Profile in Public Health Law
Angie McGowan, JD, MPH, answers our questions about her work as project director of the Healthy People 2020 Law and Health Policy Project, Office of Disease Prevention and Health Promotion, Department of Health and Human Services.
Title: Project Director, Healthy People 2020 Law and Health Policy Project; Office of Disease Prevention and Health Promotion (ODPHP), Department of Health and Human Services (assigned from CDC’s Program Performance and Evaluation Office [PPEO])
Education: JD, Vanderbilt University School of Law; MPH, Emory University Rollins School of Public Health (RSPH); BA, International Relations, College of William and Mary
Public Health Law News (PHLN): What sparked your interest in public health law?
McGowan: I’ve always been interested in health and policy issues, probably partly as a result of growing up in Atlanta—the “public health capital of the world,”—as RSPH likes to proclaim. Both of my parents worked in health, and I remember learning about issues like the dangers of smoking or the emergence of HIV at the dinner table or from friends’ parents. I found it interesting, but when I headed to college, I decided to focus on international relations. During law school, I realized that in addition to international issues, I was also greatly interested in health and healthcare issues. During my second summer in law school, I worked at CDC’s Office of General Counsel on a project with Professors Larry Gostin and Zita Lazzarini, collaborating with CDC subject matter experts, to analyze state laws and policies concerning privacy and immunizations—perhaps some of the earliest research specifically around laws and policies at CDC. During this time, I realized that I wanted to focus on health, and when I finished law school, I decided to take classes in public health. This started my career down a path focusing on public health law.
PHLN: Please describe your career path.
McGowan: Following public health school, I found a position as a legal services officer for the Georgia Division of Public Health (now the Department of Public Health). I worked on a wide range of public health legal issues from various offices, including epidemiology, chronic diseases, emergency medical services, and environmental issues. We also assisted with reviewing proposed legislation, which was exciting. I was really struck by the ability to navigate a range of public health issues and to work proactively with a variety of professionals to determine how law and policy could help with their work—hopefully changing their perception that they should work with the lawyers only after there was a problem.
My interest in learning more about how to bring strong data and science to public health law work led me to join CDC’s Epidemic Intelligence Service (EIS). I was privileged to be the first JD, as opposed to MD or PhD, to serve in the EIS. While there, I worked with the Guide to Community Preventive Services on violence issues; that work included a systematic review focused on the transfer of juveniles to the adult court system and the impacts on recidivism rates. During this time, I learned more about applied epidemiology and analyzing data. I also participated in Epi-Aids, whereby CDC provides epidemiologic assistance to health departments to investigate an urgent public health problem, and deployed to CDC’s Emergency Operations Center during SARS and West Nile virus.
After EIS, I was a public health law analyst with CDC’s National Center for Chronic Disease Prevention and Health Promotion, Office for Planning, Evaluation, and Legislation. I concentrated mainly on the role of evidence-based laws and policies in addressing chronic diseases. In 2007, I joined the Robert Wood Johnson Foundation (RWJF) a large health philanthropic organization in Princeton, New Jersey. There, I served as a senior program officer and worked on a range of public health issues, including tobacco use prevention and control, supporting leadership efforts, and preventing childhood obesity. Many of my most fulfilling projects concentrated on building the field of public health law. These projects included figuring out how best to support efforts in the field and funding programs to 1) encourage more research and evaluation of laws and policies impacting health, 2) provide assistance to those trying to use law and policy to improve their communities’ health, and 3) address workforce and training needs, including those of academia.
In 2014, I moved to ODPHP, in the Office of the Assistant Secretary of Health, to serve as the project director for the Healthy People 2020 Law and Health Policy Project.
PHLN: What do you do in your current position?
McGowan: I direct the Healthy People 2020 Law and Health Policy Project (the Project). The Healthy People initiative is led by HHS, and specifically, ODPHP. For 40 years, Healthy People has been providing science-based national objectives and ambitious, yet achievable, goals for improving the health of the nation. Healthy People serves as a roadmap for the nation’s health promotion and disease prevention efforts.
The Project—a collaborative effort between ODPHP, CDC’s Program Performance and Evaluation Office (PPEO), CDC Foundation, and RWJF—was created to advance our understanding of how law and policy affect health by examining the relationship between population health and legal and policy interventions in the context of achieving our Healthy People goals. The Project explores ways that legal and policy approaches can support Healthy People objectives and overarching goals, including those related to health equity. Through reports and other products, including a webinar series, focused on Healthy People topic areas and objectives, the Project identifies and disseminates evidence-based legal and policy solutions to public health challenges. We also support development of the next decade of the initiative, Healthy People 2030 (HP2030), by identifying opportunities to further incorporate evidence-based legal and policy tools into the initiative.
I coordinate project activities and encourage collaboration between the project partners, help convene necessary partners and workgroups, and guide development of the evidence-based products described above. I’m also part of the day-to-day efforts of Healthy People and am able to share examples of how law and policy could help us meet our targets and advance our other efforts, including development of HP2030.
PHLN: What do you find most fulfilling about your career and role?
McGowan: I’ve been very fortunate to work with some really amazing people throughout my career, including during my time here with the Project. I value being able to collaborate with multidisciplinary and multisectoral partners and to concentrate on the interrelationships among good science, public health practice, and policy and law. I find it fulfilling when people begin to understand the benefits of leveraging public health laws to improve health and well-being, and I believe this is happening more frequently—law and policy are gradually being better recognized as an integral part of public health practice. Of course, this is in great part due to the efforts of the Public Health Law Program and many key partners over the past 20 years. I’m pleased to have played a part in that work.
