Since the onset of the COVID-19 pandemic, many states in the United States have limited emergency public health authority. These limits could undermine public health efforts and raise concerns about how states and localities will prevent and respond to future public health challenges. We examined which of the 50 US states passed laws to set limits on public health emergency authority in 2021 through 2022, and their relationship to COVID-19 death rates. We explored five government characteristics: COVID-19 policy response, political partisanship (Republican control), legislative professionalism, local government autonomy, and broader non-COVID-19 related preemptions. Results of T-tests and a Generalised Structural Equation Model show that states with unified Republican control had greater odds of limiting emergency public health authority of the state executive, state governor, state health official, and local health officials. Limits of emergency public health authority were associated with a higher COVID-19 death rate. We found that states setting limits on emergency authority are primarily related to politicisation and political competition between state executives/governors and legislatures, rather than pushback against the COVID-19 public health response. Limiting emergency public health authority is less common in states with more professional state legislatures. Structural changes related to party control, legislative professionalism, and local autonomy may facilitate public health authority. 


Mortality rates from drug poisoning, suicide, alcohol, and homicide vary significantly across the United States. This study explores localized relationships (i.e., geographically specific associations) between county-level economic and household distress and mortality rates from these causes among working-age adults (25–64).


Mortality data were from the National Vital Statistics System for 2014–2019. County-level socioeconomic distress (poverty, employment, income, education, disability, insurance) and household distress (single-parent, no vehicle, crowded housing, renter occupied) were from the 2009–2013 American Community Survey. We conducted Ordinary Least Squares (OLS) regression to estimate average associations and Geographically Weighted Regression (GWR) to estimate localized spatial associations between county-level distress and working-age mortality.


In terms of national average associations, OLS results indicate that a one standard deviation increase in socioeconomic distress was associated with an average of 6.1 additional drug poisoning deaths, 3.0 suicides, 2.1 alcohol-induced deaths, and 2.0 homicides per 100,000 population. A one standard deviation increase in household distress was associated with an average of 1.4 additional drug poisonings, 4.7 alcohol-induced deaths, and 1.1 homicides per 100,000 population. However, the GWR results showed that these associations vary substantially across the U.S., with socioeconomic and household distress associated with significantly higher mortality rates in some parts of the U.S than others, significantly lower rates in other parts of the U.S., and no significant associations in others. There were also some areas where distress overlapped to influence multiple causes of death, in a type of compounded disadvantage.


Socioeconomic and household distress are significant and substantial predictors of higher rates of drug poisoning mortality, suicide, alcohol-induced deaths, and homicide in specific regions of the U.S. However, these associations are not universal. Understanding the place-level factors that contribute to them can inform geographically tailored strategies to reduce rates from these preventable causes of death in different places.

This paper explores attention to the needs of women in comprehensive plans. We interviewed practicing planners and analyzed a 2019 U.S. national survey to identify planning elements that address the needs of women, including zoning codes, built environment, and services. We collected 81 comprehensive plans from communities indicating their comprehensive plans addressed the needs of women. We used Natural Language Processing to explore how women’s needs are addressed in those plans. We found little attention to women’s needs compared to the needs of family, children, seniors, poverty, and minority populations. We conducted focus groups to explore why and what planners might do to address this. We find the “neutral” language of planning can exclude specific attention to the needs of women. Comprehensive plans need to be updated to incorporate new paradigms of land use, transportation, and economic development to better meet the needs of the diversity of residents, especially women. 

Age-friendly community planning and design mainly focus on urban aging and may be less applicable in rural communities. We collaborated with the Tompkins County Age-Friendly Center for Excellence in New York State to assess strategies for rural aging. This commentary argues that density and mixed-use development, as age-friendly development strategies, leave rural communities underserved. County governments, by supporting cross-agency collaboration and encouraging civic engagement, can link the age-friendly domains regarding built environment, service delivery, and community together to help address age-friendly issues and support rural aging.

