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1.
Artículo en Inglés | MEDLINE | ID: mdl-34206993

RESUMEN

When a novel coronavirus disease (COVID-19) made major headlines in 2020, it further exposed an existing public health crisis related to inequities within our communities and health care delivery system. Throughout the COVID-19 pandemic, populations of color had higher infection and mortality rates, and even experienced greater disease severity compared to whites. Populations of color often bear the brunt of COVID-19 and other health inequities, due to the multifaceted relationship between systemic racism and the social determinants of health. As this relationship continues to perpetuate health inequities, the local health department is an agency that has the jurisdiction and responsibility to prevent disease and protect the health of the communities they serve. When equity is integrated into a health department's operational infrastructure as a disease prevention strategy, it can elevate the agency's response to public health emergencies. Collecting, reporting, and tracking demographic data that is necessary to identify inequities becomes a priority to facilitate a more robust public health response. The purpose of this paper is to present strategies of how a local health department operationalized equity in various stages of COVID-19 response and apply these methods to future public health emergencies to better serve vulnerable communities.


Asunto(s)
COVID-19 , Salud Pública , Humanos , Gobierno Local , Pandemias , SARS-CoV-2
2.
Artículo en Inglés | MEDLINE | ID: covidwho-1273442

RESUMEN

When a novel coronavirus disease (COVID-19) made major headlines in 2020, it further exposed an existing public health crisis related to inequities within our communities and health care delivery system. Throughout the COVID-19 pandemic, populations of color had higher infection and mortality rates, and even experienced greater disease severity compared to whites. Populations of color often bear the brunt of COVID-19 and other health inequities, due to the multifaceted relationship between systemic racism and the social determinants of health. As this relationship continues to perpetuate health inequities, the local health department is an agency that has the jurisdiction and responsibility to prevent disease and protect the health of the communities they serve. When equity is integrated into a health department's operational infrastructure as a disease prevention strategy, it can elevate the agency's response to public health emergencies. Collecting, reporting, and tracking demographic data that is necessary to identify inequities becomes a priority to facilitate a more robust public health response. The purpose of this paper is to present strategies of how a local health department operationalized equity in various stages of COVID-19 response and apply these methods to future public health emergencies to better serve vulnerable communities.


Asunto(s)
COVID-19 , Salud Pública , Humanos , Gobierno Local , Pandemias , SARS-CoV-2
3.
Artículo en Inglés | PAHO-IRIS | ID: phr-54152

RESUMEN

[ABSTRACT]. Objective. Evaluate the sustainability of the Healthy Municipalities strategy in Guatemala in order to have solid evidence to support decision-making. Methods. A concurrent mixed-methods study was carried out in five phases: 1) theoretical-conceptual (based on a narrative review of the literature on sustainability, dimensions and categories were proposed for evaluation); 2) empirical (four municipalities were selected for convenience and 29 semi-structured interviews and four focus groups were conducted with key actors to explore sustainability; with this information, a score was assigned to each category and dimension); 3) analytical, by category and dimension (content analysis was performed for qualitative information, and totals and averages were calculated for quantitative information); 4) integrative (qualitative data were integrated into matrices by category and dimension, and quantitative data were supported by qualitative information); and 5) meta-inference (consideration was given to the context and its influence on the results). Results. Ninety-two (92) informants participated. In operational terms, progress was observed in the transfer and use of results, and in rotations in leadership. In the legal and political sphere, accountability and local planning were highlighted. In the economic sphere, progressive investment in health, water and sanitation was emphasized, as well as insufficient investment in social determinants of health. In the social sphere, few mechanisms were observed to promote and strengthen social participation. Conclusions. In the municipalities that participated in the study, a fair level of sustainability was observed in the Healthy Municipalities strategy.


