An Overview of the CSTE Public Health Authority Legal Repository

The Public Health Authority Legal Repository is intended to provide CSTE members access to self-education resources related to public health authority to 1) better understand the existing state law landscape and 2) identify recently proposed and enacted changes to state law for policy planning.

All repository content pertains to public health authority—the legal ability of a government entity to protect and promote the public’s health and health equity. The specific public health powers available to government entities (like health departments, governors, community health boards, or health officers) varies based on the laws of that jurisdiction. Because states have primary power over public health, including the ability to share powers with local government, the initial repository content consists primarily of existing resources related to state public health authority.[1]

Broadly, under the Tenth Amendment to the U.S. Constitution, states have primary power over public health and can share these powers with local government. In other words, state and local health departments and their officials or governing boards are the governmental entities whose legal authorities drive actions that most impact the public’s health.

Sources

During the COVID-19 pandemic, intense political backlash to mitigation measures sparked increased attempts to curtail public health powers. In 2021, several public health law organizations—the Center for Public Health Law Research, ChangeLab Solutions, the Network for Public Health Law, Public Health Law Center, and Public Health Law Watch—created a national project, Act for Public Health (A4PH), that supports health departments and advocates navigating changes to public health authority. Several other organizations, including the Local Solutions Support Center, American Heart Association, American Public Health Association (APHA), and Association of State and Territorial Health Officials, also have ongoing projects related to public health authority. Much of the initial repository content includes resources from many of these organizations, drawing primarily from resources developed through A4PH or A4PH partner organizations and the APHA’s Protecting Public Health Authority & Advocacy Toolkit (APHA Toolkit).

[1] Tribal Nations are also sovereign self-governing entities that possess public health powers. Each of the U.S. territories and freely associated states (FAS) have unique public health powers as well. The federal government’s public health powers are limited to taxation, spending, and regulating interstate commerce. Tribal, territorial, FAS, and federal public health authorities are not the focus of initial repository content.

Acknowledgements:

This project is supported by Cooperative Agreement number NU38OT000297 from The Centers for Disease Control and Prevention (CDC) and CSTE and does not necessarily represent the views of CDC and CSTE.

In recognition of the need to build cross-jurisdictional consensus on the scope of the legal repository, the Council of State and Territorial Epidemiologists (CSTE) Legal Repository Workgroup was created in partnership with the Center for Disease Control and Preventions (CDC) Public Health Law Program and the Network for Public Health Law (NPHL). The Legal Repository Workgroup consisted of CSTE members consisting of public health attorneys, state epidemiologists, and health information technology lead, who dedicated their time and provided their expertise to help with the development of the repository. CSTE thanks you for your contributions!