Public Health Law of the United States
Questions of public health in the United States come under the common law and the statute law. In the larger part of the Union they are subject to the common law only; in a certain number of the States there is statute law; and there has been since 1879 a national board of health and a quarantine law established by Act of Congress. Generally speaking, the public health procedure of the United States suffers from the want of organization. Decisions at common law relate chiefly to nuisances, and to the recovery of damages for loss caused by the same.
The first attempt at statute law was an Act of 1866 creating a metropolitan sanitary district and board of health for the city of New York; in 1869 a board of health was created by the State legislature for Massachusetts; the District of Columbia obtained its board of health in 1870; and other States have followed at intervals, so that there are now at least nineteen State boards of health, New York State and Pennsylvania having health boards only for their respective capitals and other individual towns. Besides the municipal boards in those States, there are very few others for towns in the Union, and still fewer for counties. The powers and activity of the boards of health are very various; the Massachusetts board has powers amounting to that of a court, while the function of several of the State boards is hardly more than advisory.
The sanitary statutes made by the State legislatures are in some cases very numerous. Wherever questions of quarantine for yellow fewer have arisen, as in Louisiana (New Orleans), Georgia, and Alabama, the State board of health has acquired vigour and has enlisted popular support, in the capitals at least; but in most of the States laissez faire is the ordinary feeling towards the board and its operations.
The medical profession in each State is the most powerful force, and the State medical society is not unfrequently in a semi-official connexion with the sanitary boards; on the other hand, it is alleged that the unfortunate sectarian differences in medicine (represented chiefly by homeopathy) have on several occasions prevented the formation of a State board of health, or have tended to paralyse the action of a board already existing. It is a charge also against boards of health, or at least against those in the great political centres, that their efficiency is apt to be impaired by the introduction of irrelevant political considerations in such matters as the making of appointments.
The first step towards a national public health law was gained by the Act (approved 3d March 1879) "to prevent the introduction of infectious or contagious diseases into the United States, and to establish a national board of health." The board consists of several members appointed by the president and of four official detached from the public departments of State. Its duties are "to obtain information upon all matters affecting the public, to advise the several States, and the commissions of the District of Columbia, on all questions submitted to them, or whenever, in the opinion of the board, such advice may tend to the preservation and improvement of the public health."
Quarantine was to be a special object of the boards attention, especially the establishment, if possible, of a deferral quarantine system which preserve the legitimate commercial interests of the several States and their seaports. A quarantine law passed in 1879 provides that all vessels coming from any foreign port where contagious or infectious diseases exists shall obtain a bill of health from the consular officer of the United States at the port of sailing.
One of the principal functions of the national board of health hitherto has been to institute scientific inquiries into the nature and causation of diseases of national importance, such as malarial fever. Among the acknowledged desiderata in the national sanitary law of the United States are a uniform carrying out of the practice of vaccination there is no vaccination law in certain States, and in others it is imperfectly applied and a uniform system of registration of births and deaths.
See Bowditch, Public Hygiene in America, together with a Digest of American Sanitary Law (by Pickering), Boston, 1877; Billings, Introduction to Hygiene and Public Health, edited by Buck (Eng. Ed., London), and in the Transactions of the Internat. Medical Congress, London, 1880, vol. IV., sect. "Public Health."
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