Researchers at the Johns Hopkins Bloomberg School of Public Health today launched Hopkins Judicial Health Notes, a new tool that evaluates the health implications of critical court cases. The notes draw on public health expertise and evidence to provide insights into the health and equity considerations of court decisions at various levels.
Each Hopkins Judicial Health Note provides a nonpartisan analysis for policymakers, scholars, legal experts, and advocacy organizations to support more informed judicial and legislative action. Hopkins Judicial Health Notes systematically analyze court cases and decisions on issues where health impacts may be overlooked. The notes identify ways a case or decision might improve or harm the public’s health, emphasizing the disproportionate impacts on marginalized and minoritized groups. Hopkins Judicial Health Notes are available here.
Hopkins Judicial Health Notes also include evidence-based recommendations about health impacts to consider either before the case is decided, after the court decision, or during implementation. In this way, public health expertise informs each stage of the judicial decision-making process.
“Court decisions profoundly shape our society and can have lasting implications for health,” says Keshia Pollack Porter, PhD, MPH, Bloomberg Centennial Professor and Chair of the Bloomberg School’s Department of Health Policy and Management. “Hopkins Judicial Health Notes will fill a critical gap by providing an evidence-based health assessment of courts’ actions and ramifications,” she says. Pollack Porter is also a core faculty member in the Bloomberg American Health Initiative at the Bloomberg School, which supported the launch of the project.
The Hopkins Judicial Health Notes launch was announced at the seventh annual Bloomberg American Health Summit in Washington, D.C. The event brings together public health leaders across sectors to address pressing public health issues.
In addition to examining peer-reviewed research, Hopkins Judicial Health Notes are informed by subject matter experts.A national advisory committee of public health legal scholars also provided input in the development of the notes. To date, the researchers have analyzed three representative cases to demonstrate how this methodology can be applied to court cases and decisions and answer three main questions: What are the potential health effects of this case, who is most likely to be affected, and how can public health be protected?
The cases and findings included so far in the project are:
- City of Grants Pass, Oregon v Johnson: In 2024, the U.S. Supreme Court ruled that cities can penalize unhoused individuals for sleeping in public, even if there are not enough shelter beds available, reversing previous protections. This decision supported Grants Pass, Oregon allowing ordinances that prohibit individuals from sleeping in public or in a vehicle or camping—using bedding or establishing a temporary place to live—in public areas within city limits.
The Hopkins Judicial Health Note analyzed the health impacts of criminalizing homelessness, highlighting the disruption of access to health care and social services and the increase in violence against unhoused individuals. The researchers also found evidence suggesting that anti-camping ordinances do not necessarily improve public health or safety for surrounding communities. The note suggests engaging with unhoused individuals and promoting alternatives to involuntary displacement to create effective solutions.
- United States v. Daniels: Patrick Daniels argued that his arrest for firearm and marijuana possession during a 2022 traffic stop violated his Second Amendment rights. He cited a 2022 U.S. Supreme Court ruling that says firearm restrictions must have historical support. The Fifth Circuit Court agreed, stating that in the 18th century, people who used substances weren’t specifically banned from owning guns, and the charge was deemed unconstitutional.
The Hopkins Judicial Health Note highlights health and safety concerns associated with firearm access for people who use illicit substances. It found that substance use, especially in settings of intimate partner violence and low-income communities, is linked to riskier gun behaviors and increased firearm violence, with women and Black men disproportionately affected. The note suggests evidence-based policies such as firearm purchaser licensing and extreme risk protection order laws to address firearm ownership risks among people who use substances.
- Utah Physicians for a Healthy Environment v. Utah Department of Natural Resources: In this ongoing case, a coalition of environmental and community groups represented by Earthjustice is suing Utah state agencies for failing to protect the Great Salt Lake from ecological decline.
The Hopkins Judicial Health Note highlights evidence that shows a shrinking saline lake worsens air quality, water scarcity, and economic hardship, particularly affecting low-income and minoritized communities in the region. The note underscored the importance of including Indigenous communities, whose ancestral homelands border the lake, in restoration plans.
Hopkins Judicial Health Notes build on the success of legislative health notes, a policy analysis tool that encourages local, state, and national organizations to include health considerations in proposed policy and legislation. Both health policy projects are led by Pollack Porter and Stefanie Carignan, MA, associate director of the Bloomberg School’s Health in All Policies Initiative.
“These court cases demonstrate a variety of instances where Hopkins Judicial Health Notes can illuminate health and equity implications, especially in situations where health is not at the forefront,” says Carignan. “They are a crucial advancement to ensure decisions prioritize health and work to improve outcomes for those impacted.”
The researchers will continue to monitor the legal landscape and develop Hopkins Judicial Health Notes for new cases and decisions and will offer training and technical assistance to groups interested in applying the methodology. Comprehensive analyses of all three Hopkins Judicial Health Notes and more information about the project are available online.
