Leila F.S. Barraza

Interests

Research

Impact of laws and policies on public health

Teaching

Public Health Law, Policy, and Ethics

Courses

Scholarly Contributions

Journals/Publications

• Barraza, L. F., Austhof, E., Khan, S. M., Kelley, C., Shilen, A., Ernst, K. C., Cordova, F. M., Pogreba Brown, K. M., Jacobs, E. T., & Hall-Lipsy, E. A. (2023). Differences in Perceptions of Individual and Government-Level COVID-19 Prevention Measures Based on Vaccine Willingness. Journal of Health Care Law & Policy, 26(1), 87-104.
• Barraza, L. F., Kahn, S., Shilen, A., Austhof, E., Cordova, F. M., Ernst, K. C., Heslin, K., Kelly, C., Pogreba Brown, K. M., Jacobs, E. T., & Hall-Lipsy, E. A. (2023). Differences in Perceptions of Individual and Government-Level COVID-19 Prevention Measures Based on Vaccine Willingness.. Journal of Heath Care Law & Policy.
• Hodge, J. G., Barraza, L., Piatt, J. L., & White, E. N. (2023). Midterm Maelstrom: Public Health Legal Impacts of Election 2022. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 51(1), 208-212.
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  Among the morass of critical issues impacting the results of the midterm elections in 2022 were core public health issues related to health care access, justice, and reforms. Collectively, voters' communal health and safety concerns dominated outcomes in key races which may shape national, state, and local legal approaches to protecting the public's health in the modern era.
• Hodge, J. G., Barraza, L., Piatt, J. L., White, E. N., Ghaith, S., Hollinshead, S., Krumholz, L., Puchebner, M., & Smith, E. (2023). Supreme Court Impacts in Public Health Law: 2022-2023. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 51(3), 684-688.
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  In another tumultuous term of the United States Supreme Court in 2022-2023 a series of critical cases implicate instant and forthcoming changes in multiple fronts that collectively shift the national public health law and policy environment.
• Lent, A. B., Derksen, D., Jacobs, E. T., Barraza, L., & Calhoun, E. A. (2023). Policy Recommendations for Improving Rural Cancer Services in the United States. JCO oncology practice, 19(5), 288-294.
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  Compared with urban residents, rural Americans have seen slower declines in cancer deaths, have lower incidence but higher death rates from cancers that can be prevented through screening, have lower screening rates, are more likely to present with later-stage cancers, and have poorer cancer outcomes and lower survival. Rural health provider shortages and lack of cancer services may explain some disparities. The literature was reviewed to identify factors contributing to rural health care capacity shortages and propose policy recommendations for improving rural cancer care. Uncompensated care, unfavorable payer mix, and low patient volume impede rural physician recruitment and retainment. Students from rural areas are more likely to practice there but are less likely to attend medical school because of lower graduation rates, grades, and Medical College Admission Test (MCAT) scores versus urban students. The cancer care infrastructure is costly and financially challenging in rural areas with high proportions of uninsured and publicly insured patients. A lack of data on oncology providers and equipment impedes coordinated efforts to address rural shortages. Graduate Medical Education funding greatly favors large, urban, tertiary care teaching hospitals over residency training in rural, critical access and community-based hospitals and clinics. Policies have the potential to transform rural health care. This includes increasing advanced practice provider postgraduate oncology training opportunities and expanding the scope of practice; improving health workforce and services data collection and aggregation; transforming graduate medical education subsidies to support rural student recruitment and rural training opportunities; and expanding federal and state financial incentives and payments to support the rural cancer infrastructure.
• Hodge, J. G., Piatt, J. L., Barraza, L., & White, E. N. (2022). Regressive Federalism, Rights Reversals, and the Public's Health. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 50(2), 375-379.
