Houses.

Author Q&A: State Preemption of Inclusionary Zoning Policies and Health Outcomes

Courtnee E. Melton-Fant, PhD

Historically, federal and state governments have been primarily responsible for increasing and maintaining the supply of affordable housing. But as budgets decrease, the burden has fallen more and more to local governments. Inclusionary zoning policies, which seek to reverse the negative, exclusionary effects of conventional zoning, are one tool local governments can use to increase affordable housing stock.

Courtnee Melton-Fant, PhD, an assistant professor at the University of Memphis School of Public Health, recently published research in Housing Policy Debate that explores the growing trend of preemption as it relates to these inclusionary zoning policies.

Dr. Melton-Fant’s research used policy surveillance data produced by the Center for Public Health Law Research with the National League of Cities to examine the relationship between state preemption of inclusionary zoning policies and health outcomes among different demographic groups — particularly among people of color.

We asked Dr. Melton-Fant a few questions about her work.

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stethoscope on computer keyboard

How Traditional Health Records Bolster Structural Racism

By Adrian Gropper, MD

As the U.S. reckons with centuries of structural racism, an important step toward making health care more equitable will require transferring control of health records to patients and patient groups.

The Black Lives Matter movement calls upon us to review racism in all aspects of social policy, from law enforcement to health. Statistics show that Black Americans are at higher risk of dying from COVID-19. The reasons for these disparities are not entirely clear. Every obstacle to data collection makes it that much harder to find a rational solution, thereby increasing the death toll.

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Preemption, Paid Leave, and the Health of America

As the United States continues its response to a seemingly inevitable coronavirus epidemic, experts in law and public health are stressing the importance of supportive social safety nets to ensure an equitable and fair response to the virus’s spread.

If you are one of the nearly two million Americans who works for minimum wage, for much of the service industry, or in the contingent labor force, a situation that forces you to stay home from work – because of illness, or government- or self-imposed quarantine or social distancing measures – could create dire financial circumstances and inhibit measures to mitigate the impact of an infectious disease like COVID-19.

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Histogram chart depicts the number of states that have passed restrictions, bans or protections for abortion in the United States in 2018 and 2019, as well as how court cases may have impacted the implementation of those laws.

Increased Restrictions and Court Activity for Reproductive Rights in the US in 2019

The landscape of abortion law in the United States saw increases in targeted restrictions in 2019, but also some efforts to protect access by state governments and courts, according to new data published this week to LawAtlas.org.

The data capture abortion-focused statutes and regulations (or amendments to existing laws) in effect between December 1, 2018 and December 1, 2019, as well as court cases that may impact the implementation of these laws.

Our research team noticed a few trends:

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Illustration of a diverse group of people and health care workers

Q&A with Adam Lustig, Trust for America’s Health, on Laws to Promote Cost-Savings in States

By The Temple University Center for Public Health Law Research

This week, the Center for Public Health Law Research and Trust for America’s Health (TFAH) published the first two of 13 comprehensive datasets on laws that can support cost-savings for states and promote health and well-being. Researchers from Center used the scientific policy surveillance process to create datasets that provide states with detailed information about the current state of U.S. laws.

The first two datasets, covering syringe service programs (SSPs) and tobacco pricing strategies, offer an in-depth look at two harm reduction-focused laws that can also have a positive economic impact in communities.

We spoke with Adam Lustig, MS, the manager of the Promoting Health & Cost Control in States (PHACCS) project at TFAH.

CPHLR: These new datasets are the first two of 13, what other topics are being mapped, and how were these topics chosen?

Adam Lustig: We are incredibly excited for the release of the remaining eleven datasets through the summer of 2020. For a preview of things to come, we anticipate releasing datasets on Smoke-Free policies, Alcohol Pricing Strategies, Complete Streets, Ban the Box, and Earned Income Tax Credit in the first quarter of 2020. Following those datasets, we will publish the remaining datasets on School Nutrition Programs, Earned Sick Leave, Paid Family Leave, Rapid Re-Housing, Universal pre-K, and Housing Rehabilitation Loan and Grant Programs throughout the summer of 2020.

