Many factors influence the health and well-being of communities, including who can afford to live in them; local, state, and private-sector policies; and the availability of opportunities to live a healthy, engaged, and productive life. This project will seek to explain why some communities seem to have more opportunity and be healthier than others.
Do Stricter Immunization Laws Improve Coverage? Evidence from the Repeal of Non-Medical Exemptions for School Mandated Vaccines
The rising rate of non-medical exemptions is a driving force behind our nationwide measles crisis. Chelsea J. Richwine, Avi Dor, and Ali Moghtaderi of George Washington University examine the effect of California’s 2016 decision to repeal all non-medical exemptions on immunization coverage in a new working paper.
Public health practitioners and tobacco control advocates agree that pre-emption (a higher level of government stripping lower levels of government of their authority over a specific subject matter) has an adverse impact on tobacco control efforts. Pre-emptive state laws may prohibit local tobacco control measures, such as restrictions on marketing and promotion of tobacco products, licensure of tobacco products, smoking in public or private sites, and on youth access to tobacco products.
State pre-emption is an emerging and highly contentious policy movement with potentially significant consequences on population health. Yet robust analyses to examine whether pre-emption affects health have yet to be conducted. Furthermore, pre-emption’s effect on geographic inequities in health has been largely neglected in policy debates. But it is becoming increasingly clear that state pre-emption laws could reshape the spatial distribution of health, with profound consequences for health care delivery systems and state and local budgets.
How State Pre-emption is Associated with Evidence-Based Policymaking and Health Equity Across Populations
Local governments are often on the forefront of enacting innovative public health policy, and local control over public health issues is especially vital to address social inequities. Pre-emption removes the ability of local governments to enact these laws and may hinder public health policy adoption and diffusion within a state and across the country.
Numerous studies have documented the ACA’s positive effects on coverage, access, and health care quality, but changes in mortality have not yet been rigorously assessed. Using data from a variety of sources, the team will assess the relationship between coverage expansion and population changes in mortality over time.