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  As the United States emerges from the worst public health threat it has ever experienced, the Supreme Court is poised to reconsider constitutional principles from bygone eras. Judicial proposals to roll back rights under a federalism infrastructure grounded in states' interests threaten the nation's legal fabric at a precarious time. This column explores judicial shifts in 3 key public health contexts - reproductive rights, vaccinations, and national security - and their repercussions.
• Hodge, J. G., Piatt, J., Barraza, L. F., & White, E. (2022). Regressive Federalism, Rights Reversals, and the Public’s Health.. Journal of Law, Medicine, & Ethics, 50(2), 384=388.
• Leybas Nuño, V., Mantina, N. M., Dawodu, O., Dykinga, M., Carr, D. L., Pogreba-Brown, K., Cordova-Marks, F., Jehn, M., Peace-Tuskey, K., Barraza, L., & Garcia-Filion, P. (2022). Consequences of COVID-19 on adolescents in Arizona: A longitudinal study protocol. Frontiers in public health, 10, 945089.
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  The long-term impact of COVID-19 is unknown. We developed a 5-year prospective cohort study designed to generate actionable community-informed research about the consequences of COVID-19 on adolescents ages 12-17 years in Arizona.
• Nuno, V. L., Mantina, N. M., Dawodu, O., Dykinga, M., Carr, D. L., Pogreba Brown, K. M., Cordova, F. M., Jehn, M., Peace-Tuskey, K., Barraza, L. F., & Garcia, P. C. (2022). Consequences of COVID-19 on adolescents in Arizona: A longitudinal study protocol. . Frontiers in Public Health.
• Catalfamo, C. J., Heslin, K. M., Shilen, A., Khan, S. M., Hunsaker, J. R., Austhof, E., Barraza, L., Cordova-Marks, F. M., Farland, L. V., Garcia-Filion, P., Hoskinson, J., Jehn, M., Kohler, L. N., Lutrick, K., Harris, R. B., Chen, Z., Klimentidis, Y. C., Bell, M. L., Ernst, K. C., , Jacobs, E. T., et al. (2021). Design of the Arizona CoVHORT: A Population-Based COVID-19 Cohort. Frontiers in public health, 9, 620060.
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  This study is a prospective, population-based cohort of individuals with a history of SARS-CoV-2 infection and those without past infection through multiple recruitment sources. The main study goal is to track health status over time, within the diverse populations of Arizona and to identify the long-term consequences of COVID-19 on health and well-being. A total of 2,881 study participants (16.2% with a confirmed SARS-CoV-2 infection) have been enrolled as of December 22, 2020, with a target enrollment of 10,000 participants and a planned follow-up of at least 2 years. This manuscript describes a scalable study design that utilizes a wide range of recruitment sources, leveraging electronic data collection to capture and link longitudinal participant data on the current and emerging issues associated with the COVID-19 pandemic. The cohort is built within a collaborative infrastructure that includes new and established partnerships with multiple stakeholders, including the state's public universities, local health departments, tribes, and tribal organizations. Challenges remain for ensuring recruitment of diverse participants and participant retention, although the electronic data management system and timing of participant contact can help to mitigate these problems.
• Hodge, J. G., Piatt, J. L., & Barraza, L. (2021). Legal Interventions to Counter COVID-19 Denialism. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 49(4), 677-682.
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  A series of denialist state laws thwart efficacious public health emergency response efforts despite escalating impacts of the spread of the Delta variant during the COVID-19 pandemic.
• Hodge, J. G., Piatt, J. L., Barraza, L., Freed, R., Ghaith, S., & Wells, N. (2021). Legal Challenges Underlying COVID-19 Vaccinations. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 49(3), 495-499.
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  Immunizing hundreds of millions against COVID- 19 through the most extensive national vaccine campaign ever undertaken in the United States has generated significant law and policy challenges.
