US – UAB Institute for Human Rights Blog

Why Utah’s Criminal Justice Task Force Must Include Public Health Voices

In 2016, Madison Jensen spent four days in jail, incarcerated at the Duchesne County Jail. During this time, she spent time pleading for care and support. Her incarceration, requested by her parents, ended with her death. Her initial booking was on suspicion of heroin and marijuana possession. Upon the release of her from a hospital emergency room, she was placed into Duchesne County Jail. With hopes of being protected by the county and supported through such a horrendous time, she was faced with what appears to be negligence.

Investigators found that during the four days she was incarcerated, she was projectile vomiting in her cell; even with reports from fellow inmates, the county did not take any action. From her booking to her unfortunate passing, her health condition decreased rapidly; over the time period, she lost 40 pounds. Despite her condition, no action was taken. She had completed a handwritten medical request citing her symptoms, but she was met with silence. Even when her cellmate tried to usher the officials into the cell to help mobilize a solution, she was met with silence.

During the investigation, it was noted that despite significant notices, there was limited information tracked; this is amplified by the lack of uniform guidelines that legislate how agencies and the incarceration system should track and release information related to inmate deaths. The jury awarded Madison’s family a $15 million verdict upon the conclusion that the county and jail staff were liable for her death. While this case was resolved in court, Madison’s death is representative of a larger issue: frequently inadequate healthcare access in correctional facilities.

Utah and Its Changes

As the nation is changing, especially relating to perspectives about criminal justice, states are taking a very different approach to their goals to tackle justice and healthcare issues. One state that has a new approach to this is Utah.

Utah has recently developed the Utah State Legislature’s Law Enforcement and Criminal Justice Interim Committee. This is a group tasked with overseeing the framework for Utah’s new Criminal Justice Task Force and reviewing dozens of bills that propose adding or expanding criminal penalties. This committee contains 18 legislators: 13 Republicans, 4 Democrats, and 1 Forward Party member. While most of them support the formation of this task force, many of these individuals do not have any experience in criminal justice or public health. This matters for human rights, because access to healthcare is a right for all individuals, as outlined by the United Nations.

In Utah, the landscape of incarceration is changing. Since 1980, arrests in Utah increased by 63%, with drug-related offenses spiking by an astonishing 317%. More arrests does not necessarily correlate to more incarcerated individuals, but the rate of incarceration in Utah is 396 per 100,000, which is higher than almost any other democratic country. Behind these numbers are women with complex healthcare needs, shaped by trauma and systemic neglect. More than 85% of incarcerated women in Utah report experiencing physical or sexual abuse prior to incarceration.

As the number of inmates rises, access to timely medical care becomes less available. This amplifies health risks and further deepens the cycle of trauma. These problems have further been amplified by overcrowding in prisons.

Photo 1: Photo of Central Utah Corrections CenterSource: Wikimedia Commons — Photo 1: Photo of Central Utah Corrections Center
Source: Wikimedia Commons

Maternal Care Behind Bars

All of this presents a unique challenge for women, specifically with access to maternal care in jails. Utah, however, has been making progress on this front to improve the public health outcomes for women who are pregnant. Legislation like HB326 brought much-needed improvements to prenatal care for incarcerated women. Before this bill, pregnancy behind bars often meant increased risks of premature birth, low birth weight, and labor complications: outcomes that carry lifelong consequences for both mothers and their children.

This progress is beneficial, but isolated wins are not enough.

Public Health Integration

Poor inmate health has a ripple effect beyond prison. Inmates are often released, and when women return home, they often become key contributors to their families and communities. When their health is neglected, this can result in generational consequences that feed cycles of poverty, mental health crises, and instability.

The issue is not colorblind, either; underrepresented races are overrepresented in negative health outcomes generally in correctional facilities. Black, American Indian, and Hispanic women in Utah are disproportionately incarcerated at higher rates than their white counterparts. This exposes them to increased healthcare inequities.

As the Criminal Justice Task Force develops, the Utah Department of Public Health needs to have a seat at the table. This will increase the likelihood that women will receive the healthcare they deserve whilst incarcerated. This intersects explicitly with human rights, as it expands healthcare access; by working to mobilize key resources to those who need it most, inequalities are addressed in the most efficient manner, which allows for improved health outcomes. Although health is not defined as a right by the US Constitution, it is a human right as delineated in the Universal Declaration of Human Rights.

Prioritizing Human Dignity

Understanding the nuances of health as it intersects with incarceration is integral to improving maternal health outcomes across the state. This issue presents at the intersection of compassionate and strategic approaches. As better healthcare is provided, emergency service costs decrease, there are lower rates of recidivism, and medical crises decline. If the Criminal Justice Task Force incorporates public health experts, there will be improved health outcomes for the most vulnerable inmates.

