Dissemin is shutting down on January 1st, 2025

Published in

Wiley, International Journal of Health Planning and Management, 5(38), p. 1569-1582, 2023

DOI: 10.1002/hpm.3694

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Factors limiting US public health emergency authority during COVID‐19

Journal article published in 2023 by Xue Zhang ORCID, Mildred E. Warner ORCID, Gen Meredith ORCID
This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

AbstractSince the onset of the COVID‐19 pandemic, many states in the United States have limited emergency public health authority. These limits could undermine public health efforts and raise concerns about how states and localities will prevent and respond to future public health challenges. We examined which of the 50 US states passed laws to set limits on public health emergency authority in 2021 through 2022, and their relationship to COVID‐19 death rates. We explored five government characteristics: COVID‐19 policy response, political partisanship (Republican control), legislative professionalism, local government autonomy, and broader non‐COVID‐19 related preemptions. Results of T‐tests and a Generalised Structural Equation Model show that states with unified Republican control had greater odds of limiting emergency public health authority of the state executive, state governor, state health official, and local health officials. Limits of emergency public health authority were associated with a higher COVID‐19 death rate. We found that states setting limits on emergency authority are primarily related to politicisation and political competition between state executives/governors and legislatures, rather than pushback against the COVID‐19 public health response. Limiting emergency public health authority is less common in states with more professional state legislatures. Structural changes related to party control, legislative professionalism, and local autonomy may facilitate public health authority.