Akshara N. Menon
Title: Senior Legal Analyst/ORISE Fellow
Organizations: Public Health Law Program (PHLP), Office of State, Tribal, Local and Territorial Support, CDC
Education: J.D., Emory Law; M.P.H., Yale School of Public Health
Public Health Law News (PHLN): What drew you to work in the public health law field?
Menon: When I was in college and law school, public health law was a fairly new and emerging field. I was drawn to its interdisciplinary nature and large-scale potential to use the law as a tool to improve health not just for an individual, but also for populations.
PHLN: Please describe your career path to PHLP.
Menon: I was originally pre-medicine in college, and then took some classes that piqued my interest in the interdisciplinary study of law, bioethics, and public health. I began to hear more about the growing field of public health law, and decided to explore both educational and work experiences to further understand what it was all about. The more I learned about the field, I realized that I wanted to pursue a public health law career. After receiving my J.D. and M.P.H. degrees, I was looking for employment opportunities and was excited to find that CDC had established a public health law program committed to advancing the use of law as a public health tool. I was lucky to get an Oak Ridge Institute for Science and Education fellowship position with PHLP, and here I am!
PHLN: Can you briefly describe your day-to-day duties as a legal fellow?
Menon: Because our PHLP team primarily focuses on providing technical assistance to CDC programs and the state, tribal, local, and territorial (STLT) communities, my day-to-day duties include conducting research and analysis for legal assessments on various public health topics. Once a legal assessment is completed, I also help with writing and developing law-related tools and resources for STLT public health practitioners and policy makers.
PHLN: What do you mean by “legal assessments”?
Menon: Legal assessments involve collecting, analyzing, and coding STLT laws on a particular public health issue. We typically receive technical assistance requests from CDC programs or public health officials who would like to know how other STLT jurisdictions have used the law to address a particular public health problem. Thus, we conduct these legal assessments to help our public health customers understand the legal landscape.
PHLN: Can you please describe how you carry out fifty-state assessments and why they can be challenging?
Menon: To conduct a fifty-state assessment, the assigned PHLP attorney begins by understanding the specific issue the customer wants to know about and the kind of product they are envisioning. The PHLP attorney must learn more about the public health subject matter from the customer and also study the available literature. Once the PHLP attorney is familiar with the subject matter, she can search the Westlaw legal database for relevant laws. This is often where challenges arise because searches often produce a high number of results (sometimes thousands of laws!), which then requires refining search strings and conferring with the customer to establish the scope of laws to be collected.
Once all relevant laws have been collected, the PHLP attorney analyzes what the laws have in common with one another and how they differ from state to state. The content and variations between laws are coded by breaking down provisions into distinct elements that are assigned values. Such coding is an important last step to translate the law into a format that is accessible and useful to the customer.
This entire process can be time-consuming, which can be challenging when trying to meet the customer’s deadline.
PHLN: How do fifty-state assessments advance public health and public health law?
Menon: They are inventories of state legal strategies to address particular public health problems. Understanding the legal landscape and which legal tools are being used in states is an essential first step toward evaluating such public health laws’ effectiveness. Thus, fifty-state assessments are integral components to understanding how laws can be used effectively as a tool to advance public health.
PHLN: You’ve dedicated a great deal of time to a project on prescription drug laws, the results of which will be published in the coming months. Can you please describe the importance of this research and areas of focus within this research?
Menon: CDC has declared prescription drug overdose an epidemic in the United States. Because of the widespread nature of the problem, this has become a priority area for CDC’s National Center for Injury Prevention and Control and for PHLP. Based on discussions with experts in the field, CDC identified seven state legal strategies that have the potential to impact prescription drug misuse, abuse, and overdose. These seven types of laws include 1) laws requiring a physical examination before prescribing; 2) tamper-resistant prescription form requirements; 3) pain management clinic regulation; 4) laws setting prescription drug limits; 5) “doctor shopping” laws; 6) prescription drug identification laws; and 7) laws related to prescription drug overdose emergencies.
Starting in 2010, PHLP conducted fifty-state legal assessments in each of these seven domains. We’ve been working hard for the past two years to update and refine each of these legal assessments in the seven domains. We just published menus of laws on our PHLP website for three of the seven domains: state prescription drug identification laws, pain management clinic regulation, and state laws related to prescription drug overdose emergencies. We are finalizing our work on the remaining domains and hope to publish our findings soon. Because there is little information on the effectiveness of state statutes and regulations designed to prevent prescription drug abuse and diversion, our work is a first step in assessing such laws by creating an inventory of state legal strategies.
PHLN: What was the most challenging part of this project?
Menon: This project has involved conducting seven fifty-state legal assessments, requiring patience and focused reading of many, many laws! Being able to go through all laws found efficiently and only selecting those relevant to each domain was a challenging task.
PHLN: How do you hope this research will be used in the future?
Menon: We hope that our assessment work on state prescription drug laws will serve as an initial foundation for future evaluation and impact studies.
PHLN: What other interesting projects are you working on?
Menon: Other interesting projects that I am currently working on include assessments about electronic health information; enabling authorities; and public health’s role in health system transformation.
PHLN: How can people learn more about PHLP and prescription drug laws?
Menon: They can find information on PHLP’s website. Our website contains a publications and resources section, which includes our prescription drug research. We plan to publish menus there on our legal assessment work for seven domains of prescription drug overdose laws.
CDC’s National Center for Injury Prevention and Control and PHLP have also developed a website that provides an overview of these seven types of state prescription drug laws and highlights which U.S. states have enacted them. This website is also in the process of being updated with our recent research findings.
PHLN: What’s your favorite aspect of working as a PHLP legal fellow?
Menon: What I like the best about our work is the diverse nature of projects we receive, which enables fellows like me to learn about different subject matter areas and expand my expertise in the field.
PHLN: If you weren’t working in public health law, what would you likely be doing?
Menon: I would likely have pursued a career in international relations.
PHLN: Describe any personal information, hobbies, or interests you care to share.
Menon: I enjoy travelling to new places, learning about other cultures and especially trying new foods. Brunch is my absolute favorite meal!
PHLN: Have you read any good books lately?
Menon: I’m a loyal fan of Mary Higgins Clark, and recently enjoyed reading her novel, “The Shadow of Your Smile.”