Local Initiatives, State Pre-emption, and Public Health

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.

The research team will attempt to fill these important knowledge gaps by examining pre-emption policies in labor and economic resources (including minimum wages and paid sick, family, and medical leave) and the physical environment (including natural gas extraction and pesticide use). They will focus on three research questions:

1. To what extent do state pre-emption laws influence birth outcomes and working-age adult health behaviors and mortality?
2. Does pre-emption have disproportionate consequences for the health of certain demographic and geographic populations? (i.e., do the consequences differ by sex, race, education level, or metropolitan status?)
3. Does pre-emption reduce or expand local variation in birth outcomes and working-age adult health behaviors and mortality?

Examining the role of state pre-emption policies on local health outcomes and equity is vital because these policies have the potential to drive large-scale, systemic changes in population health.

For more on this topic:

• "Equity First: Conceptualizing a Normative Framework to Assess the Role of Preemption in Public Health"