During the time of COVID-19, restrictions on municipal revenues forced cities and counties to cut services, lay off and furlough employees, and mothball capital projects, which had consequences for local employment, business contracts, and overall investment in the economy and community. Read more from Haddow, K, Carr, D, Winig, BD, Adler, S. Preemption, Public Health, and Equity in the Time of COVID-19. August 2020. https://www.publichealthlawwatch.org/covid19-policy-playbook.
During the height of the COVID-19 pandemic, many state legislatures imposed limits on public health authority. One study found that such limits were associated with higher death rates. The study concluded that the motivation behind limiting public health authority was more related to politicization and political competition rather than to pushback against specific COVID-19 public health actions. It also showed that states with unified Republican control (i.e. both legislature and governorship under Republican control) were the most likely to limit public health emergency authority.
Read more from:
Haddow K, Carr D, Winig BD, Adler S. Preemption, public health, and equity in the time of COVID-19. In: S Burris, S Guia, L Gable, DE Levin, WE Parmet, NP Terry, eds. Assessing Legal Responses to COVID-19. Boston: Public Health Law Watch; 2020.
Xue Zhang, Mildred E. Warner & Gen Meredith, Factors Limiting U.S. Public Health Emergency Authority During COVID-19, 20 Int'l J. Env't Res. & Pub. Health 12554 (2023).
Research shows that preemption of indoor dining closure laws dining may have increased the spread of COVID-19 as cities with indoor dining closure laws saw COVID-19 case rates decrease by 55% over 6 weeks when compared to cities that were preempted from passing such laws. Read more from Mahl-Schnake, A, O’Leary, G, Mullachery, P, Vaidya, V, Connor, G, Rollins, H, Kolker, K, Diez, R, Ana, V, Bilal, U. The Impact of Keeping Indoor Dining Closed on COVID-19 Rates Among Large US Cities. Epidemiology. March 2022;33(2):200-208. doi: 10.1097/EDE.0000000000001444. https://journals.lww.com/epidem/Fulltext/2022/03000/The_Impact_of_Keeping_Indoor_Dining_Closed_on.7.aspx.
A series of case studies examining how state preemption of local housing policies has affected crisis response and recovery efforts during COVID-19 found that:
Local governments failed to consider adopting local policies that would conflict with existing state preemption laws even if such policies could help stabilize housing for at-risk renters.
Local policies that were not directly preempted were nonetheless “chilled” and not pursued due to concerns that acting would spark legal challenges or new preemption efforts at the state level.
Read more from Greene S, Ramakrishnan K, Morales-Burnett J. State Preemption of Local Housing Protections: Lessons from a Pandemic. Urban Institute. September 2020. https://www.urban.org/research/publication/state-preemption-local-housing-protections.
A research brief found that in states with more preemption laws, both local and state governments were substantially less likely to adopt innovative policy responses to COVID-19. Read more from Treskon M, Docter B. Preemption and Its Impact on Policy Responses to COVID-19. Urban Institute. September 2020. https://www.urban.org/research/publication/preemption-and-its-impact-policy-responses-covid-19.
Widespread misuse of state preemption has chilled local policymaking, forced localities to start from behind when responding to the pandemic, and prevented effective, timely responses to rapidly evolving public health and economic threats. Read more from Haddow, K, Carr, D, Winig, BD, Adler, S. Preemption, Public Health, and Equity in the Time of COVID-19. August 2020. https://www.publichealthlawwatch.org/covid19-policy-playbook.
State laws preempting sanctuary policies can create hostile environments, deterring immigrants from seeking critical health care and social services, or even prohibit those services from being offered altogether. These laws may also have a chilling effect on accessing other health-related resources, including basic utilities (e.g., electricity and water), healthy foods, and public recreation spaces. Preemption of sanctuary policies that protect and support immigrants likely contribute to negative physical and mental health outcomes for those populations.
Read more from:
Hall, M, Mann-Jackson, L, Rhodes, S. State Preemption of Local Immigration “Sanctuary” Policies: Legal Considerations. Am J of Public Health. 2021;111. https://doi.org/10.2105/AJPH.2020.306018.
Mann-Jackson L, Simán FM, Hall MA, Alonzo J, Linton JM, Rhodes SD. State Preemption of Municipal Laws and Policies that Protect Immigrant Communities: Impact on Latine Health and Well-Being in North Carolina. INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2022;59. doi:10.1177/00469580221087884. https://doi.org/10.1177%2F00469580221087884.
Research suggests that taxes on sugar-sweetened beverages are associated with reductions in their purchase. While research establishes that sugar-sweetened beverages increase the risk for cardiometabolic diseases and other maladies, a number of states have nonetheless preempted local governments from levying taxes to discourage their consumption.