What leads to more age-friendly cities: professional management, passive gender representation in management, or active public engagement? In a survey of 1,378 local governments, age-friendly features were measured in the community comprehensive plan, zoning codes, and economic development plan. Gender representation does not distinguish level of age-friendly planning, but public engagement promotes age-friendly practices in all three areas: comprehensive plans, zoning, and economic development plans. Structural equation models find professionalism and public engagement matter more than gender representation in management, as they promote active representation, which leads to more age-friendly practices. 

Community development needs to address the role of schools. Beyond education, schools can be important sources of health care, nutrition, and economic development. However, schools, as separate governmental institutions, create challenges and opportunities for community development. Case studies in this special issue show both the promise and the challenges. In this article, we highlight the importance of hierarchical power relations, as schools may wield power over community, or lose power to tax abating authorities or higher levels of government. Shared power is needed, if the promise of schools as community development actors is to be realized. Because collaboration can narrow discussion to common agendas, we argue that voice, conscientization, and sharing of funding are needed to enable comprehensive community collaborations that lead to a broader agenda for community development.

Lack of physical activity is a growing concern among public health advocates and urban planners. Our socio-ecological model incorporates urban planning and World Health Organization actions on physical activity to identify key factors related to leisure-time physical activity at the community level. Our 2019 nationwide US survey of 1312 communities enables examination of the influence of individual, community, and policy levels on physical activity. Individual factors—poverty, aging, minority population, and longer commuting time—result in lower physical activity. Community-level factors have both positive and negative effects. Physical activity is lower in rural and suburban communities, but higher in communities with more transportation services, recreation and social activities, and safety. Communities with mixed-use neighborhoods and complete streets also show higher levels of physical activity. At the policy level, zoning and cross-agency collaboration have an indirect effect on physical activity by increasing these community-level factors. This suggests an alternative approach to promoting physical activity. Local governments can promote transportation, recreation and safety, especially in rural and minority communities lacking activefriendly built environments and facing challenges from aging population, poverty, and longer commuting time. This socio-ecological approach can assess multilevel factors related to physical activity in other countries.

What explains the level of joint use service delivery between communities and schools? Using a 2019 nation wide survey of 996 US local governments, we assess the community level factors that lead to more joint use services with schools. These include services for children (child care, child nutrition for evenings, weekends, summer), adults (adult education, nutrition programs, school buses to transport seniors), and the entire community (recreation and health care services for all ages). We identify key factors that differentiate more joint use services. We measure two types of power – hierarchical power over, and horizontal power with. We find power with (partnership and formal joint use agreements) is more important than power over (local government siting and budget control over schools). We also find engagement of families and seniors in the planning process can lead to a common vision, and this also leads to more joint use services with schools. 

The COVID-19 pandemic represents a short term shift in US social policy. Under the CARES Act and the American Rescue Plan, the federal government prioritized households by raising the floor for child support and unemployment benefits, and restoring fiscal federalism by providing increased funds to state and local governments. Our nationwide survey finds local governments with more citizen participation and Black Lives Matter protests prioritize social equity investments, while those with more Trump voters prioritize physical infrastructure. COVID-19 led to new policy approaches that expand government investment. These have the potential to help reshape citizen expectations and repair federal-state-local relations. 



We examined the 500 largest community water systems in the US to explore whether ownership is related to annual water bills, and the percent of income that low-income households spend on water. Regression results show that, among the largest water systems, private ownership is related to higher water prices and less affordability for low-income families. In states with regulations favorable to private providers, water utilities charge even higher prices. Affordability issues are more severe in communities with higher poverty and older infrastructure. Water policy needs to address ownership and regulation and explore new mechanisms to ensure water affordability for low-income residents. 

Zhang, X., González Rivas, M., Grant, M., & Warner, M. E. (2022). Water pricing and affordability in the US: public vs. private ownership. Water Policy, 24(3), 500-516.


This study integrates life-course theory and mobility research to explore livability factors that attract migrants in different age groups between rural and urban counties in the United States. Place livability is measured by economy, housing market, natural amenity, neighborhood, civic and social engagement, and health. Migrants are grouped into young, middle-aged, and older adults. Results of Structural Equation Modeling show that, as people age, the attractiveness of place shifts from a focus on the economy and housing market to the neighborhood and engagement. Rural communities, which rank the highest on engagement, attract working aged and older migrants. Natural amenities and lower housing costs also attract migrants moving to rural counties. This study suggests that the natural environment and social environment could make up for the lack of accessible physical design in rural communities. Affordable housing and an inclusive community are key to retaining and increasing the population in rural communities.