PHLN: Since working on the Healthy People 2020 (HP2020) initiative, what do you feel have been its greatest successes?
McGowan: An important element of Healthy People is its ability to be flexible and adapt over the decades to address new health challenges and advances while still using the best data and public health science to determine targets and goals. This has been the first decade that Healthy People has had a comprehensive online presence, which has allowed the initiative, objectives, data, and many tools and resources to be much more accessible to stakeholders. HP2020 also recognizes the importance of social determinants of health in a number of ways, including in its overarching goals, specific objectives, and useful infographics and resources such as literature reviews for 19 specific key issues. Finally, I think the increased focus on law and policy in HP2020 is a success, but I admit that I’m biased!
PHLN: How does your work, and the work of HP2020, use public health law and policy?
McGowan: As discussed, this year Healthy People will be launching its fifth set of science-based objectives and targets with HP2030. From the beginning, Healthy People has always had objectives focused on law and policy, although they’ve mainly been included in areas such as tobacco use or environmental health. But law and policy can be valuable tools to help achieve the targets for the HP2020 objectives. For example, community water fluoridation or school-based immunizations require or benefit from laws and policies. Healthy People also includes evidence-based resources, such as intervention evaluations or studies that have evidence of effectiveness, feasibility, reach, sustainability, and transferability. These resources might be from groups like the Community Preventive Services Task Force or US Preventive Services Task Force. Or they might be reports from the Surgeon General or National Academies of Science, Engineering, and Medicine, that recommend interventions or approaches to reach specific health targets. These resources often include legal and policy-related examples.
PHLN: Tell us more about the Healthy People Law and Health Policy Project.
McGowan: The Project explores the role for evidence-based laws and policies in helping us reach our Healthy People national targets. We’ve engaged and learned from some great experts and leaders, both within and external to the federal government. With them, we developed five comprehensive reports focused on Healthy People topic areas: Nutrition and Weight Status; Disability and Health; Maternal, Infant, and Child Health; Substance Abuse; and Oral Health. Each report was developed by two to four authors and a report working group, with the assistance of the respective Healthy People topic area workgroups. The reports are accompanied by executive summaries, graphics, and “bright spots” or success stories. The idea is to provide a number of learning methods for people interested in discovering more about how law and policy can potentially improve health.
We also hosted eight law and policy webinars covering a range of topics like healthy aging, suicide prevention, and health equity. The webinars also explained how to identify evidence-based resources and shared a model describing what types of laws and policies might be options when considering how to addressing a health challenge.
Finally, we were fortunate to work with the Healthy People Federal Interagency Workgroup (FIW)—the steering body for the initiative which includes representatives from more than 30 federal departments, agencies, and offices in combination with incredible engagement from the 42 topic areas, the HP2030 Secretary’s Advisory Committee, and ODPHP staff about the potential role for law and policy in this decade.
All of the resources we’ve developed are available through the Healthy People Law and Health policy page.
PHLN: What lessons are being applied in planning for the next iteration of the initiative—Healthy People 2030?
McGowan: With the launch of HP2030, our specific HP2020 Law and Healthy Policy Project is winding down. However, HP2030 will continue to consider how law and policy can improve health and well-being, since policy is referenced in Healthy People’s foundational principles, overarching goals, and plan of action for the new decade. HP2030 was informed by discussions with external partners, including a formal HP2030 listening session at the 2018 Public Health Law Conference, and an issue brief[PDF – 3.10MB] focused on law and policy as determinants of health that a subcommittee of the HP2030 Advisory Committee developed. A public health lawyer, Joel Teitelbaum, served on the advisory committee for the first time in Healthy People history. HP2030 was also informed by lessons from the Project. One of these lessons: Healthy People has always involved law and policy, but not as intentionally or explicitly as possible. This decade, I hope that law and policy will be better integrated into the overall initiative. The Project also made it a point to discuss both data and evidence—strengths of the Healthy People initiative—and to tie them to laws and policies whenever possible. While we did a good job of highlighting evidence-based laws and policies and positive examples of how law and policy can improve health outcomes, with HP2030 we realized it’s also important to discuss interventions that might not yet be evidence-based but are being tested in communities, and to provide examples of when law or policy can serve as a barrier to good health.
PHLN: What career advice do you have for young public health and public health law practitioners?
McGowan: I have two suggestions. First, be willing to take a chance on something new and different if you think it will be an exciting challenge and that you will learn and grow from it. I haven’t followed a traditional path for a lawyer, and at times it’s had its challenges. Being an EIS officer or working in philanthropy are opportunities I wouldn’t have envisioned, but both expanded my knowledge, experiences, and skills in new and different ways. Being able to articulate what you learned from an experience and what you do and don’t want to work on in the future is really valuable as you start to navigate your career. My second piece of advice is one you might have already heard—the world, and especially the public health world, is very small! I’ve been amazed by the number of times that colleagues from one stage in my life have come back into it later. There are some really great, passionate people working in the field of public health law who focus on a range of exciting issues. From my experience, they are also always excited to meet new people in the field!
PHLN: What do you look forward to on weekends?
McGowan: I enjoy having a chance to explore the DC area, visiting neighborhood hot spots like our walking trails and farmers market, or having a chance to try out fun new restaurants with friends (or good takeout these days, with COVID-19). I also try to exercise, attend sporting or music events, and catch up on reading, TV, and movies. Travel is a big part of my life, so I’m also always ready to take a weekend trip somewhere fun!
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