Read more from:
Petimar, J., Gibson, L. A., Yan, J., Bleich, S. N., Mitra, N., Trego, M. L., Lawman, H. G., & Roberto, C. A. (Accepted/In press). Sustained Impact of the Philadelphia Beverage Tax on Beverage Prices and Sales Over 2 Years. American Journal of Preventive Medicine. 2022. https://doi.org/10.1016/j.amepre.2021.12.012. Colchero, M. A, Popkin, B, Rivera, J, Ng, S. W. Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: observational study. BMJ. 2016;352. doi: https://doi.org/10.1136/bmj.h6704.
Malik, V, Hu, F. Sugar-Sweetened Beverages and Cardiometabolic Health: An Update of the Evidence. Nutrients. 2019;11(8). https://doi.org/10.3390/nu11081840.
Crosbie, E, Pomeranz, J, Wright, K, Hoeper, S, Schmidt, L. State Preemption: An Emerging Threat to Local Sugar-Sweetened Beverage Taxation. Am J of Public Health. January 2021;111. https://doi.org/10.2105/AJPH.2020.306062.
A case study explored how some states have preempted local governments from restricting natural gas appliances, the use of which has been linked to a number of negative health effects, including exposure to fine particulate matter, carcinogens, and other pollutants linked to respiratory illness. Read more from Gibbs, M, Hsain, Z, Reagan, E, Wolfman, S, & Zaccarin, A-M. Overcoming state level preemption to electrify new buildings: A Philadelphia case study. Journal of Science Policy & Governance. 2022;21(01). doi:10.38126/jspg210104. https://doi.org/10.38126/JSPG210104.
In one study, infants born to mothers living near fracking sites were 25% more likely to have low birth weight, and their average birth weight also declined significantly. State preemption of local fracking bans may be linked to negative health outcomes for infants. Read more from Currie, J, Greenstone, M, Meckel, K. Hydraulic fracturing and infant health: New evidence from Pennsylvania. Science Advances. 2017;3(12). DOI: 10.1126/sciadv.1603021. https://www.science.org/doi/10.1126/sciadv.1603021.
Research has debunked the claim that state preemption is necessary to prevent a “patchwork” of local laws inside one state from harming residents, businesses, and consumers. To the contrary, analysis shows that people who use the patchwork argument to support preemption are generally arguing against any regulation at all, not against local variation. Read more from Treskon M, Marotta J, Rajasekaran P, Ramakrishan K, Shroyer A, Greene S. Do the Effects of a Regulatory Patchwork Justify State Preemption of Local Laws? Urban Institute. January 2021. https://www.urban.org/research/publication/do-effects-regulatory-patchwork-justify-state-preemption-local-laws
A survey found that over 70% of local health officials and 60% of mayors reported abandoning or delaying local policymaking efforts because of the threat of state preemption. Local policies chilled by the threat of preemption included efforts to regulate commercial tobacco, environmental hazards, firearms, minimum wage, safe housing, and transportation, among others. Read more from Rutkow L, McGinty MD, Wetter S, Vernick JS. Local Public Health Policymakers' Views on State Preemption: Results of a National Survey, 2018. Am J Public Health. 2019;109(8):1107-1110. doi:10.2105/AJPH.2019.305140.
Research shows that the misuse of state preemption often blocks policies that promote health and equity, with severe – and preventable – consequences such as lower life expectancy, increased infant mortality, and worse overall health outcomes.
Read more from:
Montez, JK, Beckfield, J, Cooney, JK, Grumbach, JM, Hayward, MD, Koytak, HZ, WoolfH, S, Zajacova, A. US State Policies, Politics, and Life Expectancy. The Milbank Quarterly. 2020. doi:10.1111/1468-0009.12469
Wolf D, Monnat S, Montez JK. Profits protected, lives lost: The preemption tradeoff. 2020 American Public Health Association Annual Meeting. October 2020. https://apha.confex.com/apha/2020/meetingapp.cgi/Paper/467648
State preemption has kept local governments from enacting laws to improve public health, such as regulating the sale of commercial tobacco and alcohol, promoting healthy eating, and enacting gun safety regulations, as well as local laws that address social determinants of health such as economic security, access to safe, stable, and affordable housing, anti-discrimination protections, and access to quality education.
Read more from:
ChangeLab Solutions. Assessing & Addressing Preemption: A Toolkit for Local Policy Campaigns. September 2020. https://www.changelabsolutions.org/product/assessing-addressing-preemption
Carr D, Adler S, Winig BD, Montez JK. Equity First: Conceptualizing a Normative Framework to Assess the Role of Preemption in Public Health. Milbank Quarterly. 2020;98:131-149. doi:10.1111/1468-0009.12444. https://www.changelabsolutions.org/product/equity-first-approach-assessing-preemption