Recent court rulings are negatively impacting public health, including those involving reproductive health, worker pay and affirmative action. 

At a Tuesday APHA 2024 Champion Conversation, “Role of Law and the Courts on Improving Public Health,” legal experts weighed in on Supreme Court and federal court rulings creating harm.

Since the emergency phase of the COVID-19 pandemic, a pattern in high court decisions has been to limit federal agency power, panelists said. A majority of justices ruled against the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration in separate cases that overturned actions to slow COVID-19 spread. Another case curtailed the Environmental Protection Agency’s ability to regulate power plant emissions.

The Supreme Court’s decision in 2022 to end the constitutional right to abortion had immediate impact, as many states outlawed the procedure at various stages of pregnancy, leading to a health crisis for millions of people.

In 2023, justices ruled by a 6-3 majority that race-conscious affirmative actions in admission programs at Harvard University and the University of North Carolina were unconstitutional, rolling back decades of precedent that boosted student diversity. 

The ruling could limit diversity in public health programs, the health workforce and the overall health of the nation, panelists said. Studies show that a diverse health workforce improves outcomes for patients and people receiving health-related services.

Another high court ruling that year is having far-reaching consequences. In Loper Bright Enterprises v. Raimondo, a majority of justices overturned a 40-year legal precedent known as the “Chevron deference.” The end of the policy means courts will be able to sidestep the expertise of federal health agencies when interpreting U.S. laws.

Rather than relying on expertise from health and regulatory federal agencies, courts will now be able to interpret and decide how public health laws apply on their own, said Ruqaiijah Yearby, a health law professor at the Moritz College of Law and professor at the College of Public Health at Ohio State University. That means rules could be weakened or eliminated through court rulings on pollution, clean water, Medicaid, Medicare, food and drug safety, civil rights, occupational safety, worker wages and more.

One example of the legal fallout came in August. The Biden Administration had created a regulation that increased minimum wage for tipped workers to $7.25 an hour, replacing a Trump-era rule holding it at $2.13 an hour. The increase was based on the expertise of the U.S. Department of Labor, which conducted research to conclude the increase was warranted to create an appropriate living wage for tipped workers. Earning a living wage is a positive determinant of health.

Two restaurant industry trade groups appealed a district court ruling favoring the Biden Administration, and in August the Fifth U.S. Circuit Court of Appeals struck down the administration’s wage increase, citing Loper Bright and arguing that the labor department overreached.

Irony touches the history of the Chevron deference because Republicans initially supported it “to undercut community power” by ceding decision-making to federal agencies, Yearby said. But the agencies have generally been “empowering communities, protecting rights” — not the outcome sought. 

Overturning Chevron places the power in judges who may or may not have the public’s best interest in mind.

While the current Supreme Court makeup may not change for a long time, action can be taken by public health advocates, said Fatima Goss Graves, president and CEO of the National Women’s Law Center. Advocates can make their voices known through friend-of-the-court briefs, which are legal documents filed by experts who are not directly involved in a case. 

APHA frequently submits such briefs in high-level court cases that affect public health, using its expertise, reputation and partnerships to weigh in on decisions.
Advocates can also meet with state representatives to highlight the benefits of supporting public health in legislation, and voters can support public health-friendly politicians and ballot measures, the panelists said.

Meanwhile, legal experts and law centers continue to fight for public health in the courts — “upholding public health authority while centering equity,” said Sarah de Guia, CEO of ChangeLab Solutions.

Photos: Top, left to right, Fatima Goss Graves and Ruqaiijah Yearby; Sarah de Guia. Photos courtesy EZ Event Photography.