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Advocating for Public Health Authority

The Basics of Public Health Authority

Public Health’s mission

Public Health improves health by emphasizing disease prevention, health promotion, and equitable access to services and the vital community conditions that all people need to be healthy and well. Public Health’s mission–to promote and protect the health and well-being of people and communities–is carried out through The 10 Essential Public Health Services. Public Health is oriented toward equity and advancing a future in which all people have what they need for their health and well-being, regardless of race, class, ability, gender, sexual orientation or religion.

Fundamentals of Public Health Learning Series

What is public health?

Public health authority is the bedrock for implementing the work of Public Health.

What is public health authority?

Public health authority refers to the legal and regulatory power that Public Health has to do its jobs. Public health entities–such as health departments and public health agencies–use their authority to promote health, prevent the spread of infectious disease, protect against environmental hazards, advance equity, and assure local public health infrastructure. 

Examples of how public health entities use their authority:

  • Require vaccination of children attending public schools
  • Enforce drinking water standards
  • Inspect food businesses

Its Constitutional Basis 

Through the “police power” of the state granted under the 10th Amendment of the U.S. Constitution, Public Health can pass and enforce regulation for the health, safety, and welfare of society. Police power refers to the inherent authority of a government to enforce orders in the interest of the public good. The broad police powers provide the authority not just for traditional public health, but also for environmental law, land use regulation, and other areas where the government acts to protect health and safety. Police power is an inherent authority of the states, and states can delegate their police power to local governments. This is what empowers local and state public health entities to act.

While states and their divisions retain primary responsibility for health under the U.S. Constitution, the federal government plays a crucial role by making policy, providing funding, assessing public health risks, collecting and disseminating information, building capacity, and directly managing services. It uses its constitutional powers, such as regulating interstate commerce, to enforce health and safety regulations, set funding conditions, tax commodities resulting in risky behaviors, and regulate businesses affecting public health. For most of its history, the U.S. Supreme Court has upheld the federal government’s powers under the U.S. Constitution to protect the public’s health.

Tribal governments possess unique sovereignty and right to self-determinism. Many tribal communities have their own programs to provide essential public heath services–and as individuals, tribal members may also participate in state or local public health programs. Under treaties, the federal government has an obligation to provide tribes with certain services, including health-related services.

Further Reading:

Public Health Emergencies

Emergency declarations at state and federal levels trigger authorities and resources unavailable in non-emergencies. During declared emergencies, state and federal authorities have broader powers to act to assist governments, suspend or modify legal requirements, pass and enforce law and expend funds for the health, safety and welfare of society. For example, the U.S. Secretary of the Department of Health and Human Services (HHS) declared COVID-19 a public health emergency (as did all states at some point), prompting local and state public health entities to issue isolation and quarantine requirements, adopt vaccine mandates, revise standards for licensure of medical professionals, and distribute free testing kits to the public.

 

Further reading:

Emergency Authority and Immunity Toolkit

This toolkit addresses critical concepts regarding federal and state emergency declarations and the various response authorities and liability protections these...

The authority to act to protect and promote the public’s health has emerged over the course of our Nation’s history, and has enabled many of modern public health’s greatest achievements. Recently, some state legislatures have moved to limit public health powers. Such efforts pose a mounting challenge for Public Health’s response to ongoing and future population health threats.

The next module discusses threats to public health authority

Public Health Authority Toolkit

This resource provides state and territorial health officials with evidence-based resources and legal guidance to effectively respond to public health emergenci...

Reflection Questions

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  • What is public health authority? What do public health agencies use their authority to accomplish?
  • Where does the inherent authority of state governments and public health to pass and enforce regulations in the interest of the public good originate?
  • In what ways does public health authority shift when the federal government or a state government declares an emergency?

The next module discusses threats to public health authority >

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