[RESUMEN]. Objetivo. Evaluar la sostenibilidad de la estrategia Municipios Saludables en Guatemala, para disponer de evidencia sólida que permita apoyar la toma de decisiones. Métodos. Se realizó un estudio mixto concurrente en cinco fases: 1) teórica-conceptual, se realizó una revisión narrativa de literatura en sostenibilidad, con base en la cual se propusieron dimensiones y categorías para su evaluación; 2) empírica, se seleccionaron por conveniencia cuatro municipios y se realizaron 29 entrevistas semiestructuradas y cuatro grupos focales a actores clave para explorar la sostenibilidad; con esta información, se asignó un puntaje a cada categoría y dimensión; 3) analítica, por categoría y dimensión, se realizó el análisis del contenido para la información cualitativa y sumatorias y promedios para la información cuantitativa; 4) integrativa, los datos cualitativos se integraron en matrices por categoría y dimensión; y los datos cuantitativos se respaldaron con información cualitativa; y 5) metainferencia, se reflexionó sobre el contexto y su influencia en los resultados. Resultados. Participaron 92 informantes. En la dimensión operativa, se destacan avances en la transferencia y el uso de resultados, así como en el relevo de liderazgo. En la dimensión legal y política, se destacaron la rendición de cuentas y los planes locales. En la dimensión económica, se destacó la inversión progresiva en salud, agua y saneamiento, con deficiencia de inversiones en determinantes sociales de la salud. En la dimensión social, se observaron pocos mecanismos para impulsar y fortalecer la participación social. Conclusiones. En los municipios que participaron del estudio se observó un nivel regular de sostenibilidad de la estrategia Municipios Saludables.


[RESUMO]. Objetivo. Avaliar a sustentabilidade da estratégia de Municípios Saudáveis na Guatemala para dispor de evidências sólidas para apoiar o processo decisório. Métodos. Foi realizado um estudo de método misto concorrente em cinco fases: 1) fase teórica-conceitual em que foi feita a revisão narrativa da literatura em sustentabilidade a partir da qual foram propostas dimensões e categorias a serem avaliadas; 2) fase empírica em que foi feita a seleção por conveniência de quatro municípios, com 29 entrevistas semiestruturadas e quatro grupos de discussão com as principais partes interessadas para explorar a sustentabilidade; a partir das informações coletadas, foi dada uma pontuação a cada categoria e dimensão; 3) fase analítica, por categoria e dimensão, em que foi realizada a análise do conteúdo para os dados qualitativos e feito o cálculo de somatórias e médias para os dados quantitativos; 4) fase integrativa em que os dados qualitativos foram integrados em matrizes por categoria e dimensão e os dados quantitativos foram respaldados com a informação qualitativa e 5) metainferência em que foi analisado o contexto e sua influência nos resultados. Resultados. O estudo incluiu 92 participantes. Na dimensão operacional, destacam-se os avanços na transferência e no uso de resultados, bem como a ênfase em liderança. Na dimensão jurídico-política, destacam-se a prestação de contas e os planos locais. Na dimensão econômica, destaca-se o investimento progressivo em saúde, água e saneamento, com investimento inadequado nos determinantes sociais da saúde. Na dimensão social, observam-se poucos mecanismos para incentivar e reforçar a participação social. Conclusões. Foi observado nos municípios participantes do estudo um nível constante de sustentabilidade da estratégia de Municípios Saudáveis.


Asunto(s)
Estudio de Evaluación , Ciudad Saludable , Promoción de la Salud , Gobierno Local , Guatemala , Estudio de Evaluación , Ciudad Saludable , Promoción de la Salud , Gobierno Local , Estudio de Evaluación , Ciudad Saludable , Promoción de la Salud , Gobierno Local
4.
Salud Colect ; 17: e3341, 2021 05 28.
Artículo en Español | MEDLINE | ID: mdl-34105329

RESUMEN

This article critically analyzes local governments' abilities to face the COVID-19 pandemic by examining an instance of technical-scientific cooperation between a municipality and a university located in the northern Rio de Janeiro (state) beginning in April 2020. This collaboration included: the implementation of a situation room, data processing and analysis for decision making and for public communication, a telemonitoring center, ongoing training with territorial healthcare teams, and an epidemiological study of COVID-19 in the municipality, among other actions. We situate our analysis within a conceptual framework that adopts a micropolitical view of concepts such as experience, pragmatism, "live work in action," and desire. The notion of "planning-doing" is deployed as an inventive form of planning that is only narrated a posteriori, as an imperative act, a live government in action that depends on the movement of desire oriented by life, and that only takes place in collective spaces of management practices and health care.


