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Intergovernmental Relations Project
In recent years considerably more attention has been devoted to governance in health care than to governance in public health. Nevertheless, this is a very active time for national initiatives in the area of public health in Canada. Clarification of the roles and responsibilities of federal, provincial and local governments in public health activities is vital to ensure successes in these initiatives that should translate into large health benefits and to prevent failures that often evolve into high profile events. Our project is aimed at helping governments and the public to better understand the effects of different types of intergovernmental public health regimes on the public interest.
A. OBJECTIVES:
- Describe the role of different orders of government in a purposeful sample of public health case studies (e.g., water quality, blood safety, air quality, food safety, health surveillance, immunization policy, public health security, and disease migration) and identify gaps and overlaps in these roles
- Determine the variations in intergovernmental relations that exist in the case studies
- Determine the strengths and weaknesses of the various combinations of intergovernmental relations
- Determine the characteristics of a public health problem that make it amenable to a particular type of intergovernmental relationship
- Provide recommendations on mechanisms to improve existing intergovernmental relations to achieve policy objectives.
B. HYPOTHESIS:
Harvey Lazar and Tom McIntosh have advanced a model for describing, evaluating and comparing federal-provincial relations based on the extent of interdependence between the two orders of government and the presence or absence of a hierarchical relationship. Our hypothesis is that their model can be usefully adopted and modified to describe intergovernmental relations in public health and incorporate a third (local) level and potentially a fourth (supranational) level.
C. RESEARCH PLAN:
Researchers will obtain information for the case studies through document reviews and semi-structured interviews with key informants. Preliminary results will periodically be presented to a steering committee of experts in the fields of public health, health policy and governance. Descriptive, evaluative, and comparative analyses will be performed to derive general themes about the effectiveness of different intergovernmental relationships in health protection. This 3-year project will provide the following information:
- A detailed analysis of the development of several public health initiatives
- A description of the various forms of intergovernmental relationships at work in public health and their respective strengths and weaknesses
- Recommendations on what forms of intergovernmental relationship may be useful for particular types of public health initiatives
- An outline of what type of intergovernmental problems to expect when embarking upon public health initiatives and suggestions on how to overcome them.
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