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

A paper examined the critical role grassroots organizations play in fostering equitable political processes and supporting housing policies that may reduce health inequities. The study found that state preemption often forces such organizations to narrow their policy goals and adapt their political strategies, which then stretches their capacity and limits their ability to be successful. The study concluded that state preemption may therefore cement inequitable housing policies by weakening the political capacity of grassroots organizations that are critical to building power in racially and economically marginalized communities. Read more from  Jamila Michener, Entrenching Inequity, Eroding Democracy: State Preemption of Local Housing Policy, 35 Stan. L. & Pol'y Rev. (2023).

A study showed that the more politically conservative a state legislature is, the more likely it is that the state will preempt local affordable housing policies. The same study found that it is less likely for states with more professional legislatures and those with a higher proportion of renters to preempt affordable housing policies. Accordingly, it may be helpful to consider these factors when organizing campaigns to address preemption of affordable housing policies. Read more from Christopher B. Goodman & Megan E. Hatch, State Preemption and Affordable Housing Policy, 49 Publius: J. Fed. (2023).

Austin, Texas, sought to address racial and socioeconomic discrimination in rental housing by prohibiting landlords from rejecting otherwise qualified tenants based solely on their source of income (e.g., federal housing assistance). Across the country, only one in three voucher households is protected by nondiscrimination laws like those Austin adopted. The Texas state legislature responded by invalidating Austin’s ordinance and preempting localities from adopting similar antidiscrimination laws, despite the absence of any statewide protections for recipients of housing assistance and despite clear evidence that source-of-income discrimination disproportionately harms people of color. Read more from Tighe JR, Hatch ME, Mead J. Source of income discrimination and fair housing policy. J Plan Lit. 2016;32(1):3-15. https://doi.org/10.1177/0885412216670603.

A study suggests a relationship between state preemption of local mandatory inclusionary zoning (IZ) policies and both increased rates of self-reported poor or fair health status and a greater likelihood that Black adults report delaying medical care because of cost. Read more from Melton-Fant, C. Relationship Between State Preemption of Inclusionary Zoning Policies and Health Outcomes: Is There Disparate Impact Among People of Color?. Housing Policy Debate. 2020. doi: 10.1080/10511482.2020.1798488.

Various studies have concluded that universal basic income (UBI) programs contribute to improved financial well-being, increased savings, and the ability to control daily finances. These studies have also shown that UBI programs can lead to improved housing conditions, increased food security, and even additional employment opportunities. State preemption of UBI programs, therefore, deprives local governments of an important policy shown to improve people’s economic and overall well-being. Read more from  Denver Basic Income Project; Elizabeth DeYoung et al., The American Guaranteed Income Studies: Ulster County, New York (Ctr. for Guaranteed Income Rsch., Univ. of Pa. 2023); Mary Bogle, Owen Noble & Lauren Fung, Austin Guaranteed Income Pilot: Participant Outcomes at 12 Months (2024).

When a worker without paid leave must miss work because of their own illness or caregiving responsibilities, two days of lost wages equate to a month’s worth of gas, three days equal a monthly utility payment, and roughly a week of lost wages equals an entire month’s rent or mortgage payment. State preemption of local paid leave laws prevents local governments from addressing these economic injustices. Read more from  Gould E, Schieder, J. Work sick or lose pay? The high cost of being sick when you don’t get paid sick days. Economic Policy Institute. June 2017. https://www.epi.org/publication/work-sick-or-lose-pay-the-high-cost-of-being-sick-when-you-dont-get-paid-sick-days.

A large portion of those without paid sick leave are low-wage, part-time workers who are disproportionately Hispanic, Black Americans, and women, meaning state preemption that prevents cities and counties from adopting paid leave laws adds to racial and socioeconomic inequities. Read more from Partnership for Working Families. For all of Us, By All of Us: Challenging State Interference to Advance Gender and Racial Justice. May 2019. https://www.forworkingfamilies.org/resources/publications/challenging-state-interference-advance-gender-and-racial.’

Research finds that laws mandating universal paid leave reduce racial disparities, increase economic security, and improve health outcomes, including reduced emergency department use, increased use of preventive care, and fewer occupational injuries. The same research did not find evidence that paid leave laws reduce employment, wages, or labor force participation. Read more from Marotta, J, Greene, S. Paid Sick Days: What Does the Research Tell Us about the Effectiveness of Local Action?. Urban Institute. January 2019. https://www.urban.org/research/publication/paid-sick-days-what-does-research-tell-us-about-effectiveness-local-action.

One study found statistically significant associations between paid-sick leave requirements and reductions in homicides (in men and women), suicides (in men), and alcohol poisoning (in women). If state laws preempting paid-sick leave protections were repealed, mortality by these causes may decline by more than 5% in some places. Read more from Wolf DA, Montez JK, Monnat SM. U.S. state preemption laws and working-age mortality. Am J Prev Med. 2022;63(5): 681- 688. doi:10.1016/j.amepre.2022.06.005. https://doi.org/10.1016/j.amepre.2022.06.005.

A report examining minimum wage laws found that state preemption of previously enacted minimum wage laws in 12 cities and counties affected nearly 346,000 workers and resulted in nearly $1.5 billion of lost income per year. These preemption laws disproportionately harmed women, people of color, and communities with high rates of poverty.  Read more from Laura Huizar and Yannet Lathrop. Fighting Wage Preemption: How Workers Have Lost Billions in Wages and How We Can Restore Local Democracy. National Employment Law Project. July 2019. https://s27147.pcdn.co/wp-content/uploads/Fighting-Wage-Preemption-Report-7-19.pdf. 

A study assessing how preemption affects birth outcomes – a key indicator of population health – found that state preemption of local minimum wage laws accounted for as much as 3.5% of infant deaths, resulting in more than 600 infant deaths in 2018 alone. The same study also found that the largest metro counties could reduce the infant mortality rate by 1.5 to 1.8% by increasing the minimum wage by one dollar. Read more from 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 of local minimum wage laws prevent communities from improving health outcomes such as decreased adult body weight, increased infant birth weight, declined rates of preterm birth, declined child maltreatment reports, 3 and lower rates of suicide. Read more in Marotta, J, Greene, S. Minimum Wages: What Does the Research Tell Us about the Effectiveness of Local Action?. Urban Institute. January 2019.

A study assessing how preemption affects birth outcomes – a key indicator of population health – found that state preemption of local minimum wage laws accounted for as much as 3.5% of infant deaths, resulting in more than 600 infant deaths in 2018 alone. The same study also found that the largest metro counties could reduce the infant mortality rate by 1.5 to 1.8% by increasing the minimum wage by one dollar. Read more in Wolf D, Monnat S, Montez JK. Profits protected, lives lost: The preemption tradeoff. 2020 American Public Health Association Annual Meeting. October 2020.

Research shows that women, particularly women of color, and working people are disproportionately harmed by state preemption of local worker protection laws. Read more in Partnership for Working Families. For all of Us, By All of Us: Challenging State Interference to Advance Gender and Racial Justice. May 2019.