• Hodge, J., Piatt, J., Barraza, L. F., Freed, R., & Ghaith, S. (2021). Vaccinating Urban Populations in Response to COVID-19: Legal Challenges and Solutions. Fordham Urban Law Journal.
• Lent, A. B., Mohan, P., Derksen, D., Cance, W. G., Barraza, L., Jacobs, E. T., & Calhoun, E. A. (2021). The association between breast cancer capacity and resources with incidence and mortality in Arizona's low populous counties. Rural and remote health, 21(3), 6357.
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  While cancer deaths have decreased nationally, declines have been much slower in rural areas than in urban areas. Previous studies on rural cancer service capacity are limited to specific points along the cancer care continuum (eg screening, diagnosis or treatment) and require updating to capture the current rural health landscape since implementation of the 2010 Affordable Care Act in the USA. The association between current rural cancer service capacity across the cancer care continuum and cancer incidence and death is unclear. This cross-sectional study explored the association between breast cancer service capacity and incidence and mortality in Arizona's low populous counties.
• Warholak, T. L., Lee, J. K., Barraza, L. F., Slack, M. K., & Axon, D. R. (2021). Nationally representative health care expenditures of community-based older adults with pain in the United States prescribed opioids versus those not prescribed opioids.. Pain Medicine., 22(2), 282-291. doi:10.1093/pm/pnaa114
• Axon, D. R., Slack, M., Barraza, L., Lee, J. K., & Warholak, T. (2020). Nationally Representative Health Care Expenditures of Community-Based Older Adults with Pain in the United States Prescribed Opioids vs Those Not Prescribed Opioids. Pain medicine (Malden, Mass.).
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  To compare health care expenditures between older US adults (≥50 years) with pain who were prescribed opioid medications and those who were not.
• Barraza, L. F., Campos-Outcalt, D. E., & Reeves, C. (2020). Outcome of Coronavirus Disease 2019 on School Vaccination Policies for 2020-2021. JAMA Health Forum.
• Barraza, L. F., Lebedevitch, C., & Stuebe, A. (2020). The Role of Law and Policy in Assisting Families to Reach Healthy People’s Maternal, Infant, and Child Health Breastfeeding Goals in the United States. HHS, Office of Disease Prevention and Health Promotion.
• Hodge, J., & Barraza, L. F. (2020). Violating People's Rights Is Not the Way to Address the Coronavirus. SLATE.
• Barraza, L. F. (2019). Exploring Legal and Policy Responses to Opioids: America’s Worst Public Health Emergency.. South Carolina Law Review.
• Barraza, L. F. (2019). Housing Rx: Policy Innovations and Opportunities for Action in New York State.. New York State Bar Association Health Law Journal.
• Barraza, L., Hodge, J. G., Gulinson, C. L., Hensley, D., & Castagne, M. (2019). Immunization Laws and Policies Among U.S. Institutes of Higher Education. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 47(2), 342-346.
• Barraza, L., Reiss, D., & Freeman, P. (2019). Legal and Policy Responses to Vaccine-Preventable Disease Outbreaks. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 47(2_suppl), 11-14.
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  Laws and policies are vital tools in preventing outbreaks and limiting the further spread of disease, but they can vary in content and implementation. This manuscript provides insight into challenges in responding to recent vaccine-preventable disease outbreaks by examining legislative changes in California, policy changes on certain university campuses, and the laws implicated in a measles outbreak in Minnesota.
• Hodge, J. G., Barraza, L., Castagne, M., Fleming, H. K., & White, E. N. (2019). Major Health Law and Policy Positions Among 2020 Democratic Presidential Candidates. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 47(3), 459-464.
• Hodge, J. G., Gulinson, C. L., Barraza, L., Augur, H. R., Castagne, M., Cheff, A., Hensley, D., Sobek, M., & Weisberg, A. (2019). Innovative Law and Policy Responses to the Opioid Crisis. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 47(1), 173-176.
• Barraza, L. F., & Hall-Lipsy, E. A. (2018). Airport Public Health Preparedness and Response: Legal Rights, Powers, and Duties.. National Academies Press.