Asunto(s)
COVID-19/prevención & control , Planificación en Salud Comunitaria/organización & administración , Colaboración Intersectorial , Gobierno Local , Pandemias/prevención & control , Universidades/organización & administración , Brasil/epidemiología , COVID-19/epidemiología , Investigación Participativa Basada en la Comunidad , Política de Salud , Humanos
6.
Salud Colect ; 17: e3341, 2021 05 28.
Artículo en Español | MEDLINE | ID: covidwho-1262710

RESUMEN

This article critically analyzes local governments' abilities to face the COVID-19 pandemic by examining an instance of technical-scientific cooperation between a municipality and a university located in the northern Rio de Janeiro (state) beginning in April 2020. This collaboration included: the implementation of a situation room, data processing and analysis for decision making and for public communication, a telemonitoring center, ongoing training with territorial healthcare teams, and an epidemiological study of COVID-19 in the municipality, among other actions. We situate our analysis within a conceptual framework that adopts a micropolitical view of concepts such as experience, pragmatism, "live work in action," and desire. The notion of "planning-doing" is deployed as an inventive form of planning that is only narrated a posteriori, as an imperative act, a live government in action that depends on the movement of desire oriented by life, and that only takes place in collective spaces of management practices and health care.


Asunto(s)
COVID-19/prevención & control , Planificación en Salud Comunitaria/organización & administración , Colaboración Intersectorial , Gobierno Local , Pandemias/prevención & control , Universidades/organización & administración , Brasil/epidemiología , COVID-19/epidemiología , Investigación Participativa Basada en la Comunidad , Política de Salud , Humanos
7.
J Occup Environ Med ; 63(7): 629-631, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-34184657

RESUMEN

OBJECTIVE: To study how county-level differences in employment in healthcare occupations contributes to county-level differences in COVID-19 cases. METHOD: The number of active COVID-19 cases were gathered from the Johns Hopkins University Coronavirus Resource Center weekly between April 22, 2020 and July 1, 2020. Data for the number of workers employed in healthcare occupations were collected at the county-level from the American Community Survey. These data were combined to explore the association between employment patterns and rates of COVID-19 cases. RESULT: Counties with more employment in healthcare-related occupations experienced higher rate of COVID-19. This association was strongest in April and May compared to later months of the pandemic. CONCLUSION: Employment in healthcare occupations may contribute to the spread of COVID-19. Intervention to protect workers may help to prevent the spread of COVID-19 and other infectious diseases.


Asunto(s)
COVID-19 , Empleo , Empleos en Salud , Personal de Salud , COVID-19/epidemiología , Atención a la Salud , Humanos , Gobierno Local , Ocupaciones , Factores de Riesgo , SARS-CoV-2 , Estados Unidos/epidemiología
8.
Stud Health Technol Inform ; 282: 333-347, 2021 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-34085979

