. There were 25 homicides, two suicides and two unintentional firearm-related deaths. Nine (31%) homicides resulted from child abuse and neglect, and eight (28%) were among bystanders. The most common mechanism of fatal injury was firearm (63%). Victims' families were more likely to have a history of familial violence, prior contact with the state social services agency, > or = 2 adults and > or = 4 persons in the household (P<0.05)., Conclusions: The 2002 deaths did not represent a statistically significant increase from previous years. Several findings were remarkable: the proportion of deaths among bystanders, females and children age <5.

Objective: Recent research has highlighted the magnitude of alcohol use and alcohol-related problems on college campuses. However, the effects of alcohol use and abuse during the college years on early adult role attainment are not well characterized. Accordingly, this study was designed to prospectively examine relations between alcohol involvement during the college years and early adult educational and occupational attainment., Method: Participants (N = 429: 231 women) at low and high risk for the development of alcoholism were recruited at a large midwestern university for a study of alcohol and health during the college years. Alcohol involvement was assessed by self-report and structured clinical interviews conducted annually for 4 years. Educational and occupational attainment were assessed by self-report 6 years postmatriculation., Results: Alcohol involvement demonstrated a modest prospective effect on educational attainment, with a reduced effect observed when analyses controlled for academic aptitude and high school academic achievement. Prior academic achievement moderated the relation between alcohol involvement and educational attainment, such that individuals who were higher on secondary school class ranking were more negatively affected by pathologic alcohol involvement than those with lower levels of prior academic achievement. Less consistent evidence was found for prospective relations between alcohol involvement and early adult occupational attainment., Conclusions: These findings indicate a modest role for alcohol involvement in negative educational outcomes, with a more pronounced negative effect of alcohol involvement on educational attainment among those who were high academic performers in high school.