Connecting preemption, public health, and equity

Preemption — a legal doctrine in which a higher level of government may limit or even eliminate the power of a lower level of government to regulate a specific issue — can have profound significance for public health.

Preemption historically has been used as a legislative and judicial tool for resolving problems that arise when different levels of government adopt conflicting laws on the same subject. Preemption in itself is neither bad nor good; it is simply a legal concept. However, powerful interest groups have recently led numerous state-level efforts to preempt local laws aimed at improving public health and advancing health equity. These interest groups have successfully thwarted laws that threaten their profits — for example, local minimum wage laws, sugary drink taxes, and tobacco control ordinances — thus impeding communities’ ability to pursue equity- and health-promoting policies.

ChangeLab Solutions has created resources to help inform public officials and community leaders about how preemption can affect their efforts to promote health and equity. In our preemption materials, we explore questions such as

  • What do preemption considerations mean for public health policy?
  • How does preemption thwart or advance efforts to promote health equity?
  • How can policymakers and advocates determine when proposed legislation includes preemptive language? What can they do about it?

Get started with the resources we’ve highlighted below, or learn more about all of our areas of work.

Fundamentals of Preemption
Fundamentals of Preemption
This fact sheet explains the basic concept of preemption, different types of preemption, and how preemption works in US law.
Consequences of Preemption
Consequences of Preemption
Although it can be used to promote public health, preemption often protects special interests at the expense of health and equity considerations.
Government Layers
An Equity-First Approach to Assessing Preemption
In this journal article, ChangeLab Solutions staff argue for the creation of an equity-first framework for assessing preemption.
COVID-19 Premption Blog
Preemption & COVID-19
The COVID-19 pandemic highlights the positive and negative effects of preemption on underserved communities and health equity. This blog post offers information and action steps for policymakers and advocates.