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  http://www.trb.org/Publications/Blurbs/177931.aspx
• Barraza, L., & Campos-Outcalt, D. (2018). More Research Needed to Increase Policies for HPV Vaccine Uptake. American journal of public health, 108(4), 430-431.
• Garba, I., Barraza, L., & Hall-Lipsy, E. (2018). Acquired Duties for Ethical Research With American Indian/Alaska Native Populations: An Application of Pierson and Millum's Framework. The American journal of bioethics : AJOB, 18(11), 40-42.
• Hall-Lipsy, E., Barraza, L., & Robertson, C. (2018). Practice-Based Research Networks and the Mandate for Real-World Evidence. American journal of law & medicine, 44(2-3), 219-236.
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  The 21 Century Cures Act encourages the Food and Drug Administration to consider "real-world evidence" in its regulation of the safety and efficacy of drugs and devices. Many have interpreted this mandate to focus on non-randomized observational research. However, we suggest that regulatory science must also move from rarefied academic hospitals to community-based settings, where the vast majority of patients in fact receive care in the fragmented U.S. healthcare system. This move is especially important if innovations are to reach, and be validated in, more diverse populations. A solution can be found in the 183 Practiced-Based Research Networks ("PBRN"), i.e., groups of primary care clinicians and practices in all 50 states working to improve clinical care and translate research findings into practice. This symposium contribution seeks to (1) describe some of the common shortcomings of clinical trials, (2) explore the opportunities and challenges posed by use of real-world evidence as a basis for drug and device regulation, (3) briefly describe the history and evolution of PBRNs, and (4) articulate the challenges and opportunities for using PBRNs to fulfill the 21 Century Cures Act mandate for real-world evidence.
• Hodge, J. G., Wetter, S. A., Barraza, L., Morcelle, M., Chronister, D., Hess, A., Piatt, J., & Johnson, W. (2018). Emerging Legal Threats to the Public's Health. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 46(2), 547-551.
• Barraza, L. F., Weidenaar, K. E., Cook, L. T., Logue, A. R., & Halpern, M. T. (2017). Regulations and policies regarding e-cigarettes. Cancer, 123(16), 3007-3014.
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  Electronic cigarettes (e-cigarettes) are a growing public health concern because of a dramatic increase in use by adolescents and the uncertainty of potential health impacts. These health concerns and lack of an established federal regulatory scheme have led many local and state governments to address the regulatory void for e-cigarettes by incorporating them into the statutory definition of tobacco or by passing laws specific to the use of e-cigarettes. In August 2016, the US Food and Drug Administration issued a final rule deeming e-cigarettes within their authority; providing uniform requirements like premarket approval applications, Harmful and Potentially Harmful Constituents reporting, and warning labels; and establishing 18 years as a minimum age of purchase. Although the impact on the public's health remains uncertain, regulations and laws governing e-cigarettes continue to develop. This review highlights the available data regarding safety and public health impacts of e-cigarettes and details the status of US regulations and policies affecting their sale and use. Cancer 2017;123:3007-14. © 2017 American Cancer Society.
• Barraza, L., Schmit, C., & Hoss, A. (2017). The Latest in Vaccine Policies: Selected Issues in School Vaccinations, Healthcare Worker Vaccinations, and Pharmacist Vaccination Authority Laws. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 45(1_suppl), 16-19.
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  This paper discusses recent changes to state legal frameworks for mandatory vaccination in the context of school and healthcare worker vaccination. It then discusses state laws that allow pharmacists the authority to vaccinate.
• Glenn, M., Zoph, O., Weidenaar, K., Barraza, L., Greco, W., Jenkins, K., Paode, P., & Fisher, J. (2017). State Regulation of Community Paramedicine Programs: A National Analysis. Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors, 1-8.
