Creative Federalism and Public Health

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Authors

Wilson, Kumanan
Lazar, Harvey

Date

2008

Type

working paper

Language

en

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Public Health 2008

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Abstract

Response to infectious disease outbreak is but one of a series of public health concerns where coordinated approaches to manage the threats are being sought. Food safety, water safety, and air quality are others. All share some principles in common. First, the scientific properties of the public health threat determine the potential extent of spillover of harm from one jurisdiction to another and therefore should, in principle, influence the nature of the intergovernmental relationship that is most appropriate for managing the threat. Second, the health protection programs for responding to such threats should balance local/regional governance, where expertise and responsiveness as well as public confidence and trust may lay, with the need to have a coordinated national approach. These programs therefore have to be coordinated nationally among the several orders of governance but also, depending on the case, with foreign governments and international organizations. Furthermore, while it is relatively easy to state what should be done in principle, in practice it is sometimes less than clear “who is doing what” in relation to the management of these public health threats. This is in part because of constitutional ambiguity over which order of government is responsible for delivering various aspects of public health services and which order of government should be responsible for financing the components of the public health system. Even when this is clear, the clarity alone does not necessarily lead to the desired public health outcomes

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© IIGR, 2008

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Queen's University Institute of Intergovernmental Relations

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