CPHLR: These first two datasets, and one forthcoming on alcohol pricing, focus specifically on harm reduction for substance use. Why are harm reduction strategies integral to cost control? Read More

Photo of pencil case filled with colored pencils and an e-cigarette

Tracking Youth Electronic Cigarette Laws with Policy Surveillance

By Justine Fuga

Just last year, one in five high school students and one in 20 middle school students across the country used electronic cigarettes (e-cigarettes). According to the 2018 National Youth Tobacco Survey, more than 3.6 million middle and high school students used electronic cigarettes, more than double the number of youth using e-cigarettes in 2017. This increase is concerning given what is known about the adverse health effects of e-cigarettes. Recent research shows that nicotine has a negative effect on the developing brain. Other chemicals found in e-cigarettes are toxic to cells and have been linked to cardiovascular and lung diseases, including cancer.

Diverse strategies have emerged to curb the youth e-cigarette epidemic, including million-dollar campaigns from CVS Health and school policies implementing random nicotine testing. Most notable is the recent ordinance passed by San Francisco, the first city to institute a large-scale sales restriction. The city-wide ban prevents residents from purchasing any e-cigarettes in stores or online until products have undergone a premarket review by the U.S. Food and Drug Administration (FDA). The ban is motivated in part to decrease youth access to e-cigarettes. From 2016 to 2017, current e-cigarette use among California high school students increased from 8.6% to 10.9%, according to the California Student Tobacco Survey.The San Francisco ban is not the first law implemented to impact youth access to e-cigarettes. California state law sets various online purchasing requirements for e-cigarettes: online purchasers must provide proof of age, distributors must deliver to verified mailing addresses, and online purchaser age must be verified by a third-party service. These laws were in place in 2016 and 2017, but it is unclear whether these state laws had any impact on the 2.3% increase in youth vaping because, problematically, there is no current research exploring the link between the laws and youth e-cigarette use.

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Illustration of two young hipsters drinking coffee and an old woman carries groceries home

Inclusionary Zoning Laws offer Opportunity to Combat Low Income Residency Exclusion

By Lilo Blank

Gentrification is highly contentious as it transforms neighborhoods from low to high value.  A National Community Reinvestment Coalition study shows that gentrification and subsequent displacement has increased in urban areas within the last decade, with black and Hispanic residents among the most affected. Proponents of gentrifying neighborhoods point to the economic benefits for communities and potentially improved physical and mental health in adults and longitudinal educational success and monetary attainment for residents – emphasis on “potential.” Opponents point to the negative social and health outcomes for lower socio-economic residents, such as forced displacement of established residents and systemic socio-economic discrimination. Gentrification is a phenomenon of class interest and vulnerable minorities, such as black and Hispanic communities, are more likely to experience structural violence associated with socio-economic status than white counterparts. For those who avoid displacement, the CDC describes reduced access to healthy food, health care, recreation, and social networks as possible financial health consequences of gentrification. To combat negative effects, policy makers are taking a residential housing approach to improve community outcomes.

Inclusionary zoning (IZ) laws are one such approach, and are intended to create affordable housing through collaboration between public and private developers. These laws create requirements and incentives for developers, such as unit size minimums and establishing income eligibility criteria. IZ laws counter preceding ‘exclusionary zoning’ policy where large-lot zoning is used to prevent low-income integration into rising developments. Contrary to the original intent, IZ laws have been criticized for creating potential financial disincentives to develop in low-income areas and increasing housing price inflation.

To combat this risk, states like New Jersey, Massachusetts, and California have added additional incentives such as density bonuses, expedited approvals, and fee waivers. These have been presented to developers as part of state ordinances and regulations. Under its Affordable Housing Act, Illinois seeks to create grants, mortgages, and loans to rehabilitate, develop, operate, and maintain housing for low-income and very-low-income families. The Act requires local governments to create affordable housing plans based upon their municipalities’ median incomes. For example, based upon population median incomes and housing values, the town of Evanston, Illinois is required to provide 4,993 affordable housing units to accommodate its population of 75,472 who have an area median income of $63,327.

The Cook County Health Department in Illinois just published a dataset to LawAtlas.org as part of a yearlong legal epidemiology project funded by the CDC Public Health Law Program and ChangeLab Solutions. The health department created a policy surveillance dataset tracking IZ laws in 10 municipalities across the country, concentrating on residential areas around Cook County and the Chicago Metropolitan area: Boulder, Colorado; Burlington, Vermont; Cambridge, Massachusetts; Evanston, Illinois; Highland Park-Lake County, Illinois; Irvine, California; Lake Forest-Lake County, Illinois; San Diego, California; Santa Fe, California; Stamford, Connecticut.

