What is Public Health Law and How Does One Get Into The Field?

Public Health is a growing field. Anyone who has spent some portion of time paying attention to the career environment in the United States will have noticed this. The health care field in general is growing as we face an aging population, an intense interest in health legislation, and changes to our country’s healthcare framework.

Public health professionals, rather than focusing on individual patients like doctors and nurses, examine the larger picture of the population they are responsible for overseeing. Their purpose is to try to prevent health-related problems from happening or re-occurring through implementing educational programs, developing policies, administering services, regulating health systems and conducting research.

Public Health Law is where the mission of public health intersects with the practice of the law. Here are some examples of that intersection, where public health lawyers are needed:

The city needs to draft a law to protect the public from the dangers of food borne illness. 

The federal government wishes to make personal health insurance compulsory…does this violate the constitutional rights of the individual? Ask a lawyer.

A local pig farm is violating the state health code…the state needs a lawyer to prosecute them.

How does one get involved in public health law? I asked this question of Lori Buschbaum, who first brought to my attention public health law as a career. I met Lori through a program called the Immigrant Families Advocacy Project. She is supervising me while we work on attaining a U-Visa for a victim of domestic violence

Lori actually started her career in the field of public health. She attained a Masters in Public Health, and began working in San Diego. After moving to Washington D.C. to be closer to her husband, she started looking around for a way to further her ability to work in international public health policy-making.

I took a few classes in public health and public policy thinking I would just go back and do more in public health. But I had a great professor who works for the Georgetown University Center for Children and Families, there were actually two professors. [One] was both an MPH [Masters in Public Health] and a lawyer, and the kind of policy work they were doing was really interesting to me. So I ended up having a lot of discussion with these two professors, auditing a couple of classes, and had them both say to me, “You know, for what you want to do, getting into policy, you could go one of two ways: you could do the PHD in public health…The other option they suggested to me was that I could do every bit as much with the combination of a JD and an MPH. And so I applied to law school, never in my wildest dreams in my prior life thinking I had any interest in law school or being a lawyer.

Having both a Masters and Public Health and a law degree, like Lori, makes one eminently suitable for work in public health law. But there are other options and paths. There are more and more LL.M. programs at universities targeted to bring a lawyer up to speed on public health issues. Georgetown University has an LL.M. in Global Health Law, and several law schools, including my own University of Washington, have an LL.M. in Health Law. Public Health is a subset of the larger focus of Health Law, but attaining a one-year LL.M. degree is a good way to demonstrate an interest and dedication to the health care field.

Without some sort of degree in health care, it may be more difficult to break into the field of public health law. However, as with any career in the law, as long as you are willing to scramble and volunteer and gain experience, your law degree can usually take you where you want to go.

Working for the Government

The idea behind Public Health Law, versus plain old Health Law, is that you are working for the public good, rather than that of individual plaintiffs or companies. Who worries constantly about the public good? My mother (“Oh my goodness, Sierra, high fructose corn syrup is a conspiracy against the people of this country!”) Aside from her? The government. Many of the jobs for public health lawyers are in different levels and branches of government.

For an example at the federal level, the FDA is currently hiring lawyers and second and third year law interns. A degree in public health law is not required, but practical work experience with the FDA is a great opportunity for a lawyer interested in public health. The Center for Disease Control and Prevention also has its Public Health Law Program, in Atlanta, GA. Pretty much any regulatory agency involved with public health has legal counsel/policy developer positions associated with it.

For those interested in politics and policy-making, the legislatures at every level of our government, from federal to state to local, have positions for public health lawyers. Lori described that type of work to me:

“[A]s a staff person on the work committee you are doing work for both the Republicans and the Democrats equally... It’s research work, it’s putting together legislation, it’s writing legislation, it’s background, and it’s pulling together committees. So it would be actually quite fascinating. I had an interview for one of those positions and was told, which really surprised me, that one of the problems with me getting one of those positions would be that I had worked in Senator Kennedy’s office when I was in DC. I never saw Senator Kennedy (laughs). His office is huge; he was never in our office. The health policy office was totally separate. I worked there for three months. I did nothing that was earth shattering, I wasn’t working on legislation that all the Republicans would hate—well, probably some if it passed—but it was really funny to me, because they said to me that may be a big problem.

Working for Non-governmental Organizations

If you aren’t interested in going the governmental route, there are plenty of non-governmental agencies that focus on the public service aspects of health law. There are organizations that fill every sort of public health niche, such as advocating and lobbying for legislation in particular areas, such as immigrant health reform, or women’s reproductive health rights. Some organizations focus on international health issues, and others narrow their focus to specific communities.

For example, Lori worked for several years for an organization here in Seattle called Northwest Health Law Advocates. The group advocates for affordable health care for low-income populations, researches the efficacy of current laws and policies, and represent consumer interests. Lori found this job through volunteering and informational interviews she conducted with public health professionals.

Life/Work Balance

            Governmental work and non-profit work seem to be less high-pressure careers than the usual private practice lawyer route. I recently attended a breakfast panel discussion by four lawyers working in different aspects of public service law. As we were winding up the discussion, the lawyer who worked for the Social Security Administration, as if casting about for one last thing to say, volunteered, “I go to work at 8:30am every morning, and leave by 5:00pm every day.” Another panelist, a young woman who worked in legal aid, timidly added, “Um. I’ve never worked on the weekend before.” The other two lawyers, who had backgrounds in litigation prior to their transitions to public service jobs, looked at them in disbelief, and everyone began to laugh.

The fact is that government jobs (especially federal ones) tend to be structured so that you do your work while you are in the building during office hours and getting paid to do it. Non-profit work, usually underfunded and consisting of small offices of close-knit co-workers, is often the same way.

Working with Lori, I have seen her use the flexibility of her situation. There was one evening that we had to meet our client after school hours, so she simply brought her five-year old son along with her to the meeting. He sat at his desk and did his connect-the-dot book. At one point, he sidled up to her where she was speaking, and whispered, “I can’t find the number 27.” Lori looked at him gravely, with that look moms give their kids to let them know they will talk to them about interrupting later, pointed at the correct dot, and he went back to his corner to finish his mission.

As she told me:

I do not have any desire right now to be doing the kind of “ramp-up” lawyer life-style. I’ve done law-firm stuff and—what it takes to get up to speed, and what it takes to be in the position—I don’t know that you ever get the flexibility…My experience is that private sector lawyers, no matter what level they are at, they are all working tremendous hours. I was a summer associate in D.C. and the senior partners were working crazy hours. They needed someone else who had a more flexible life as part of their family, or they needed full-time childcare…. [My husband’s] work is like that; if one of us was going to be flexible, it was going to be me.