Separation and Integration in Public Health: Evidence from Organizational Structure in the States

• 成果类型: Article
• 署名作者: Sinclair, Amber H.; Whitford, Andrew B.
• 署名单位: University System of Georgia; University of Georgia
• 刊物名称: JOURNAL OF PUBLIC ADMINISTRATION RESEARCH AND THEORY
• ISSN/ISSBN: 1053-1858
• DOI: 10.1093/jopart/mus005
• 发表日期: 2013
• 页码: 55-77
• 关键词: POLITICAL CONTROL; environmental-health; administrative arrangements; Path dependence; PROTECTION; inference; culture; DESIGN; COSTS; MODEL

摘要

Recent studies contend that public health agencies in the United States are in a state of turmoil because their organizational form causes them to take on conflicting mandates. One key reason is thought to be a trade-off in design: between creating stand-alone agencies for health and environment and creating agencies that combine the two. We use data on the organizational form of state health and environmental agencies to assess the choice of organizational form as a problem of institutional design from the perspective of path-dependency theory. Our results suggest that initial social conditions help explain the choice of combined or independent agencies. We believe that this case provides useful information about the roots of organizational design for resolving competing demands and provides insight into concerns about the delivery of health and environmental protection in the states.