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U.S. State Preemption Laws and Working-Age Mortality.

Douglas A Wolf1, Jennifer Karas Montez2, Shannon M Monnat3

  • 1Aging Studies Institute, Syracuse University, Syracuse, New York; Center for Aging and Policy Studies (CAPS), Syracuse University, Syracuse, New York; Public Administration and International Affairs Department, Maxwell School of Citizenship & Public Affairs, Syracuse University, Syracuse, New York.

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State preemption laws limiting local minimum wage and paid sick leave may increase working-age mortality. Repealing these laws could reduce deaths from suicide, homicide, and alcohol-related causes, especially in metropolitan areas.

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Area of Science:

  • Public Health
  • Health Policy
  • Epidemiology

Background:

  • State preemption laws restrict local governments from enacting policies like minimum wage increases and paid sick leave.
  • These restrictions may impact public health outcomes, particularly for working-age adults.
  • External causes of death, including suicide, homicide, drug overdose, alcohol poisoning, and transport accidents, are a growing concern.

Purpose of the Study:

  • To estimate the impact of state preemption laws on working-age mortality.
  • To assess the contribution of these laws to deaths from suicide, homicide, drug overdose, alcohol poisoning, and transport accidents.

Main Methods:

  • Analysis of county-by-quarter death counts (1999-2019) by cause and sex.
  • Regression models incorporating minimum wage levels and paid sick leave requirements.
  • Control for time-varying covariates and place- and time-specific fixed effects.
  • Prediction of mortality reductions following hypothetical repeal of preemption laws.

Main Results:

  • Paid sick leave mandates were associated with reduced mortality.
  • Statistically significant associations were found for suicide and homicide deaths in men, and homicide and alcohol-related deaths in women.
  • A 5% or greater mortality decline is predicted in large central metropolitan counties if a 40-hour annual paid sick leave mandate were implemented.

Conclusions:

  • State preemption of local health-promoting legislation may exacerbate concerning trends in external causes of death.
  • Reinstating local authority could lead to significant reductions in preventable mortality.
  • Policy interventions at the local level, such as paid sick leave, are crucial for improving public health outcomes.