The Economic, Institutional, and Political Determinants of Public Health Delivery System Structures

Abstract

This research provides information regarding the determinants of system change, and may help public health leaders to better prepare for the impacts of change in the areas discussed. It may also help those who are seeking to implement change to determine the contextual factors that need to be in place before change can happen, or how best to implement change in the face of contextual factors that are beyond their control.

An institutional ethnography of political and legislative factors shaping online sexual health service implementation in Ontario, Canada

“…Strategically working with political and legislative actors may therefore be an important strategy to improve healthcare access for GBQMSM. Ingram et al (2012) similarly highlight the value of political relationships in public health systems change.…”

Cross-Sector Partnerships for Systemic Change: Systematized Literature Review and Agenda for Further Research

“…At the local scale, the systems include homeless services system (Mosley 2014 ), local public health delivery system (Ingram et al 2012 ), water system or watershed (Gopakumar 2014 ; Weber 2009 ), urban development (Zhang et al 2016 ), land management (McCauley and Murphy 2013 ), urban governance (Guarneros-Meza 2009 ; Meijer and Bolívar 2016 ). This is only a sampling of the articles which focus at the local scale, but shows the diversity of topics.…”

“…The next quotation shows transformation of the structures within a system. This is from an article about transformation of public health delivery system structures (Ingram et al 2012 ). Four key determinants of structural change emerged: availability of financial resources, interorganizational relationships, public health agency organization, and political relationships.…”

“…The next quotation shows transformation of the structures within a system. This is from an article about transformation of public health delivery system structures (Ingram et al 2012). …”

The Relationship Between Local Public Health Agency Administrative Variables and County Health Status Rankings in Kentucky

“…10 While a variety of inputs appear to be associated with public health system performance, evidence suggests that certain inputs, notably finances, particularly noncategorical funding, may be major factors that influence LPHA performance. 6 These nonrestricted services allow for LPHAs to respond to local needs and provision of essential public health services that are not provided by other members of the public health system and that appear to have the most significant need in their local community. 2,4 While LPHAs are mandated by the state and federal governments to perform many of the same services, nonrestricted funding (primarily local tax dollars) allows LPHAs the flexibility to provide additional services.…”