ArrayPreemption

As we progress into 2025, Policies for Action reflects on a year of compelling policy research published in 2024. A wide range of studies that connect to health equity in America provided evidence and insights for policymakers, advocates, and community leaders.

State governments have long used their powers to preempt local government rulings. This practice, known as preemption, describes the primacy of a higher authority of law (e.g. the state) over a lower authority (e.g. counties and cities).

This study examines the impact of North Carolina’s House Bill 318 (HB 318), a state law that preempts municipal protections for immigrant communities, on the health and well-being of Latine immigrants.

The project will scrutinize state preemption of local workers' rights policies, focusing on how these laws influence local government efficacy and public engagement, particularly within communities of color.

The economic security and health equity (ESHE) project examines the drivers and effects of state preemption laws in Kansas and Missouri that limit local government control over economic and housing policies.

The research will examine the impact of policies that preempt instruction on racial justice and health equity in Iowa school districts.

This research will assess whether preemption of local land-use regulation can have beneficial impacts for racial justice and health equity.

This project will examine the effect of the State of North Carolina’s preemption policy, which effectively bars local governments from adopting so-called proactive local housing code enforcement programs requiring rental units to pass housing code inspection prior to leasing.

The overarching goal of this study is to quantify the effect of state preemption of local immigration policies on voting, participation in public assistance programs, and birth outcomes.

Public health practitioners and tobacco control advocates agree that preemption (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 preemption is an emerging and highly contentious policy movement with potentially significant consequences on population health. Yet robust analyses to examine whether preemption affects health have yet to be conducted. Furthermore, preemption’s effect on geographic inequities in health has been largely neglected in policy debates. But it is becoming increasingly clear that state preemption laws could reshape the spatial distribution of health, with profound consequences for health care delivery systems and state and local budgets.

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.