We examine the roles of sub-national and national governments in Canada and the United States vis-a-vis the protective public health response in the onset phase of the global coronavirus disease 2019 (COVID-19) pandemic. This period was characterized in both countries by incomplete information as well as by uncertainty regarding which level of government should be responsible for which policies. The crisis represents an opportunity to study how national and sub-national governments respond to such policy challenges. In this article, we present a unique dataset that catalogues the policy responses of US states and Canadian provinces as well as those of the respective federal governments: the Protective Policy Index (PPI). We then compare the United States and Canada along several dimensions, including the absolute values of sub-national levels of the index relative to the total protections enjoyed by citizens, the relationship between early threat (as measured by the mortality rate near the start of the public health crisis) and the evolution of the PPI, and finally the institutional and legislative origins of the protective health policies. We find that the sub-national contribution to policy is more important for both the United States and Canada than are their national-level policies, and it is unrelated in scope to our early threat measure. We also show that the institutional origin of the policies as evidenced by the COVID-19 response differs greatly between the two countries and has implications for the evolution of federalism in each.
机构:
Univ Calif San Diego, Dept Anesthesiol, San Diego Sch Med, La Jolla, CA 92093 USA
Global Hlth Policy Inst, San Diego, CA 94158 USAUniv Calif San Diego, Dept Anesthesiol, San Diego Sch Med, La Jolla, CA 92093 USA
Cuomo, Raphael E.
Purushothaman, Vidya
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机构:
Univ Calif San Diego, Dept Anesthesiol, San Diego Sch Med, La Jolla, CA 92093 USA
Global Hlth Policy Inst, San Diego, CA 94158 USA
Univ Calif San Diego, Masters Program Publ Hlth, Dept Family Med & Publ Hlth, La Jolla, CA 92093 USAUniv Calif San Diego, Dept Anesthesiol, San Diego Sch Med, La Jolla, CA 92093 USA
Purushothaman, Vidya
Li, Jiawei
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Global Hlth Policy Inst, San Diego, CA 94158 USA
Univ Calif San Diego, Dept Healthcare Res & Policy, La Jolla, CA 92093 USAUniv Calif San Diego, Dept Anesthesiol, San Diego Sch Med, La Jolla, CA 92093 USA
Li, Jiawei
Cai, Mingxiang
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Univ Calif San Diego, Dept Healthcare Res & Policy, La Jolla, CA 92093 USAUniv Calif San Diego, Dept Anesthesiol, San Diego Sch Med, La Jolla, CA 92093 USA
Cai, Mingxiang
Mackey, Timothy K.
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Univ Calif San Diego, Dept Anesthesiol, San Diego Sch Med, La Jolla, CA 92093 USA
Global Hlth Policy Inst, San Diego, CA 94158 USA
Univ Calif San Diego, Dept Healthcare Res & Policy, La Jolla, CA 92093 USAUniv Calif San Diego, Dept Anesthesiol, San Diego Sch Med, La Jolla, CA 92093 USA
机构:
Modibbo Adama Univ Technol, Sch Life Sci, Dept Microbiol, Yola, Nigeria
United Arab Emirates Univ, Coll Med & Hlth Sci, Dept Med Microbiol & Immunol, Al Ain, U Arab EmiratesModibbo Adama Univ Technol, Sch Life Sci, Dept Microbiol, Yola, Nigeria
Hassan, Zubaida
Hashim, Muhammad Jawad
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United Arab Emirates Univ, Coll Med & Hlth Sci, Dept Family Med, Al Ain, U Arab EmiratesModibbo Adama Univ Technol, Sch Life Sci, Dept Microbiol, Yola, Nigeria
Hashim, Muhammad Jawad
Khan, Gulfaraz
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United Arab Emirates Univ, Coll Med & Hlth Sci, Dept Med Microbiol & Immunol, Al Ain, U Arab EmiratesModibbo Adama Univ Technol, Sch Life Sci, Dept Microbiol, Yola, Nigeria