Recent decades have seen an explosion of transnational networking and activism, but participation varies widely around the globe. Using negative binomial regression, we explore how national and global political and economic factors shape this "uneven geography" of participation in transnational social movement organizations (TSMOs). Contrary to assumptions in popular discourse, we find a continued importance of the state and limited importance of global economic integration in determining participation in transnational associations. But while ties to the global economy do not significantly impact participation, a country's links to global institutions enhance opportunities for transnational activism. Rich countries' citizens are more active transnationally, but low-income countries with strong ties to the global polity are also more tied to global activist networks. This suggests that TSMOs do not simply reproduce worldsystem stratification, but -aided by a supportive institutional environment--they help sow the seeds for its transformation. Globalization, or the expansion of all types of social interactions across national boundaries, has led governments to turn increasingly to global institutions like the World Trade Organization (WTO) and the United Nations to resolve transnational problems. As this happens, social movement actors seeking to change local and national practices find that they must look beyond their national boundaries to do so. The global political context both expands and complicates the strategic choices available to those advocating political and social change.Activists increasingly need information and expertise relevant to transnational political arenas in order to pursue their social change goals. Therefore, it is not surprising that the growth of international agreements and organizations among governments has been accompanied by a corresponding proliferation of transnational civil society associations of all types.The dramatic growth in cross-border interactions among non-state actors has led scholars of transnational relations to call for an expansion of our traditional, state-bounded notions of civil society to account for a transnational public sphere (see Guidry et al. 2000). Many speak of a "global civil society" (see, e.g., Wapner 1996;Clark et al. 1998;Anheier et al. 2001;Warkentin and Mingst 2000), which we, along with Paul Wapner, define as "that dimension of transnational collective life in which citizens organize themselves --outside their identity with a particular state or their role as a producer or consumer--to advance shared agendas and coordinate political activities throughout the world " (2002:204). But there are strong reasons to be skeptical that this "global civil society" is "global" in the sense that it is broadly representative of and accessible to all the world's citizens. Some analysts (e.g., Tarrow 2001a; Rootes 2002) question the very presence of a global civil society by pointing to the limits of its global-ness and the weakness of the actual trans...

This cohort study of adult Medicaid patients discharged from the hospital assesses the outcomes of a program to reduce readmissions by increasing access to timely primary care appointments after hospitalization.

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Since the late 1980s, governments have focused intensely on formalizing political and economic relationships within regions. There has also been a concurrent rise in transnational, regional level organizing among social movement activists globally, suggesting the regionalization of "global civil society." However, opportunities for participation in transnational associations vary widely across countries. In this paper, we examine the influence of international (both global and regional) institutional contexts, citizen participation in international society, and national level factors on varying levels of participation in regional transnational social movement organizations (TSMOs). We use negative binomial regression to examine relationships among these factors at three time points : 1980, 1990, and 2000. We find that in the early time period, citizen network connections to international society facilitated the formation of and participation in regionally organized TSMOs. Over time, however, regional and global institutional contexts were more predictive of participation in regional TSMOs than were international network ties. Our analysis also uncovered how qualitatively different forms of regionalism translated into significantly different levels of TSMO regionalization. In Europe, where the regional institutional structure is more elaborated than elsewhere in the world, the number of regional TSMOs in which citizens participated greatly outpaced that found elsewhere. Irrespective of international, institutional factors, however, state-level features remained crucial to explaining the development of regional TSMO sectors and the variable levels of participation in them. Citizens in states with restrictions on political rights and civil liberties had significantly lower participation in these organizations in 1990 and 2000. Even so, over time, citizens in states with more ties to global and regional multilateral processes found more ways to overcome this disadvantage and strengthen their participation in regional, transnational civil society.