Tag Archives: public health

Child and Public Health in a Libertarian Legal Framework

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Earlier this year the West Coast saw a measles outbreak, another recurrence in a string of previously eradicated childhood illnesses. Stories of parents’ various objections to vaccination quickly flooded the news, underscoring the main question: who is responsible for these public health crises, families or the state? While some people may have been surprised or confused to see such illnesses return, Clare Huntington and Elizabeth Scott’s explanation of children’s health in a legal framework for The Future of Children provides valuable context.

The U.S. legal system, say Huntington and Scott, “gives parents the authority and responsibility to make decisions about their children’s health care, and favors parental rights over society’s collective responsibility to provide for children’s welfare” or, in the case of vaccination, overall public health. They call this a libertarian legal framework as a way to describe the legal context in which parents are permitted to make their own decisions about child health. There are exceptions, such as when a child’s life is in danger or when a child is in juvenile justice custody; however, since parental rights are constitutionally protected, a high standard of harm must be met before intervention can occur.

In public health cases such as vaccination, where can the line of “harm” be drawn? Currently, all healthy children are required to receive vaccinations in order to attend school. However, almost all states offer exemptions for religious beliefs and many also offer them for other philosophical convictions. The balance between the libertarian argument and public health theoretically rests on the understanding that those with strong beliefs both deserve their right to decide and are a small enough segment of the population that the overall public interest of immunity is still met. However the return of some childhood illnesses shows that this balance is no longer being maintained.

Now many states are tightening their exemption policies. For example, California (origin of the measles outbreak) is on the verge of eliminating philosophical exemptions. For some states, making these adjustments may be more difficult. As Huntingdon and Scott put it, “without an affirmative legal obligation to promote children’s [or public] health, governmental investment is optional.” In this context, public health policy is often reactive rather than proactive or preventative.

Recent shifts in both cultural and legal views of vaccination deliver an immediate and crucial example of the libertarian legal context for child health policy and its limits. To read further on current issues in children’s health, see our latest issue of The Future of Children, “Policies to Promote Child Health.”

Social Marketing to Teens Thrives Through Web 2.0 Technology

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YouTube videos for a new public health campaign are going viral: the Boston Public Health Commission hopes its messages on sexual safety, disseminated through new internet media, will spread as markedly among city youth as sexually transmitted diseases have. As highlighted in the Boston Globe, this campaign understands that adolescents today are deeply entrenched in media sources that constantly bombard them with messages about how to live; rather than fighting against media exposure, Boston is responding with a positive message sent through the same channels.
The media is a ubiquitous presence in our lives, from radio to TV to the internet. American teens are particularly influenced by their access to the web, which offers chances both to absorb information from outside sources (“Web 1.0”) and to actively contribute to the internet’s offerings through social networking sites, videos, blogs, or message boards and forums (“Web 2.0”). By capitalizing on these many options that play such a large role in adolescent life, social campaigns such as the STI Prevention Drive in Boston can connect with teens on their own terms.
This concept has been explored in an article in Children and Electronic Media, “Social Marketing Campaigns and Children’s Media Use,” and the companion policy brief “Using the Media to Promote Adolescent Well-Being.” Both of these recognize the positive ways that online media can be used to promote healthy behaviors, and they detail successful Web 2.0 campaigns.
With internet available in schools, homes, and even on cell phones, preventing teens from viewing objectionable content is virtually impossible. Some have worried that teens’ web use will lead to more dangerous sexual behavior, including becoming sexually active at a younger age and being less cautious about disease and pregnancy prevention – issues that are explored in another FOC article, “Media and Risky Behaviors.” While such concerns are not unfounded, the designers of Web 2.0 media campaigns recognize that rather than prohibiting internet access, it is far more successful to fight fire with fire – using the same media that promote unhealthy behaviors to promote healthy ones.
While parental guidance and school programs can play a role in discouraging unhealthy behaviors, Web 2.0 media campaigns acknowledge the reality that adolescents are heavily influenced by their peers. The new Boston campaign uses YouTube videos generated by and starring teens, and it also recruits teens to spread the message through other forums, such as street theater and visual advertisements. By having the teens design the content, the messages are more accessible than if they were created and imposed on teens by adults.

Web 2.0 campaigns also offer social organizations increased potential for spreading their messages. For example, the Boston Public Health Commission will field anonymous Facebook questions to experts, allowing teens to ask and get information without embarrassment or social stigma. The internet allows for viral messaging as well – videos can be passed around through blogs, Twitter, emails, or even news coverage, greatly increasing their reach. Marketers know that casual but frequent exposure to a message makes consumers more likely to buy their products; Web 2.0 campaigns use the same methods to promote healthy lifestyle choices among teens.