The Challenges of Conducting Intrastate Policy Surveillance: A Methods Note on County and City Laws in Indiana.

Policy surveillance is critical in examining the ways law functions as a structural and social determinant of health. To date, little policy surveillance research has focused on examining intrastate variations in the structure and health impact of laws. Intrastate policy surveillance poses unique methodological challenges because of the complex legal architecture within states and inefficient curation of local laws.We discuss our experience with these intrastate policy surveillance challenges in Indiana, a state with 92 counties and several populous cities, a complicated history of home rule, systemically underfunded local governments, and variations in demography, geography, and technology adoption. In our case study, we expended significant time and resources to obtain county and city ordinances through online code libraries, jurisdiction Web sites, and (most notably) visits to offices to scan documents ourselves.A concerted effort is needed to ensure that local laws of all kinds are stored online in organized, searchable, and open access systems. Such an effort is vital to achieve the aspirational goals of policy surveillance at the intrastate level.