The Need of the WHO

On January 20th, 2025, President Donald Trump signed an Executive Order that withdrew the United States from the World Health Organization (WHO). This, however, was not President Trump’s first time withdrawing from the organization; in July 2020, he signed a similar executive order. However, due to the one-year notice for withdrawal, it never took place, as President Bident revered the order. The withdrawal took place primarily due to the mishandling of the COVID-19 pandemic and the “inability to demonstrate independence from the political influence of WHO member states.”

What is the WHO?

The WHO was established in 1948 as a specialized agency of the United Nations, consisting of 194 countries. The main role of the non-governmental organization is to set global health standards; serving as a multilateral organization motivates collaboration between all partner countries to coordinate international health response. This coordination also translates into supporting other partner countries during health crises.

One of the WHO’s roles is gathering and evaluating data from all over the world to understand the current status of health. This data spans regions and represents the holistic health of the world. Through these analyses, acute crises can be addressed in a streamlined way, and larger trends in health can be used as benchmarks to denote progress, ensuring sustained efforts.

Beyond the technical role of the WHO, it helps with on-the-ground support in countries across the world. By working to mobilize vaccines and drugs, individuals from underrepresented or marginalized communities can gain access to life-saving care. Beyond the mobilization of resources, the WHO helps coordinate humanitarian response and volunteers to ensure resources are being used appropriately. The holistic nature of the WHO and the support they provide ensures that countries worldwide are best equipped to support the health and well-being of their citizens.

Photo 1: Photo of WHO Poster in 1988Source: Flickr — Photo 1: Photo of WHO Poster in 1988
Source: Flickr

What has the WHO accomplished?

The WHO has tussled with many different diseases worldwide. For example, the WHO has helped eradicate smallpox worldwide. From leveraging the vaccine developed by Edward Jenner in 1796 to intensifying the vaccine mobilization plan in 1967, smallpox was eradicated by 1980, with the last known natural case in Somalia in 1977. This hallmark success for global health represents the first and only infectious disease ever to be eradicated.

The WHO has contributed to many other successes in the past as well, one being helping reduce polio cases worldwide by 99% since 1988. As of 2022, the number of endemic countries decreased by 123, representing the power of the WHO in reducing the global disease burden.

The visible and less visible responsibilities of the WHO were most recently put on the front stage during the COVID-19 crisis. At the pandemic’s peak, the WHO collected data from across the world to analyze its outcomes and progress made through community health initiatives and vaccine rollouts. Beyond this, the WHO consistently released situational reports, reporting on the research they have collected thus far. Though the incidence of COVID-19 has decreased significantly and is no longer a public health emergency of international concern, the WHO still works to contain the illness and reduce adverse outcomes.

What is the impact of the US withdrawing from the WHO?

The US is one of the largest contributors to the WHO. Supporting around 12%-15% of the budget in the fiscal year 2022-2023, the US has contributed to the investment of millions of jobs, work opportunities, and streamlining functions. Without the US, all of these opportunities will stop in the upcoming fiscal year.

This support is not new to the US. Since World War II, the US has held this top funder spot, serving as a leader in global diplomacy. In an ever-globalized world, this role in the WHO affects our allies and our nation domestically. With this, the international community will suffer and have poorer health; without the investment in life-saving interventions and preventative systems, health is on the line for everyone.

Beyond the tangible impact of the withdrawal, if a decrease in health resilience is observed, there will be an increase in mistrust and a reduction in international cooperation. The withdrawal in both 2020 and 2025 resulted in increased mistrust by partnerships and organizations like Gavi, the Vaccine Alliance, and COVAX, as well as our geopolitical allies. By increasing the vulnerability in our relationships, there is an increased risk of adverse outcomes that will compromise the health of millions worldwide. This distrust may result in the withdrawal of other vital multilateral agreements; demonstrating a lack of cooperation may result in other countries questioning their commitment to the WHO and the overall responsibility to global health.

Beyond the political and financial nuances of the US withdrawing from the WHO, the most tangible impact is the compromise of future pandemic preparedness and the creation of vulnerabilities in the global health landscape. The WHO’s holistic role relies on support to share data and track emerging health threats. Without US support, these threats cannot be effectively analyzed and will result in weakened systems.

What can we learn from the 2025 withdrawal from the WHO?

As it is still early in the year, there is no promise about the legislation’s longevity. However, it reminds us all about the need for bipartisan commitment to global health and development. Not only is this a safeguard to protect our own nation, but it also helps us in terms of international engagement. US foreign policy should prioritize funding for health initiatives regardless of political leadership, working to legislate commitments to our global partners.