RESUMEN

The Barrier-Free Basic Plan (BFBP) of Japan is based on Article 25 in the Act on the Promotion of Smooth Transportation, etc. of Elderly Persons, Disabled Persons, etc., abbreviated as the "Barrier-Free Act". BFBPs are created by municipal governments and play a crucial role in progressing the accessibility of existing buildings/facilities in cities. However, the number of municipal governments which have their own BFBPs stands at only 304 out of a total of approximately 1700 municipalities in 2020. The purpose of this paper is to describe the barriers and difficulties that administrative officers face in creating and managing BFBPs. The questionnaires were distributed in 2018 to 183 municipal governments which have their own BFBPs. The procedures of analyzing the results were as follows: 1) motivation for creating their own BFBPs, 2) supportive advisers in proceeding with the creation of BFBPs, 3) difficulties of creating their own BFBPs, 4) key factors promoting the quality of BFBPs, and 5) self-evaluation of their own BFBPs. In conclusion, the challenges that administrative officers faced in creating BFBPs and the required measures to raise the quality of BFBPs on a practical level were discovered, by considering the population scales of municipalities and the establishment year of the BFBP. The continuous removing of obstacles in existing buildings based on BFBPs will allow for more comfortable and accessible cities for everyone.


Asunto(s)
Gobierno Local , Anciano , Ciudades , Humanos , Japón , Encuestas y Cuestionarios
9.
Artículo en Inglés | MEDLINE | ID: mdl-34067068

RESUMEN

Combined with the characteristics of the Chinese environmental regulation supervision system and evolutionary game theory, the spillover effect of local governments' investment behaviour has been incorporated into their payment function to study the influence of spillover on the strategy choice of local governments and enterprises. The results show that (1) the spillover effect is one of the reasons for distortions in the implementation of environmental regulations. Whether the influence of the spillover effect on the probability of local governments choosing the strategy of strict supervision is positive or negative depends on the environmental benefit of the local government's environmental protection investment. (2) Increasing the reward for the enterprise's complete green technology innovation behaviour is conducive to improving the probability of the enterprises choosing the strategy of complete green technology innovation, while it reduces the probability of local governments choosing the strategy of strict supervision. Increasing punishment for enterprises' incomplete green technology innovation behaviour is conducive to improving the probability of enterprises choosing the strategy of complete green technology innovation, but its impact on the probability of local governments choosing the strategy of strict supervision is uncertain due to the limitations of many factors. (3) Enterprises' emission reduction capacity is positively related to the probability of the enterprises choosing the strategy of complete green technology innovation and is negatively related to the probability of local governments choosing the strategy of strict supervision. The research conclusions provide a new explanation for the distorted enforcement of environmental regulations from the perspective of the spillover of local governments' investment behaviour.


Asunto(s)
Teoría del Juego , Gobierno Local , China , Conservación de los Recursos Naturales , Invenciones , Inversiones en Salud
11.
BMC Public Health ; 21(1): 1192, 2021 06 22.
Artículo en Inglés | MEDLINE | ID: mdl-34157995

RESUMEN

BACKGROUND: The physical environment has been shown to have a positive effect on the promotion of physical activity of older people. Outdoor environments that incorporate specialised exercise equipment suitable for older people are uniquely placed to promote physical activity and social connectedness amongst older people. The ENJOY project included the installation of specialised outdoor exercise equipment (the Seniors Exercise Park) and the delivery of a physical and social activity program for older people as part of a prospective pre-post research design. The installation of the specialised equipment in public sites and an aged care facility was also aimed at increasing usage of the equipment by older people from the wider community and to increase physical and social activities. METHOD: A conceptual framework for implementation and several engagement methods were utilised to guide the research and to support the participating partners throughout the project. This paper is a reflective narrative describing the collaborative process and approach utilised to engage local governments and community, and reports the challenges and the lessons learnt to inform future strategies for implementation. RESULTS: The conceptual framework for the implementation process that guided the conduct and delivery of the ENJOY project included the core elements of the Interactive Systems Framework and the ecologic framework. These models incorporate elements of research-to-practice and community-centred implementation to accommodate the unique perspectives of a range of stakeholders. CONCLUSION: Partner characteristics such as local governments' structure and policy as well as community factors can impact on implementation. Partnership with local governments with effective communication, strategic planning and community and seniors engagement approaches are recommended for successful implementation. The lessons learnt can further assist public health research design around changes to the built environment to positively impact on older people's physical activity levels. TRIAL REGISTRATION: Trial registration number ACTRN12618001727235. Date of registration 19th October 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375979.


