All Public Health Is Local: Local Politics and the Dynamics of Public Health

Session Submission Type: Full Paper Panel

Session Description

All politics is local. It could also be argued that all public health is local. The history of public health in the United States centers around direct federalism, structuring the inceptive public health bureaucracy around local governments. Even as the federated relationship changed, giving greater oversight to states, local governments have continued to be at the forefront of public health policy and implementation through prevention and management activities. Arguably even more influentially, local governments are often in the most direct control of the social determinants of health: local policies involve exclusionary zoning for public goods, sanitation and waste management, housing, water, and physical safety. Since local governments are the primary form of government most citizens encounter, much of the field of urban and local politics is oriented around understanding the causes and consequences of local government activities and citizen’s interactions with these activities. Yet the field often does not connect the causes and consequences of these activities back to public health, or public health policy. Because most local government activities have substantial influence on public health– through resource distribution, policy, and democracy–the field of urban and local politics has the opportunity to make a substantial contribution to our understanding of public health policy processes and outcomes. The opportunity is particularly salient, now, as local public health departments face staffing and funding shortages, and cities struggle with ongoing epidemics and crises: police and gun violence, climate change mitigation, the opioid epidemic, the housing and homelessness crisis, among others. This panel explores the complex mechanisms behind public health policy outcomes and processes at the local level. De Benedictis-Kessner and co-authors consider the political consequences of the opioid epidemic, and whether or not voters hold politicians accountable for opioid overdoses and deaths. Michener examines how tenants in predominantly Black and Latinx neighborhoods organize to build local political power in response to health threatening housing conditions like asbestos and lead exposure. Willison and Einstein examine cities’ use of harm-reduction vs. punitive responses to homelessness, and the influence of police officers in policy choices. Zimmerman investigates how Black Chicagoans work with institutions and neighbors they distrust to pursue common policy goals – in this case, to remedy state and community violence.

Sub Unit

• Division 30: Urban Politics

Individual Presentations

• Opioids and Subnational Elections - Ryan Baxter-King, University of Nevada, Reno; Justin de Benedictis-Kessner, Harvard University; Brian T. Hamel, University of North Texas; Michael Hankinson, George Washington University; John Holbein, University of Virginia

• Racism, Power, and the Local Politics of Health Equity - Jamila D. Michener, Cornell University

• Moving Them Elsewhere: Police as Influencers & Implementers in Homeless Policy - Katherine Levine Einstein, Boston University; Charley Ellen Willison, Cornell University

• Working through Distrust: How Black Chicagoans Advocate against Violence - Justin Zimmerman, University at Albany

Chair

• Richardson Dilworth Drexel University

Discussant

• Richardson Dilworth Drexel University