With lack of accountability being cited as the primary reason for withdrawal, it is integral for all entities to seek avenues to increase financial transparency and independence without compromising the organization’s day-to-day operations. Collective problem-solving is reinforced by working to advocate for improvements rather than abandoning the WHO.

The temporary absence of the US in the WHO has created a void that has weakened global health cooperation in a matter of weeks. Though the official withdrawal will take around a year to feel the impact, the impact is already being noted in the attitudes and perspectives on the global stage. There is a need to uphold health as a universal human right; developing policies prioritizing equitable healthcare access reinforces the idea that we cannot combat global health alone now without the US; there is a lot of vulnerability in the unknown space.

US Sanctions Against Foreign Jurisdictions Violate Human Rights

For years the United States (US) has been employing extraterritorial jurisdiction to impose oppressive sanctions on foreigners. Often, these sanctions violate due process rights because they are imposed without providing individuals with adequate notice, a fair hearing, or an opportunity to challenge the designation. The US has the authority to freeze assets, ban travel, and place other restrictions on financial transactions. This significantly impacts an individual’s human rights as the freedom to travel, freedom to work, and freedom to have privacy. Targeting individuals abroad for alleged activities that occurred outside of the US makes it evident that these restrictions are over-complying out of fear, a fear which is rooted in ethnophobia. Many Americans fear immigrants are taking their jobs, and sanctions like this only bolster this. Arbitrarily depriving someone of their property based on where they are from is an inherent violation of human rights. Unilateral coercive measures like the Global Magnitsky Act, Specially Designated Nationals and Blocked Person List, and Office of Foreign Assets Control sanctions have a disproportionately negative effect on international people.

Global Magnitsky Act

The Global Magnitsky Human Rights Accountability Act authorizes the president to block or revoke the visas of certain “foreign persons” (both individuals and entities) or to impose property sanctions on them. People can be sanctioned (a) if they are responsible for or acted as an agent for someone responsible for “extrajudicial killings, torture, or other gross violations of internationally recognized human rights,” or (b) if they are government officials or senior associates of government officials complicit in “acts of significant corruption.” It was enacted as a deterrent for foreign political corruption but instead was a catalyst for arbitrary detention and arrests without due process. There is a lack of transparency and little to no evidence provided to justify designating individuals under the Act. UN Special Rapporteur Alena Douhan concerned about human rights violations states, “This is a clear violation of due process rights, including the presumption of innocence and fair trial.” The Act allows the US government to impose sanctions on individuals accused of human rights violations and corruption but does not provide them with a fair opportunity to challenge these allegations. Though it serves the purpose of preventing acts of terrorism and maintaining foreign accountability, the language is not concise enough to prevent arbitrary detentions or sanctions.

Specially Designated Nationals and Blocked Person List

The SDN list is updated regularly with the names of individuals, entities, and organizations deemed to be involved in a range of criminal activities such as terrorism, narcotics, or arms. Therefore, US nationals are prohibited from engaging in any form of transaction with SDNs. Based on similar provisions under the Patriot Act, the government can block all of an individual’s or entity’s assets in the US. Similar to Magnitsky, there are concerns over transparency and due process violations. There have been inconsistencies in the way that individuals and entities are designated on the list, including cases where some individuals or entities are designated while others engaged in similar activities are not. Since the process behind the designation is not made public, it begs the question what is the real intention behind this decision and are there any underlying motives? Also, the list is public which subjects the individuals on the list to political abuse by targeting people that are seen as political opponents or rivals, rather than based on evidence of wrongdoing. “This is a clear violation of due process rights, including the presumption of innocence and fair trial, “ The Special Rapporteur observed.

Office of Foreign Assets Control Sanctions

OFAC is an office of the U.S. Treasury that administers and enforces economic and trade sanctions based on U.S. foreign policy and national security goals against targeted individuals and entities from foreign countries. OFAC sanctions can have unintended consequences and harm innocent parties, such as businesses or individuals that have no connection to the sanctioned entities or countries. The exterritorial reach the US has over foreign businesses is overt and unnecessary. Similar to the other legislation, there is a significant gap in knowledge between the government and the individuals affected. They do not know what they have done that has caused them to be targeted. The affected parties have no way to challenge these accusations if they are not aware of what they have done wrong, thus hindering the due process. The UN expert mentioned how human rights are infringed upon when US trade sanctions against specific countries penalize foreign companies for doing business.