Zhang, X. (2021). Linking people’s mobility and place livability: implications for rural communities. Economic Development Quarterly. doi:10.1177/08912424211045916


A total of 34 U.S. state governments imposed moratoria on water shutoffs between March and May 2020 to ensure equitable access to water during the COVID-19 pandemic. However, by the end of 2020, most of these moratoria had expired, and millions of people were exposed to the risk of water disconnections. This study examines the linkage between water equity and public health and provides policy recommendations for improving water access and health equity.


Event study was used to analyze the impact of a water shutoff moratorium on COVID-19 daily infection growth rate and daily death growth rate from April 17, 2020 to December 31, 2020. The data were collected at the state level. The model controlled for mask mandates, at-risk groups (percentage Hispanic population, percentage essential workers), and percentage health insurance coverage.


During the study period, having a water shutoff moratorium in place significantly lowered the COVID-19 infection daily growth rate by 0.235% and significantly lowered the death growth rate by 0.135%. In addition, a comprehensive moratorium covering all water systems (public and private) significantly lowered the infection growth rate by 0.169% and significantly lowered the death growth rate by 0.228%.


This study raises attention to the importance of water equity and the need for government actions to create more uniform protections from water shutoffs across all states. A comprehensive approach to water equity can protect the health and safety of all communities.

Zhang, X, Warner, M.E. & Grant M. (2021). Impact of water shutoff moratoria on COVID-19 infection and death rates across US States. American Journal of Preventive Medicine. 62(2), 149-156.


Sub-national policy responses to the COVID-19 pandemic have been politicized in the US. Survival analysis was run on when stay-at-home orders were enacted and lifted across US states from March to June 2020. Results show a strong linkage between pre-crisis social safety net protections (paid sick leave, expanded Medicaid Health Insurance, higher state minimum wage, higher welfare benefits) and crisis policy response – whether a state shuts down earlier and reopens later. Republican-controlled states imposed stay-at-home orders later and reopened sooner. This comparative policy research shows that providing social safety net protections is a policy complement to public health.

Warner, M.E. & Zhang, X. (2021). Social Safety Nets and COVID-19 Stay Home Orders across US States: A Comparative Policy Analysis. Journal of Comparative Policy Analysis 23 (2), 176-190

See dataset on social safety net:


This work used event study to examine the impact of three policies (shutdowns, reopening, and mask mandates) on changes in the daily COVID-19 infection growth rate at the state level in the US (February through August 2020). The results show the importance of early intervention: shutdowns and mask mandates reduced the COVID-19 infection growth rate immediately after being imposed statewide. Over the longer term, mask mandates had a larger effect on flattening the curve than shutdowns. The increase in the daily infection growth rate pushed state governments to shut down, but reopening led to significant increases in new cases 21 days afterward. The results suggest a dynamic social distancing approach: a shutdown for a short period followed by reopening, combined with universal mask wearing. We also found that the COVID-19 growth rate increased in states with higher percentages of essential workers (during reopening) and higher percentages of minorities (during the mask mandate period). Health insurance access for low-income workers (via Medicaid expansion) helped to reduce COVID-19 cases in the reopening model. The implications for public health show the importance of access to health insurance and mask mandates to protect low-income essential workers, but minority groups still face a higher risk of infection during the pandemic.

Zhang, X. & Warner, M.E. (2020). COVID-19 Policy Differences Across the US States: Shut Down, Reopen and Mask Mandates. International Journal of Environmental Research and Public Health. 17 (24), 9520. doi:10.3390/ijerph17249520


•35 states and almost 500 cities implemented moratoriums on water disconnections during the COVID-19 pandemic.

•Moratoriums were more likely in states with higher COVID-19 case rates and cities with greater need and capacity.

•Moratoriums were less likely in states and cities with Republican control.


