that encourage the use of law as a tool to protect and promote public health.
Finally, of these five states, all are home rule states except for North Carolina.
27 In home rule states, local governments are free to pass laws and ordinances as they see fit to further their operations, within the bounds of the
state and federal constitutions. These states may not have the same access to
legal assistance through state resources that non-home rule states have.
When data on the structure of the state’s public health system is included, analysis of the number of requests originating from state and local entities across the country indicates that requests from local entities originate in
states with decentralized public health systems more frequently than requests from state entities.
29 Ninety percent of requests from local entities
come from states with decentralized public health systems, whereas sixty-five percent of requests from state entities originate in decentralized states.
Additionally, requests from state entities originate in a larger number of
states with centralized public health systems than requests from local entities; twenty-one percent of state requests originate in centralized states
whereas one percent of local requests come from centralized states. This
may be indicative of the varying needs among entities with different public
health systems; in decentralized states, local entities are granted greater authority in decision-making and may accordingly have greater need for legal
guidance on matters such as analyzing their public health legal authority,
developing policies through administrative rulemaking or ensuring compliance with existing regulations.
This study’s analysis of trends among requests submitted to the Network
by government entities is a small step towards the goal of developing a
broader base of practice-based research. This research can complement oth-
er efforts in public health law research and identify priorities for the devel-
opment and delivery of legal resources to public health professionals.
The Network’s collaboration with requesters across the country provides
a unique opportunity to examine the needs of state and local entities in prac-
27. It is important to note that the Southeastern Region of the Network is housed in
North Carolina and may account some increase in legal technical assistance requests from
28. See Hoffman, supra note 24.
29. See Ass’n of State & Territorial Health Officials, State Public Health Agency Classification: Understanding the Relationship Between State and Local Public Health17-19
ASTHO%20NORC%20Governance%20Classification%20Report.pdf (listing public health
system structure for every U.S. state).
30. See id. at 9 (defining traits of decentralized public health agency).