How federal health-care policies interface with urban and rural areas: A comparison of three systems

Abstract

Global public health policies span national borders and affect multitudes of people. The spread of infectious disease has neither political nor economic boundaries, and when elevated to a status of pandemic proportions, immediate action is required. In federal systems of government, the national level leads the policy formation and implementation process, but also collaborates with supranational organisations as part of the global health network. Likewise, the national level of government cooperates with sub-national governments located in both urban and rural areas. Rural areas, particularly in less developed countries, tend to have higher poverty rates and lack the benefits of proper medical facilities, communication modes and technology to prevent the spread of disease. From the perspective of epidemiological surveillance and intervention, this article will examine federal health policies in three federal systems: Australia, Malaysia and the USA. Using the theoretical foundations of collaborative federalism, this article specifically examines how collaborative arrangements and interactions among governmental and non-governmental actors help to address the inherent discrepancies that exist between policy implementation and reactions to outbreaks in urban and rural areas. This is considered in the context of the recent H1N1 influenza pandemic, which spread significantly across the globe in 2009 and is now in what has been termed the 'post-pandemic era'.

Men's Sheds and the experience of depression in older Australian men

“…The demographic and cultural characteristics of people living in regional and remote areas differ from populations living in metropolitan areas (Baracskay, ). Barriers of access to quality health care include: lower economic status, smaller populations, dated technology, difficulty in recruiting specialist staff and greater geographical distances that are travelled to access health services (Humphreys, Wakerman & Wells, ).…”

Comparative Federal Health Care Policy: Evidence of Collaborative Federalism in Pakistan and Venezuela

“…One aspect of embracing the collaborative approach was to balance these disparities while allowing for national governments to respond to potentially severe health crises by working with both international organizations like the World Health Organization (WHO), and local health care clinics (Baracskay, 2012).…”

“…Collaborative federalism is a particularly useful analytical approach for examining health care policy and governmental responses to crisis situations, as exhibited by several recent studies where it has been applied to specific federal systems (Cameron and Simeon, 2002;Brock, 2008;Graefe and Bourns, 2009;Baracskay, 2012). As a theoretical strain of federalist theory, the literature on collaborative federalism is continuing to evolve with studies that apply it to specific federal systems marked by intergovernmental and intersectoral cooperation.…”