What is the basis for the historic tension between the powers of the federal government and powers of states in public health matters? What actions have been taken?
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What is the basis for the historic tension between the powers of the federal government and powers of states in public health matters? What actions have been taken?
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Prior to the federal government’s enactment of the Sixteenth Amendment (federal income tax) states held the primary position in health matters. The state held “police powers” that limited the action of individuals to control and avoid hazards and also served the role of providing health care for those unable to provide for themselves. States set up various laws to protect citizens from environmental and communicable hazards. Federal funding, available after 1935, however, changed public health. The federal government dictated priorities and tied federal grants to specific programs. In order to receive funding the states needed to give up some of their autonomy and agree to the federal government’s public health agenda. Most state constitutions “impart the authority for local government to influence health”. That said, counties usually carry out the duties delegated by the state. However, local …
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