Revaluate

While these laws are in the interest of national security, we need to reevaluate if their ability to reach their intended goals or if have they just enforced discriminatory, biased legislation. There are concerns about their impact on innocent parties, lack of transparency and due process, extraterritorial reach, and potential for abuse. These are important factors to consider when evaluating the country’s presence in foreign entities. It is important to incorporate human rights protections in the sanctions the government passes because they affect international relations, global human rights, and the preservation of American ideals of democracy and equality.

A Brief Judicial History of Religious Freedom

The first line of the first amendment in the Constitution of the United States, also known as the Establishment clause, asserts that “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof…” This clause, although seemingly simple in nature, has been the root of many judicial battles throughout the United States’ history. Religion, as a human right, has always been a topic of political debate.

One might inquire as to why this is the case: what makes the freedom of religion such a sensitive topic? In this blog, I seek to answer this question by outlining fundamental cases which have shaped how our legislators interpret our right to religion. Moreover, this blog shall conclude with how our fundamental right to religion is being interpreted today, as well as what is potentially in store for religious interpretation in the future.

Lemon v. Kurtzman (1971) | Introduction of the Lemon Test

US constitution — (source: yahoo images)

Our journey begins in 1971, with the landmark Supreme Court Case of Lemon v. Kurtzman which involved the states of Pennsylvania and Rhode Island. The issue materialized when both of the aforementioned states decided to introduce legislation that would use taxpayer money to fund church-affiliated schools. In doing so, the government funds would pay for teacher salaries, textbook costs, and many other educational materials. Funding church-affiliated schools could be construed as a violation of the Establishment Clause. The Supreme Court followed this logic, and with an 8-1 ruling, they decided to strike down the legislation passed by Rhode Island and Pennsylvania, no longer allowing state funds to go to church-affiliated schools.

What is particularly remarkable about this case is that it formally introduced the so-called Lemon Test, a judicial test constructed to see if legislation defies the Establishment Clause. The Lemon Test has three ways to test and see if a piece of legislation defies the clause:

The piece of legislation must have a secular purpose;
The piece of legislation must not advance or prohibit the practice of religion;
The piece of legislation must not force the government into “excessive entanglement” with religious affairs.

If a piece of legislation passes the Lemon Test, then it does not defy the Establishment Clause and can proceed to further scrutiny. That is, the legislation will be evaluated to see if aligns with the other amendments. With these three prongs noted, one can see how easily Lemon v. Kurtzman would have failed the Lemon Test.

Wallace v. Jaffree (1985) | Application of the Lemon Test

Wallace v. Jaffree, a case that took place in the state of Alabama, is another landmark Supreme Court case involving a dispute in legislation around religion. In 1981, Alabama decided to introduce legislation that mandated a 1-minute moment of silence at the start of class in all public schools. Although, ostensibly, the legislators claimed that this moment of silence could be used either for reflection or prayers, the legislation’s intent was to create an opportunity for students to pray before school started.

This decision naturally upset many non-religious parents, and multiple lawsuits soon followed, climbing their way up all the way to the Supreme Court. Throughout this process, the Alabama legislators argued that this bill does not defy the Establishment Clause, as the moment of silence can be used in any way that pleases the student— not necessarily just for prayer. However, the fault in this is that the introduction of the bill was done to allow students to pray, not to give them a moment of silence; thus, this bill failed the Lemon Test’s first prong as it did not have a secular purpose. In a vote of 6-3, the Supreme Court held that the bill defies the Establishment Clause.

Oregon v. Smith (1990) | Introduction of RFRA

street signs saying church and state — (source: yahoo images)

This case, unlike the aforementioned ones, has a bit more nuance to it and led to a wide range of implications. This case is the primary reason Congress enacted the Religious Freedom Restoration Act in 1993, which is one of the most bipartisan pieces of legislation, having passed the House unanimously and the Senate 97-3.

In Oregon v. Smith, two people, who both worked at a drug rehabilitation center, were fired due to having consumed peyote, a hallucinogenic drug. The issue at hand, however, is that their consumption of peyote was done during a sacred religious practice. This case did not make it to the Supreme Court because the drug rehabilitation center fired them (as the center very much can fire whoever they please — they are a private entity); it made it to the Supreme Court because after they were fired, these two individuals sought unemployment benefits and were denied due to being fired for consuming drugs, which is considered “workplace misconduct.”

However, unlike the previous cases, the Supreme Court did not rule in favor of the appellants. The Court, by a 6-3 vote, ruled that since the denial of unemployment benefits due to workplace misconduct is a rule of general application (meaning it does not specifically target any people or religious practice), it is constitutional.