Asunto(s)
Ejercicio Físico , Gobierno Local , Anciano , Humanos , Estudios Prospectivos
12.
J Korean Med Sci ; 36(19): e134, 2021 May 17.
Artículo en Inglés | MEDLINE | ID: covidwho-1232535

RESUMEN

During the three the coronavirus disease 2019 (COVID-19) surges in South Korea, there was a shortage of hospital beds for COVID-19 patients, and as a result, there were cases of death while waiting for hospitalization. To minimize the risk of death and to allow those confirmed with COVID-19 to safely wait for hospitalization at home, the local government of Gyeonggi-do in South Korea developed a novel home management system (HMS). The HMS team, comprised of doctors and nurses, was organized to operate HMS. HMS provided a two-way channel for the taskforce and patients to monitor the severity of patient's condition and to provide healthcare counseling as needed. In addition, the HMS team cooperated with a triage/bed assignment team to expedite the response in case of an emergency, and managed a database of severity for real-time monitoring of patients. The HMS became operational for the first time in August 2020, initially managing only 181 patients; it currently manages a total of 3,707 patients. The HMS supplemented the government's COVID-19 confirmed case management framework by managing patients waiting at home for hospitalization due to lack of hospital and residential treatment center beds. HMS also could contribute a sense of psychological stability in patients and prevented the situation from worsening by efficient management of hospital beds and reduction of workloads on public healthcare centers. To stabilize and improve the management of COVID-19 confirmed cases, governments should organically develop self-treatment and HMS, and implement a decisive division of roles within the local governments.


Asunto(s)
COVID-19/terapia , Servicios de Atención de Salud a Domicilio/organización & administración , Atención Domiciliaria de Salud/organización & administración , Gobierno Local , Pandemias , SARS-CoV-2 , COVID-19/epidemiología , Consejo , Sistemas de Administración de Bases de Datos , Bases de Datos Factuales , Necesidades y Demandas de Servicios de Salud , Servicios de Atención de Salud a Domicilio/estadística & datos numéricos , Atención Domiciliaria de Salud/estadística & datos numéricos , Capacidad de Camas en Hospitales , Humanos , Grupo de Atención al Paciente , República de Corea/epidemiología , Autocuidado , Listas de Espera
13.
F1000Res ; 10: 8, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33968360

RESUMEN

We present a database listing local government mask orders for COVID-19 that were enacted between April and September, 2020, prior to the date that the governors issued statewide mask wearing mandates. We obtained data from a Google search of web pages of local and national commercial and public broadcasters and newspapers, and of the orders themselves.  In the database, we present data identifying the county, municipality or tribal council, date of the order, and the source's internet address. In the 34 states with statewide orders, local governments in 21 of these states issued mandates in 218 municipalities, 155 counties, and 1 tribal council.  The dataset can be accessed from https://doi.org/10.7939/DVN/NDFEHK.


Asunto(s)
COVID-19 , Gobierno Local , Humanos , Máscaras , SARS-CoV-2
14.
Asian J Psychiatr ; 61: 102689, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34004459

