The Collaborative Center for Legal Epidemiology: Evaluating law as an intervention to improve health outcomes and reduce disparities related to HIV, Viral Hepatitis, STDs, and Tuberculosis - Recipients funded under Component 1 of the Notice of Funding Opportunity CDC-RFA-PS-23-0009 from CDC's National Center for HIV, Viral Hepatitis, STD, and TB Prevention will use their expertise in legal epidemiology and policy evaluation to advance evidence-based policy to improve health outcomes and reduce health disparities related to HIV, viral hepatitis, STDs, and tuberculosis. The purpose of this project is to strengthen the ability of health decision makers to identify and deploy laws and policies that improve health and health equity. The team will identify legal topics of greatest salience to NCHHSTP; scientifically build longitudinal legal datasets; make the legal data available to policymakers, the public and researchers on a CDC-housed website/dashboard; work with CDC to timely and rigorously evaluate the implementation and effects of these laws; and make all findings and other products available to stakeholders in a timely and user-friendly manner. This work will measurably 1) increase awareness of and access to longitudinal law and policy surveillance datasets, increasing knowledge of laws and policies that reduce morbidity, mortality and health disparities, and 2) increase the breadth and depth of available evidence demonstrating the impact that laws and policies have on health and economic outcomes, leading to increased application of evidence-based laws and policies to improve health and reduce disparities. The team will employ best scientific practices from legal epidemiology and policy evaluation, and leverage technology to reduce costs, improve efficiency, and increase the usefulness and accessibility of the products. The team will conduct a data-driven landscape assessment -- to be reviewed annually -- to determine policy topics for legal epidemiological analysis. The assessment will involve three main parts: 1) identifying candidate laws and legal practices that may influence levels and disparities in STDs, HIV, viral hepatitis, and TB, as well as potential syndemics (co-occurring multiple nature of multiple epidemics); 2) mobilizing existing research knowledge and the expertise of a diverse group of subject-matter experts to identify important research questions; and 3) prioritizing policies/research questions for analysis. After the landscape assessment is complete and topics are selected, the team will use scientific legal mapping methods to systematically collect and analyze relevant laws. The team will create longitudinal legal datasets identifying key features of the law and capturing changes in the law over time. The datasets will include the relevant text of the law linked to specific attributes. Rigorous quality control measures will be used to ensure reliability of the legal data produced. By converting the words of the law into numeric data, the team will enable the digitization of legal information, making it possible to create dashboards of the kinds NCHSSTP is planning. The team plans to use the same rigorous research process for updating datasets in the final year of the project. The team will use the legal data created, along with quasi-experimental study designs, application of the novel policy target trial emulation framework, and data science best practices to measure the effects of key policies on morbidity, mortality and disparities in HIV, viral hepatitis, STDs, and tuberculosis. The team will develop numerous deliverables with varying levels of rigor and speed, and deploy various study design methods after conversation with the CDC. The team will work in collaboration and under the guidance of CDC colleagues in all phases of this work and will also work closely with the Component 2 grantees to ensure that all data and findings are relevant and accessible to policymakers, including health department officials, general counsels, state legislators, governors, and the support staff advising these leaders.