Many U.S. states and cities have imposed water disconnection moratoriums during the COVID-19 pandemic. Using logistic and Cox Proportional-Hazards models, we assess factors that differentiate which governments imposed moratoriums. States, which have economic regulation of private water utilities, were more likely to impose moratoriums, and those with higher COVID-19 case rates imposed moratoriums earlier. States with unified Republican Control and cities with more 2016 Trump voters were less likely to impose moratoriums on water disconnection. Cities in states without statewide moratoriums, were more likely to impose moratoriums if they had higher income, more minority residents, and more income inequality.

Warner, M. E., Zhang, X., & Rivas, M. G. (2020). Which states and cities protect residents from water shutoffs in the COVID-19 pandemic?. Utilities Policy, 67. doi:10.1016/j.jup.2020.101118


In the US, rural communities face challenges to meet the community health needs of older adults and children. Meanwhile, rural areas lag in age-friendly built environment and services. AARP, a US based organization promoting livability for all ages, has developed a Livability Index based on the World Health Organization’s (WHO) domains of age-friendly communities: health, housing, neighborhood, transportation, environment, engagement, and opportunity. This study links the 2018 AARP Livability Index categories with demographic structure and socio-economic factors from the American Community Survey at the county level in the US to examine if the physical, built and social environment differentiate communities with better community health across the rural–urban divide. Results show that the neighborhood built environment has the largest impact on community health for all county types. Although rural areas lag in community health, those which give more attention to engagement and opportunity rank higher. Rural communities with more African Americans, children, and poor Whites, rank lower on community health. While neighborhood characteristics have the strongest link to community health, a broader approach with attention to age, race, poverty and engagement and opportunity is needed for rural areas.

Zhang, X., Warner, M. E., & Wethington, E. (2020). Can Age-Friendly Planning Promote Equity in Community Health Across the Rural-Urban Divide in the US?. International Journal of Environmental Research and Public Health, 17(4), 1275. doi:10.3390/ijerph17041275


As US society ages, pressures on local government planning and service delivery increase. We conducted a national survey of 1474 US local governments in 2013 to measure the range of services local governments provide and how these relate to local planning processes, public engagement and local government attitudes and motivators. We differentiate measures of public engagement and cross-agency collaboration, and control for built environment, demographic structure, socio-economics and metro status to explain what differentiates communities that provide more services. Our regression models find communities with more cross-agency collaboration (for service delivery, information and trust) and more engagement of older adults and families with children, provide more services to meet their needs. Capacity constraints do not differentiate level of service delivery. Local governments with conservative councils provide fewer services for children and seniors. Communities with increasing senior populations, and suburbs with increasing child populations provide fewer services targeted to their needs.

Warner, M. E., & Zhang, X. (2020). Serving an ageing population: collaboration is key. Local Government Studies, 1-20. doi:10.1080/03003930.2020.1787166


Planning plays a critical role in promoting healthy communities for children. We conducted a national survey of United States (US) cities and counties in 2019 and found only half of the 1312 responding communities report they give attention to the needs of children in their community plans. Those that do, provide more services and have more child-friendly zoning codes. We use a human ecological framework to build structural equation models of child-friendly zoning and services. We find communities with more engagement of families with children and youth and a common vision across generational, race, and ethnic lines report higher levels of child-friendly zoning and services. Collaboration between health providers and schools builds trust and leads to more services. However, child-friendly zoning is lower in communities with higher child poverty, and in suburbs and rural areas. Our results support a dynamic human ecological model where the processes of collaboration, inclusion, and engagement are key to creating healthy places for children. These processes may be especially important in addressing the unique challenges of suburban and rural communities.

Warner, M.E. & Zhang, X. (2020). Healthy Places for Children: the critical role of engagement, common vision and collaboration. International Journal of Environmental Research and Public Health. 17 (24), 9277. doi:10.3390/ijerph17249277


Using a 2013 national survey of 1,474 U.S. communities, we differentiate communities that address the needs of children and seniors in planning and zoning codes, and their impacts on the built environment at the street, neighborhood, and housing levels. Structural equation modeling results show engagement and professionalism are the most important drivers of multigenerational planning and zoning codes, and zoning has the greatest impact on built environment outcomes. Denser, larger communities are more child- and age-friendly. Rural communities and places with more seniors lag in response. Attitudes and income are not barriers to action, which gives hope for change.