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  Community Paramedicine (CP) is a rapidly evolving field within prehospital care where paramedics step outside of their traditional roles of treating acute conditions to provide elements of primary and preventive care. It is unclear if current state oversight regarding the scope of practice (SOP) for paramedics provides clear guidance on the novel functions provided and skills performed by CP programs.
• Barraza, L., Weidenaar, K., Campos-Outcalt, D., & Yang, Y. T. (2016). Human Papillomavirus and Mandatory Immunization Laws: What Can We Learn From Early Mandates?. Public health reports (Washington, D.C. : 1974), 131(5), 728-731.
• Hodge, J. G., & Barraza, L. F. (2016). Legal regulation of sodium consumption to reduce chronic conditions.. Preventing Chronic Disease, 13(E26), 1-4.
• Barraza, L., Collmer, V., Meza, N., & Penunuri, K. (2015). The Legal Implications of HIPAA Privacy and Public Health Reporting for Correctional Facilities. Journal of correctional health care : the official journal of the National Commission on Correctional Health Care, 21(3), 213-21.
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  Inmates in cramped living quarters, a situation common to correctional facilities, are especially vulnerable to disease. Cramped living conditions, coupled with above-average rates of HIV, tuberculosis, and other communicable diseases, increase inmates' risk of problematic health outcomes. Thus, high-quality health care and sustained efforts to prevent disease are especially important to improve inmate health within correctional facilities. Compliance with federal privacy restrictions pursuant to the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule and state disease reporting requirements will foster inmate health and assist efforts to prevent the spread of disease. This article examines the interplay between HIPAA rules and state reporting laws to preserve health information privacy and to control the spread of disease.
• Davidson, B., Sherman, S., Barraza, L., & Marinissen, M. J. (2015). Legal challenges to the international deployment of government public health and medical personnel during public health emergencies: impact on national and global health security. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 43 Suppl 1, 103-6.
• Hodge, J. G., Barraza, L. F., Weidenaar, K., Corbett, A., Measer, G., & Agrawal, A. (2015). Efficacy in Emergency Legal Preparedness Underlying the 2014 Ebola Outbreak. Texas A&M Law Review, 2, 353-383.
• Hodge, J. G., Weidenaar, K., Baker-White, A., Barraza, L., Bauerly, B. C., Corbett, A., Davis, C., Frey, L. T., Griest, M. M., Healy, C., Krueger, J., Lowrey, K. M., & Tilburg, W. (2015). Legal Innovations to Advance a Culture of Health. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 43(4), 904-12.
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  As conceptualized by the Robert Wood Johnson Foundation and its partners, a culture of health centers on a society in which health flourishes across all populations and sectors. Law, among other tools, is critical to advancing a culture of health across multiple arenas. In this manuscript, Network for Public Health Law colleagues illustrate how legal innovations at all levels of government contribute to societal health. Examples include modern laws that promote healthy and safe low-income housing, telemedicine reimbursement, paid sick and safe time, healthy food and beverages, reduced smoking rates, child vaccinations, universal pre-k, adolescents' healthy sleep, overdose prevention, and medical-legal partnerships.
• Yang, Y. T., Barraza, L., & Weidenaar, K. (2015). Measles Outbreak as a Catalyst for Stricter Vaccine Exemption Legislation. JAMA, 314(12), 1229-30.
• Barraza, L. F., & Burkhart, L. (2014). The Expansion of Newborn Screening: Implications for Public Health and Policy. Annals of Health Law, 23, 42-58.
• Hodge, J. G., Barraza, L. F., Measer, G., & Agrawal, A. (2014). Emergency Legal Responses to the 2014 Ebola Outbreak. Journal of Law, Medicine, and Ethics.
• Hodge, J. G., Barraza, L. F., Russo, S., Nelson, K., & Measer, G. (2014). A Proposed Ban on the Sale to and Possession of Caloric Sweetened Beverages by Minors in Public. Journal of Law, Medicine, and Ethics, 42, 110-114.

