Introduction: In the U.S., federal, state, and local governments have various legal tools to support public health and prevent diet-related disease, including enacting policy and bringing lawsuits against businesses that produce harm-causing products. Yet, states preempt, or limit, government's authority to enact public health policies or initiate litigation.
Methods: In 2018, research was conducted to find state laws enacted through March 16, 2018, using state legislatures' websites, LexisNexis, UConn Rudd Center's Legislative Database, Centers for Disease Control and Prevention Chronic Disease State Policy Tracking System, and the Internet, that preempt local food and nutrition policies including their legislative histories; and preempt lawsuits related to food consumption and chronic disease (e.g., Commonsense Consumption Acts), including explicitly preempting government activity.
Results: Between 2008 and March 16, 2018, 12 states enacted 13 preemptive laws on nutrition labeling, content or "criteria"; consumer incentive items; "food-based health disparities"; sale, distribution, or serving of food and beverages; portion size; food safety; menus; taxes; and "marketing." Between 2003 and 2013, 26 states enacted laws preempting lawsuits claiming long-term food consumption causes obesity and diet-related disease; of these, ten states explicitly preempt such litigation by the government and five explicitly preempt laws providing litigation as a remedy.
Conclusions: State preemption may hinder public health progress by impeding local food and nutrition policies and government-initiated litigation. Local governments are in a prime position to address fundamental concerns, such as reduction of health disparities, the provision of nutrition information, access to healthy food, and the cost of unhealthy food. Government-initiated litigation could potentially support broader policy changes.
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