RESUMEN

Although local government staff are crucial in post-quake reconstruction, their long-term psychological and professional consequences remain unclear. This longitudinal study investigated changes of posttraumatic stress disorder (PTSD) and professional burnout over seven years, and their underlying relationship. The study assessed 250 staff at one year (T1y) after the earthquake, and 162 (64.8 %) were followed up at seven years (T7y). PTSD and professional burnout were assessed with the Short Screening Scale for DSM-IV PTSD and the burnout subscale of Professional Quality of Life Scale (ProQOL), respectively, at both time points. Longitudinal changes in PTSD and burnout were examined and cross-lagged panel analyses were conducted to test the relationship between PTSD and burnout. The rates of positive cases of PTSD screening were 23.2 % at T1y and 11.1 % at T7y. The percentages of moderate burnout were 61.7 % at T1y and 23.5 % at T7y. Scores of PTSD (z = -5.70, p < 0.001) and burnout (t = 10.07, p < 0.001) from T1y to T7y decreased. The cross-lagged analysis indicated that burnout at T1y predicted PTSD at T7y (ß = 0.19, p = 0.025). In conclusion, the Wenchuan earthquake has long-lasting negative effects on local government staff, although they can recover over time. Interventions to reduce professional burnout after disaster may does be beneficial to decrease the risk of PTSD in the long run.


Asunto(s)
Agotamiento Profesional , Terremotos , Trastornos por Estrés Postraumático , Agotamiento Profesional/epidemiología , China/epidemiología , Humanos , Gobierno Local , Estudios Longitudinales , Calidad de Vida , Factores de Riesgo , Trastornos por Estrés Postraumático/epidemiología
15.
J Korean Med Sci ; 36(19): e134, 2021 May 17.
Artículo en Inglés | MEDLINE | ID: mdl-34002552

RESUMEN

During the three the coronavirus disease 2019 (COVID-19) surges in South Korea, there was a shortage of hospital beds for COVID-19 patients, and as a result, there were cases of death while waiting for hospitalization. To minimize the risk of death and to allow those confirmed with COVID-19 to safely wait for hospitalization at home, the local government of Gyeonggi-do in South Korea developed a novel home management system (HMS). The HMS team, comprised of doctors and nurses, was organized to operate HMS. HMS provided a two-way channel for the taskforce and patients to monitor the severity of patient's condition and to provide healthcare counseling as needed. In addition, the HMS team cooperated with a triage/bed assignment team to expedite the response in case of an emergency, and managed a database of severity for real-time monitoring of patients. The HMS became operational for the first time in August 2020, initially managing only 181 patients; it currently manages a total of 3,707 patients. The HMS supplemented the government's COVID-19 confirmed case management framework by managing patients waiting at home for hospitalization due to lack of hospital and residential treatment center beds. HMS also could contribute a sense of psychological stability in patients and prevented the situation from worsening by efficient management of hospital beds and reduction of workloads on public healthcare centers. To stabilize and improve the management of COVID-19 confirmed cases, governments should organically develop self-treatment and HMS, and implement a decisive division of roles within the local governments.


Asunto(s)
COVID-19/terapia , Servicios de Atención de Salud a Domicilio/organización & administración , Atención Domiciliaria de Salud/organización & administración , Gobierno Local , Pandemias , SARS-CoV-2 , COVID-19/epidemiología , Consejo , Sistemas de Administración de Bases de Datos , Bases de Datos Factuales , Necesidades y Demandas de Servicios de Salud , Servicios de Atención de Salud a Domicilio/estadística & datos numéricos , Atención Domiciliaria de Salud/estadística & datos numéricos , Capacidad de Camas en Hospitales , Humanos , Grupo de Atención al Paciente , República de Corea/epidemiología , Autocuidado , Listas de Espera
16.
Front Public Health ; 9: 614915, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33981660

RESUMEN

Introduction: A number of provinces have implemented a fiscal reform of flattening government since the first decade of this century in China. This study aims to quantitatively analyze the influences of this government fiscal reform on county-level health expenditure. We also bring forward policy suggestions for improving county-level fiscal system and healthcare delivery. Methods: We collected a novel longitudinal county-level data from 2003 to 2010, including counties' socioeconomic data, fiscal revenue, and health expenditure. Jilin Province, Hebei Province, and Anhui Province were selected as representative samples for this policy evaluation. The study employed a time-varying difference-in-difference model specification to investigate the impacts of flattening fiscal reform on health expenditure. Results: The analyses find that the fiscal system reforms of the three provinces have a significantly positive impact on the health expenditure of county-level governments. However, we find no policy effects on the proportion of health expenditure to fiscal expenditure of county-level governments. The estimation results are robust after controlling several background variables. Conclusion: The results yield important policy insights that public finance and its reform significantly impacts health expenditures in China. The government may still need to strengthen the transfer payment system to guarantee the social welfare provision in healthcare.


