Governance, Microgovernance and Health

Abstract:     
Governance, by which I mean the management of the course of events in a system, is an overarching issue of concern to health from an ecological point of view. Governance consists largely in the policing social relations, environmental conditions and the allocation of resources essential to well-being. Who decides, and how they decide, are key drivers of substantive policy. Moreover, there is at least some epidemiological evidence that the ability of people to participate in the governance of their communities is in itself significant for health. This paper offers an emerging theory of "nodal governance" to describe the management of events in social systems. The use of this theory in mapping, assessing and then productively "destabilizing" these systems is discussed, with particular attention to the extent to which promoting "microgovernance" institutions is a plausible strategy for improving population health. Nodal governance focuses attention on how governance happens - how power is wielded - at specific points within a system, and thus raises essential normative questions about democratic decision making. But the theory, with its obvious intellectual debts to network theory, systems theory and the work of Hayek, also seems to imply a challenge to the sort of thinking about regulation and law often encapsulated in the idea of the "risk society." In the final section of the paper I conclude with some speculations about new, constitutive paradigms for social governance.

Number of Pages in PDF File: 27

Keywords: Health, Governance, Risk

Accepted Paper Series