Assessing the impact of federal and state preemption in public health: A framework for decision makers

Mark Pertschuk, Jennifer L. Pomeranz, Julie Ralston Aoki, Michelle A. Larkin, Marjorie Paloma

Research output: Contribution to journalArticlepeer-review


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 SUPPL.ort 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.

Original languageEnglish (US)
Pages (from-to)213-219
Number of pages7
JournalJournal of Public Health Management and Practice
Issue number3
StatePublished - May 2013


  • framework
  • grassroots
  • local policy
  • preemption
  • state policy

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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