Coevolution of Policy Sectors: A Comparative Analysis of Health Care and Public Health

Abstract

This paper analyzes the institutional coevolution of policy sectors – in other words, the mutual influence and adaptation of the institutional connection between related policy areas. The article proposes a two-dimensional analytical space ranging from separation to unity on one axis and from superiority/subaltern to equality on the other. The paper argues that the overall governance framework behind the coevolving sectors affects the institutional relationship between the sectors. In its empirical part, the paper focuses on the health care and public health sectors. Based on a comparative historical examination of three countries with different health care systems – Australia, Germany, and the United States – the paper shows that health care and public health coevolve differently depending on the type of national health care system. Further research can transfer the concepts introduced in this article to the analysis of other policy challenges, such as immigration or environmental protection.

Keywords: Health Care, Public Health, Institutions, Policy Sectors, Coevolution

JEL Classification: I10