One common provision of IZ policies are set-asides. These are ordinances that require developers to reserve a portion of the new development for low-income residents. Through its policy surveillance project, the health department found that nine of the jurisdictions have implemented mandatory IZ policies and six jurisdictions have established preferences for who can live in set-aside units. The percentage of set-aside required for low-income housing varies by jurisdiction – from 10 percent in two jurisdictions, up to 25 percent in one. Of the 10 jurisdictions studied, one (Stamford, Connecticut) doesn’t require any set-aside, and nine allow for alternatives to set-asides, such as fee-in-lieu (nine jurisdictions), land dedication (six jurisdictions), and alternative proposals (four jurisdictions). For those jurisdictions with fee-in-lieu alternatives, seven provide those payments to Affordable Housing Funds.

Map of the United States illustrating how cities incorporate affordable housing
Inclusionary zoning laws can serve as a mechanism to provide more housing opportunities by requiring or incentivizing developers to set aside a certain portion of new developments for affordable housing, and are designed to provide more affordable rental and/or owner-occupied housing for low to moderate-income individuals and families. Image via LawAtlas.org.

 

While extensive literature provides evidence for a positive association between levels of wealth in an area and the levels of health in that area, more research is needed to establish the efficacy of IZ laws. Governments are increasingly implementing relevant policies to combat the negative effects of gentrification and IZ policies could be part of the mix, particularly when used in conjunction with efforts to preserve existing community culture beyond property interest, as neighborhoods provide important social support networks for residents. “Revitalization without displacement” is a rising standard for preserving the positive economic benefits of gentrification without destroying communities through displacement. This policy advocates increasing the total population by filling vacancies and increasing housing densities and preserving community bonds. Experts consider ‘social mix’ to be a common good.

The ten policies in this dataset are just the tip of the iceberg, but they do offer an interesting, important look into the complexity and variation of these laws.

You can explore the Cook County Inclusionary Zoning dataset by visiting LawAtlas.org.

 

Lilo Blank is the summer communications intern for the Temple University Center for Public Health Law Research. She is a student at the University of Rochester.

Polar chart depicting state conscience protection laws for abortion (46 states), sterilization (17 states), contraception (16 states), or emergency contraception (5 states).

New Dataset: Conscience Protections for Providers and Patients

Scholarship and public debate about law’s role in protecting health care providers’ conscience rights often focus on who should be protected, what actions should be protected, and when and whether there should be any limitations on conscience rights.

But the how of these legal protections is rarely addressed – that is, when health care providers decline to participate in medical services that violate their deeply-held beliefs, exactly what consequences do state laws protect them from? The new dataset I’ve just released on LawAtlas answers this question in the context of reproductive health conscience laws, and reveals some surprising trends.

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Pro-choice and pro-life protesters face off in front of the Supreme Court

“Fetal Heartbeat” Bans are Gaining Momentum, but Abortion Restrictions Come in Many Forms

By Alexandra Hess

Alabama, Georgia, and Ohio have passed laws in recent weeks that ban many, if not all, abortions in their state. These bans are the latest additions to the litany of laws and policies that severely limit or totally prevent access to abortion for women in the United States.

“Fetal heartbeat” bans, like those enacted in both Ohio and Georgia, are some of the most restrictive types of gestational limitations on abortion in the U.S. They prohibit abortion at the point a fetal heartbeat is detectable by ultrasound—as early as six weeks’ gestation. This is often a point before many discover they are pregnant. Ohio and Georgia are not the first states to have enacted fetal heartbeat bans, however, and current legislative trends suggest they will not be the last. In 2019 alone, lawmakers have proposed heartbeat bans in at least 14 other state legislatures. Read More

Back view of a little boy wearing a backpack walking to school

Zeroing In on “Zero Tolerance” School Discipline Laws

By Alexandra Hess

Exclusionary school discipline (ESD) policies, also known as Zero Tolerance policies, enforce disciplinary measures like suspension, expulsion, or law enforcement referral to address particular student behaviors.

Though it began as part of the Gun-Free Schools Act of 1994, which mandated one-year expulsion for possessing a firearm at school, ESD became more widely adopted over time. Now, the policies apply nationwide to a broad range of behaviors — from damaging property and fighting, to possessing a cell phone or tobacco, as well as behaviors described by subjective terms often undefined in the law, like willful defiance, obscenity, or profanity. Read More