How State Preemption 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. Preemption 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.

Although preemption is increasingly being used as a policy tool, it is unclear whether states are preempting local control over four policy domains—tobacco control, firearm safety, paid sick days, and food and nutrition policy—while simultaneously not enacting state-level laws. Nor has there been research into which states are more likely to pass preemption and which populations are most affected by state preemption of public health policies.

The research team will address the following five critical knowledge gaps:

1. Are states preempting evidence-based policies related to tobacco control, firearm safety, paid sick days, and food and nutrition policies?
2. Are states that preempt evidence-based policies simultaneously enacting evidence-based policies or, alternatively, not acting while preempting the ability of communities to enact evidence-based policies?
3. Which legislative policy strategies are being used by states to pass preemptive laws on these public health topics?
4. Which population and state-level characteristics are associated with state preemption of public health policies within and across states?

The findings will provide policymakers, researchers, advocates, and public health practitioners with new insights and practical tools to assess the true implications of preemption on evidence-based public health policy enactment and diffusion.