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

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9 Scopus citations


Introduction: The goal of this study was to estimate how state preemption laws that prohibit local authority to raise the minimum wage or mandate paid sick leave have contributed to working-age mortality from suicide, homicide, drug overdose, alcohol poisoning, and transport accidents. Methods: County-by-quarter death counts by cause and sex for 1999–2019 were regressed on minimum wage levels and hours of paid sick-leave requirements, controlling for time-varying covariates and place- and time-specific fixed effects. The model coefficients were then used to predict expected reductions in mortality if the preemption laws were repealed. Analyses were conducted during January 2022–April 2022. Results: Paid sick-leave requirements were associated with lower mortality. These associations were statistically significant for suicide and homicide deaths among men and for homicide and alcohol-related deaths among women. Mortality may decline by more than 5% in large central metropolitan counties currently constrained by preemption laws if they were able to mandate a 40-hour annual paid sick-leave requirement. Conclusions: State legislatures’ preemption of local authority to enact health-promoting legislation may be contributing to the worrisome trends in external causes of death.

Original languageEnglish (US)
Pages (from-to)681-688
Number of pages8
JournalAmerican Journal of Preventive Medicine
Issue number5
StatePublished - Nov 2022

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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