In-Person Full Paper Panel
Participants:
- (Chair) Matthew Kavanagh, Georgetown University
- (Discussant) Charley Ellen Willison, Cornell University
- (Discussant) Ashley M. Fox, SUNY at Albany
Session Description:
In times of crisis and political upheaval around the globe, governance and health policy implementation become one of the battlegrounds for defining belonging, justice, and the state’s legitimacy and ability to respond to citizen need. Global disruptions like the COVID-19 pandemic laid bare the stark inequalities embedded in health systems everywhere, underscoring how public goods are often unevenly distributed amid rising distrust, polarization, economic upheaval, and political disruption. The politics of health often extend beyond moments of crises, and in their aftermath continue to be shaped by narratives of power, inclusion, and exclusion that vary across borders, communities, and across time.
This panel examines how health policies reflect and reshape broader political divisions rooted in citizenship, generational priorities, and structures of government. Whether addressing cross-border health inequities, demographic pressures on welfare systems, or multi-level implementation challenges, the panel highlights how states and institutions both respond to and perpetuate structural inequities. In doing so, it also underscores how health governance can become a site for reimagining power and citizenship, revealing opportunities for, and barriers to, more inclusive and effective health policy and promotion.
Lucia Vitale’s paper examines how “Assembled Access” shapes cross-border health citizenship in the Dominican Republic and Haiti. Her research reveals how fragmented care systems force marginalized populations to manage their own medical coordination, leading to incoherence, inconsistency, and deeper inequities in healthcare access, reinforcing exclusionary frameworks of political inclusion and exclusion.
Jacques et al. investigated how aging populations influence political priorities and healthcare spending. Using survey data and party positions across seven countries, they show that older voters favor parties perceived as health care leaders, prompting parties to prioritize health care. This politically driven focus on health care contributes to rising public expenditure.
Deviana Dewi’s research on Indonesia’s stunting reduction policy highlights how weak multi-level coordination limits the reach of interventions. Her work emphasizes the importance of translating national strategies into local action by improving horizontal and vertical governance, demonstrating that effective public health policies require not only strong design but also coordinated implementation.
Emma Willoughby’s historical analysis of Vietnam’s market governance shows how the state shifted from controlling populations to accommodating informal enterprises during economic reforms. Her work illustrates how “fence-breaking” behavior redefined governance, highlighting the state’s adaptation to grassroots economic activity and how market reforms reshaped the relationship between citizens and the state.
Rachel Kulikoff explores how model-based health data, such as infant mortality rates (IMR), affect political science research. She shows how differences in estimation methods and regional smoothing can influence findings, making causal claims about regime transitions and health outcomes more complex. Her research underscores the importance of considering proximate causes and data limitations.
Collectively, these papers demonstrate how health governance serves as a lens for understanding political contestation and transformation amid crises. By examining how states allocate resources, navigate competing interests, and address—or exacerbate—inequities, the panel illustrates the ways in which health policies both shape and are shaped by power dynamics. This discussion enriches ongoing debates about the capacity of political institutions to foster resilience, accountability, and collective well-being in an era of heightened global uncertainty and conflict. Ultimately, the panel invites reflection on how reimagining governance in the health sector can illuminate pathways toward more equitable and inclusive political systems.
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