Presentations

• Barraza, L. F., & Hall-Lipsy, E. A. (2020, November). Overcoming Legal Barriers to Healthcare for LGBTQ+ Patients. UAHS Diversity and Inclusion Speakers Series. Virtual: University of Arizona Health Sciences Center for Diversity and Inclusion.
• Hodge, J., & Barraza, L. F. (2020, December). Election 2020: Public Health Law Reforms. National Bar Association Young Lawyers Division.
• Hodge, J., Barraza, L. F., Piatt, J., & Wetter, S. (2020, November). COVID-19 Legislative Proposals- Assessing their Legality. Special Training Workshop for the American Public Health Association.
• Stuebe, A., McGowan, A., Lebedevitch, C., & Barraza, L. F. (2020, May). The Role of Law and Policy in Assisting Families to Reach Healthy People’s Maternal, Infant, and Child Health Breastfeeding Goals in the United States.. United States Breastfeeding Committee’s “Power Tools” Webinar Series.
• Barraza, L. F., & Hall-Lipsy, E. A. (2019, June). Travel in the time of communicable diseases: airport public health preparedness and legal duties. ASLME Health Law Professors Conference. Chicago, IL: ASMLE.
• Barraza, L. F. (2018, November). Vaccine Mandates and Exemptions. UA COPH Epi Seminar.
• Barraza, L. F. (2018, September). Public Health and Healthcare Services: Law, Policy, and Equity Division. Arizona Well-Being Commons 2018 Meeting.
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  Panelist
• Barraza, L. F., Reiss, D., & Freeman, P. (2018, October). Preventing Communicable Disease Through Vaccination Laws.. 2018 Public Health Law Conference.
• Garba, I., Ahmed, P., Hall-Lipsy, E. A., Barraza, L. F., & Robertson, C. T. (2018, May). Smartphone Applications as Adjuncts to Medical Devices: A Case Study in Health Regulation. Sixth Annual Conference on Governance of Emerging Technologies: Law, Policy and Ethics. Tempe, AZ.
• Barraza, L. F., Schmit, C., & Hoss, A. (2016, September). Vaccine Policy: Legal Issues, Policy Trends and Litigation. 2016 Public Health Law Conference. Washington, D.C..

Others

• Schell, B., & Barraza, L. F. (2022, August). Exemptions to School Entry Vaccines and Corresponding Vaccine Coverage. Network for Public Health Law: Fact Sheet.
• Lawton, B., Hunter, D., & Barraza, L. F. (2020, September). Equitable Law and Policy Solutions to Mitigate Health Risks from Climate Change and COVID-19. Network for Public Health Law Blog.
• Pogreba Brown, K. M., & Barraza, L. F. (2020, March). COVID-19: Your Questions About Quarantine and Isolation Answered.. BottomLineInc..
• Rees, C., Carey, E., & Barraza, L. F. (2020, October). Safe Voting During the COVID-19 Pandemic: Public Health Orders and Legal Challenges in Two Jurisdictions. Network for Public Health Law Blog.
• Wetter, S., & Barraza, L. F. (2020, March 2020). Fighting COVID 19 – Navigating Protections for Businesses and Workers in the United States.. Verfassungslblog.
• Barraza, L. F., & Redmon, E. (2017, March). FDA’s Recent Drug Labeling Changes Will Help Pregnant Women and Their Physicians. Network for Public Health Law Blog.
• Barraza, L., Hall-Lipsy, E. A., & Garba, I. (2017, July). Response: Rethinking the Belmont Report? Friesen et al. Bioethics.net Weblog. http://www.bioethics.net/2017/07/rethinking-the-belmont-report/
• Garba, I., Hall-Lipsy, E. A., & Barraza, L. F. (2017, July 6, 2017). Rethinking the Belmont Report?. American Journal of Bioethics Blog: Bioethics.net.
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  http://www.bioethics.net/2017/07/rethinking-the-belmont-report/
• Hodge, J. G., Weidenaar, K., & Barraza, L. F. (2016, December). Integration of Health and Impact Assessments Via Environmental Policy Acts. Pew Charitable Trusts. https://www.networkforphl.org/_asset/ltcwv8/PEW-HIA-NEPA-Stage-1---Report-FINAL.pdf