Asunto(s)
Gastos en Salud , Gobierno Local , China , Atención a la Salud
18.
Artículo en Inglés | MEDLINE | ID: mdl-33917335

RESUMEN

The promotion of walking and cycling to stay active and mobile offers great potential for healthy aging. Intersectoral collaboration for age-friendly urban planning is required in local government to realize this potential. Semi-structured interviews were conducted with the heads of planning and public health departments in city and district administrations of a Metropolitan Region in Germany to identify factors influencing action on the cross-cutting issue of active mobility for healthy aging. Although some administrations are working on the promotion of active mobility, they consider neither the needs of older people nor health effects. A lack of human resources and expertise, mainly due to the low priority placed on the issue, are described as the main barriers for further strategic collaboration. Furthermore, the public health sector often focuses on pathogens as the cause of morbidity and mortality, reducing their acceptance of responsibility for the topic. Facilitating factors include the establishment of new administrative structures, projects with rapid results that create awareness and credibility among citizens and politicians, additional staff with expertise in health promotion, and political commitment. In the future, new administrative structures for intersectoral collaboration are needed in order to consider various perspectives in complex developments, such as healthy aging, and to benefit from synergies.


Asunto(s)
Envejecimiento Saludable , Gobierno Local , Anciano , Anciano de 80 o más Años , Ciudades , Alemania , Promoción de la Salud , Humanos , Colaboración Intersectorial
19.
Waste Manag ; 126: 800-809, 2021 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-33895563

RESUMEN

Currently, in all developed countries there is great interest in improving democratic practices in local governments, as the administration closest to citizens. However, the possible influence of these actions on the management of public services and municipal finances have been side-lined, despite the great interest in evaluating the performance of local governments under budgetary constraints. Our research aims to fill this knowledge gap by studying the impact of key aspects of local governance (transparency and citizen participation), together with other environmental variables, on the efficiency of two municipal public services of both qualitative and quantitative importance: waste collection and street cleaning. The results show that the type of management, population density, the tourist activity of the municipality and the strength of local government are determinants that explain the efficiency of the public services examined in this research, while transparency and citizen participation have little impact.


Asunto(s)
Eliminación de Residuos , Administración de Residuos , Ciudades , Gobierno Local , Densidad de Población
20.
Artículo en Inglés | MEDLINE | ID: mdl-33807436

RESUMEN

Food safety is related to public health, social welfare, and human survival, all of which are important and pressing areas of concern all over the world. The government plays an increasingly important role in the supervision of food safety. The role of the government, however, is also controversial. Using provincial panel data of China from 2005 to 2015, the present study intends to shed light on the associations between government intervention and food safety performance under two scenarios of local government-competition and noncompetition. This will be accomplished through an exploratory spatial data analysis and a spatial econometric model. The results reveal negative associations between food safety performance and government intervention without considering local government competition. As was also observed, government intervention not only inhibits the improvement of food safety in the region, but also has a negative spatial spillover effect on food safety in neighboring provinces. This is the result after considering government competition, thus, showing the competitive strategic interaction of the "race to the bottom". Further analysis reveals that, if geographically similar regions are selected as reference objects, the food safety performance of each province will have a stronger tendency to compete for the better. If regions with similar economic development levels are selected as reference objects, food safety performance will have a stronger tendency to compete for the worse. This work provides new evidence for the relationships between government intervention and food safety, and, also, proposes some insightful implications for policymakers for governing food safety.


Asunto(s)
Desarrollo Económico , Gobierno Local , China , Inocuidad de los Alimentos , Humanos , Análisis Espacial
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