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Assessing the Impact of Federal and State Preemption in Public Health: A Framework for Decision Makers

Pertschuk, Mark JD; Pomeranz, Jennifer L. JD, MPH; Aoki, Julie Ralston JD; Larkin, Michelle A. JD, MS, RN; Paloma, Marjorie MPH

Journal of Public Health Management & Practice: May/June 2013 - Volume 19 - Issue 3 - p 213–219
doi: 10.1097/PHH.0b013e3182582a57
Original Articles

In the United States, state and local public health policies play a fundamental role in innovation and progress. Preemption, by which Congress or the state legislatures limit the authority of lower jurisdictions, can eliminate the benefits of state and local policy initiatives. Preemption can also have a negative impact on enforcement, civic engagement, and grassroots movement building.

In June 2011, the Institute of Medicine published a groundbreaking report on policy and law that considered preemption as a crosscutting issue in public health. The Institute of Medicine recommended that federal and state policy makers “should set minimum standards...allowing states and localities to further protect the health and safety of their inhabitants,” and “should avoid language that hinders public health action.”

The Preemption Framework is a tool to support effective decision making by helping the public health field anticipate, assess, and, if necessary, counter preemptive policy proposals. We review the consequences of preemption, including its potential impact on grassroots public health movements, and propose practical questions and considerations to assist decision makers in responding to preemptive proposals.

The authors review the consequences of preemption, including its potential impact on grassroots public health movements, and propose practical questions and considerations to assist decision makers in responding to preemptive proposals.

Preemption and Movement Building in Public Health, Public Health Law Center (Mr Pertschuk) and Public Health Law Center, William Mitchell College of Law (Ms Aoki), St Paul, Minnesota; Rudd Center for Food Policy and Obesity, Yale University, New Haven, Connecticut (Ms Pomeranz); and Robert Wood Johnson Foundation, Princeton, New Jersey (Mss Larkin and Paloma).

Correspondence: Mark Pertschuk, JD, 2134 Carleton St, Berkeley, CA 94704 (pertschuk@gmail.com).

Development of the Preemption Framework and this article were supported by a grant from the Robert Wood Johnson Foundation.

The authors thank Karen Pertschuk and Warren Ortland for reviewing and contributing to drafts of this article.

The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.