Warner, M. E., & Zhang, X. (2019). Planning communities for all ages. Journal of Planning Education and Research. doi:10.1177/0739456X19828058


The rapid pace of population aging in cities around the world demands that planners design communities that are livable for people of all ages and abilities. In 2017, to assess progress toward this end, AARP and the International Division of the American Planning Association conducted a global survey of planners on their efforts to incorporate a livable-community for-all-ages approach into their work. The survey of 559 planners measured motivators, barriers, strategies for engagement and practices facilitating planners’ work on livable communities for all ages (LCA). Using the international survey, we analyze factors driving local governments’ actions to advance LCA, and factors driving outcomes incorporating a livable community-for-all-ages approach in planning practices. We show how these differ between the US and non-US respondents, including how US suburbs and rural areas lag in actions toward LCA. Regression results show that local motivations such as awareness of substantial growth in older populations is a primary factor motivating local governments to take more actions. While physical design is a critical part of the solution, we find that facilitating practices and community engagement in the process are key to advancing planning for age-friendly communities. Additionally, communities that practice more traditional approaches to planning and have limited resources actually exhibit a higher level of LCA outcomes. This suggests that focusing on community engagement and facilitating practices could be a promising approach to incorporating an all age lens in planning practices.

Zhang, X., Warner, M. E., & Firestone, S. (2019). Overcoming Barriers to Livability for All Ages: Inclusivity is the Key. Urban Planning. doi: 10.17645/up.v4i2.1892


Little is known about the level or impact of community policing in suburban and rural communities. We surveyed more than 1,300 cities and counties and asked city managers about social cohesion, collective efficacy, and community policing variables. We find no effect of community policing on perception of safety and a positive effect on community participation only in the metro core. For suburbs and rural areas, community policing is only related to youth services. Collective efficacy is positively associated with safety perceptions across all communities but only related to community participation in suburbs and low crime communities. These results raise questions on how to better link collective efficacy and community policing in high crime communities, especially in suburbs and rural areas.

Rukus, J., Warner, M. E., & Zhang, X. (2018). Community Policing: Least Effective Where Need Is Greatest. Crime & Delinquency, 64 (14), 1858-1881. doi:10.1177/0011128716686339


What role do local governments play in promoting sustainable economic development? This study uses a 2014 national survey to analyze the relationship between local environment and social equity motivations and the kinds of economic development strategies local governments pursue (business incentives or community economic development policies). Municipalities that pay more attention to environmental sustainability and social equity use higher levels of community economic development tools and lower levels of business incentives. These places are also more likely to have written economic development plans and involve more participants in the economic development process. In contrast, communities that use higher levels of business incentives have lower income and are more dependent on manufacturing employment. Other capacity measures do not differentiate types of economic development strategies used. This suggests that sustainable economic development strategies can be pursued by a broad array of communities, especially if the motivations driving their economic development policy include environment and equity goals.

Zhang, X., Warner, M. E., & Homsy, G. C. (2017). Environment, Equity, and Economic Development Goals: Understanding Differences in Local Economic Development Strategies. Economic Development Quarterly, 31(3), 196-209. doi:10.1177/0891242417712003 


This article explores trends in business retention and expansion (BRE) and business clusters over the last two decades (1994–2014). Using national surveys of local governments, this article finds that BRE has evolved from a focus on strengthening branch plants and their competitive links to parent firms to a broader emphasis on building local business cluster networks. BRE strategies have diffused across the nation, but business clusters are more common in metro core cities. Municipalities that have written economic development plans and use local funding are more likely to use BRE. This article finds cluster strategies are embedded in a broader set of community economic development strategies that strengthen quality of life and the foundation for community wellbeing. Unlike Michael Porter’s emphasis on business clusters and competitiveness alone, this article finds economic developers recognize the need to focus not only on business clusters and competitiveness, but also on local services.

Zhang, X., & Warner, M. E. (2017). Business retention and expansion and business clusters–A comprehensive approach to community development. Community Development, 48(2), 170-186. doi:10.1080/15575330.2017.1285332