However, as one might conclude, many did not like this outcome. Therefore, as aforementioned, Congress enacted the Religious Freedom Restoration Act (RFRA) to clarify some of the issues raised by Oregon v. Smith. The first clause of RFRA states its purpose, saying that it aims to prohibit “any agency, department, or official of the United States or any State (the government) from substantially burdening a person’s exercise of religion even if the burden results from a rule of general applicability.”

This first clause seeks to prohibit exactly what was the outcome in Oregon v. Smith, but it also comes with some limitations. That is, Congress is free to burden one’s exercise of religion if (1) doing so will further a compelling government interest; and, (2) doing so is the least restrictive means of furthering that compelling government interest. The introduction of this incredibly bipartisan bill, as we will shortly explore, has some interesting implications.

Burwell v. Hobby Lobby (2014) | Application of RFRA

In the case of Burwell v. Hobby Lobby, we see the RFRA being put to use which leads to an interesting implication from the outcome of this case. Burwell v. Hobby Lobby sprouted from one of the requirements of the Affordable Care Act (ACA), namely, that all nonexempt employers are legally required to offer their employees health coverage and benefits, including contraceptives, some of which stop an egg from fertilizing. Before progressing with the case, we ought to make note that some employers, primarily religious institutions such as churches, are exempt from the ACA.

Hobby Lobby, a crafts company, is a tightly-owned company, meaning that there are only a few number of people who own the company. All of these owners, moreover, do not want to comply with the ACA since they believe life begins at conception and to thereby provide their employees with free contraceptives would go against their religious beliefs. However, if a company does not comply with the ACA, it would have to pay a fee per employee. For Hobby Lobby, the total cost would amount to about $475 million per year.

Hobby Lobby was conflicted about whether they should go against their religious beliefs and supply their employees with contraceptives or instead pay $475 million a year and adhere to their religious stance. Due to this ethical dilemma, Hobby Lobby decided to sue the Department of Human Health Services (those who implemented the ADA), and the case made its way up to the Supreme Court. Hobby Lobby cited RFRA, stating that the ACA mandate does not comply with RFRA’s second clause. They argued that forcing Hobby Lobby to offer its employees contraceptives is not the least restrictive means of furthering a compelling government decision. Rather, Hobby Lobby stated that they, like religious institutions, should be exempt from the ACA, as that is the least restrictive means of furthering a compelling government interest (health care for employees). The employees of companies who are exempt from the ACA have their health care paid for by taxes.

The Supreme Court agreed with Hobby Lobby. By a vote of 5-4, the Supreme Court ruled that Hobby Lobby is correct—the least restrictive means indeed is making Hobby Lobby an exempt company, thereby allowing governmental taxes to pay for the health care of their employees.

What is remarkable about this case is its implication that the Supreme Court stated that the best course of action to resolve a religious dispute over health care is to simply allow the government to fund health care. One might argue, then, that the Supreme Court is hinting toward universal health care, as they view that as the least restrictive means.

Kennedy v. Bremerton School District (2022) | Abandonment of the Lemon Test

The last case we shall discuss is one that has been all over the media recently: Kennedy v. Bremerton School District. In this case, a high school football coach decided to kneel and pray before and after games. The school district feared that his actions would violate the Establishment Clause, so they asked him to stop. When he did not, they fired him.

Claiming his first amendment right to the freedom of religion was violated, he sued the school. The lawsuit eventually made its way up to the Supreme Court, and, by a 6-3 vote, the Court ruled in the coach’s favor, stating that he was not complicit in praying since he did it during post-game periods when people were free to do as they pleased.

However, something remarkable also happened in this case: the Supreme Court decided to stop using the Lemon Test, which has been in practice since 1971. Instead of the Lemon Test, the Court stated that they will decide disputes over the Establishment Clause by “accor[ding] with [what] histor[ically] and faithfully reflec[ts] the understanding of the Founding Fathers.”

What this means, we do not yet know, as this is yet another new change by the Supreme Court. Throughout history, the Lemon Test has proved itself to be a great way of settling legislative disputes, so one could only wonder why the Supreme Court decided against it.

Summary

US Capitol Building — (source: yahoo images)

As I showed with this blog post, cases revolving around religious freedom are by no means simple, but the courts, thankfully, have historically always ruled in favor of the Establishment Clause, never seeking to subdue religious freedom.

However, after the abandonment of the Lemon Test in Kennedy v. Bremerton School District, it is clear that the Supreme Court is planning on interpreting the Establishment Clause differently than they have had since 1971. What this means for upcoming cases, we have yet to find out. However, what we do know is that religious freedom, despite how tricky it might be at times, should remain a human right.