LAUSR

The field of prevention science has been instrumental in the development and testing of strategies to promote mental, emotional, and behavioral (MEB) health among children and youth. Yet, despite an abundance of scientific evidence of effective programs, little progress has been made in scaling up and creating structural change to support healthy development for all children (Fagan et al. 2019; National Academies 2019). The National Academies of Sciences, Engineering, and Medicine’s (the National Academies) Board on Child, Youth, and Families consensus study report entitled Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth (National Academies 2019) concludes that a national agenda including institutional and policy change is central to achieve improved and lasting outcomes at the population level. The 2019 report is the third in a series on MEB development published since 1994 that have synthesized evidence and provided recommendations for promotion of healthy development and prevention activities (Institute of Medicine 1994; National Research Council and Institute of Medicine 2009; National Academies 2019). The 2019 report includes a greater emphasis on achieving population-level effects through institutional and policy change. “This emphasis reflects the fact that despite the development of programs that are effective in supporting healthy MEB development in individuals and groups of children and youth, successful population-based efforts that can broadly counter adverse environments and experiences that threaten healthy MEB development for so many of the nation’s young people have not materialized.” (p. vii). Conclusions of the consensus study highlight broad societal factors, such as poverty, inequality, and discrimination, as key influences on MEB health, and recommend a coordinated national agenda to address healthy MEB development universally with particular attention to geographic areas of concentrated disadvantage. Given its emphasis on achieving population-level effects, the 2019 consensus study dedicated a chapter to research on policies (National Academies 2019). In this chapter, guided by conceptual frameworks of policy effects on child health and health equity (Komro et al. 2011, 2014; Solar and Irwin 2010), I illustrate the multitude of laws and central mechanisms through which laws may influence child health (Fig. 1). Below, I briefly summarize research from a few key areas included in the commissioned paper that I wrote for the consensus study, including results from foundational public health law research on the effectiveness of laws designed to protect children from physical harms and emerging research on policies that address social determinants of health. The long-standing fields of injury prevention and alcohol and tobacco control have often pointed the way on use of strong research designs such as controlled time-series to assess effects of laws on health. Sophisticated research methods are increasingly being applied evaluating health effects of laws that affect the upstream social determinants of health.