consumption (seen in sodium and “transfat” consumption, school lunch
options, and soda serving sizes) have proven effective locally in managing
public health. This effort is aided by rapid uptake of policy reforms into local
law and derailing of obstacles to regulation at the local level.68 Such
duplicative delegations across agencies further a multi-sectoral approach to
“health in all policies,”69 creating synergy across regulating agencies and
allowing for recognition of the extent to which underlying determinants of
non-communicable disease require a whole-of-government response.70
Further, with concurrent governance stretching beyond the public sector,
corporate actors have become policymakers in overlapping systems for non-communicable disease control.71 This result is highlighted by a proliferating
set of business practices restricting tobacco use among employees and
creating workplace wellness programs. These flexible partnerships across
government and non-government actors have proven effective where
centralized hierarchies (at both the national and international level) have been
incommensurate to the growing threat of non-communicable disease.
C. Emergency Preparedness
Critics view redundancy in emergency preparedness as leading to
operational confusion and conflicting mandates that result in breakdowns
during crises.72 This operational confusion presents itself both across and
within states.73 Notwithstanding efforts to harmonize state emergency
preparedness laws through model acts,74 there is comparatively less
understanding of how states will approach a cross-jurisdictional public health
68. Michelle M. Mello, David M. Studdert, & Troyen A. Brennan, Obesity—The New
Frontier of Public Health Law, 354 NEW ENG. J. MED. 2601 (2006) (Because of the advantages
of localized governance in non-communicable disease control, researchers and practitioners
have come to see coordination as a threat to innovation, with a growing public health
movement opposing industry-sponsored efforts to limit local governance through
“preemption” by state law.); Scott Burris et al., Moving from Intersection to Integration:
Public Health Law Research and Public Health Systems and Services Research, 90 MILBANK
Q. 375 (2012).
69. TIMO STAHL ET AL., HEALTH IN ALL POLICIES: PROSPECTS AND POTENTIALS (2006),
available at http://www.euro.who.int/__data/assets/pdf_file/0003/109146/E89260.pdf.
70. Steven H. Woolf & Paula Braveman, Where Health Disparities Begin: The Role of
Social And Economic Determinants—And Why Current Policies May Make Matters Worse,
30 HEALTH AFF. 1852 (2011).
71. Hunter, supra note 14, at 105.
72. Robert M. Pestronk et al., Improving Laws and Legal Authorities for Public Health
Emergency Legal Preparedness, 36 J.L. MED. & ETHICS 47 (2008).
73. Dorothy Puzio, An Overview of Public Health in the New Millenium: Individual
Liberty vs. Public Safety, 18 J.L. & HEALTH 173, 179 (2004).
74. James G. Hodge, Jr., The Evolution of Law in Biopreparedness, 10 BIOSECURITY &
BIOTERRORISM: BIODEFENSE STRATEG Y, PRAC., & SCI. 38 (2012).