Coevolution of policy sectors: A comparative analysis of healthcare and public health
| Published date | 01 September 2017 |
| Author | Philipp Trein |
| Date | 01 September 2017 |
| DOI | http://doi.org/10.1111/padm.12323 |
ORIGINAL ARTICLE
Coevolution of policy sectors: A comparative
analysis of healthcare and public health
Philipp Trein
Institute of International, Political, and
Historical Studies (IEPHI), University of
Lausanne, Lausanne, Switzerland
Correspondence
Philipp Trein, Institute of International,
Political, and Historical Studies (IEPHI),
University of Lausanne, Quartier UNIL-/
Mouline, Géopolis 4346, Lausanne 1015,
Switzerland.
Email: josefphilipp.trein@unil.ch
This article analyses the institutional coevolution of policy sectors
–in other words, the mutual influence and adaptation of the insti-
tutional connection between related policy areas. The article pro-
poses a two-dimensional analytical space ranging from separation
to unity on one axis and from superiority/subaltern to equality on
the other. The article argues that the overall governance frame-
work behind the coevolving sectors affects the institutional rela-
tionship between the sectors. In its empirical part, the article
focuses on the healthcare and public health sectors. Based on a
comparative historical examination of three countries with differ-
ent healthcare systems –Australia, Germany, and the United
States –the article shows that healthcare and public health co-
evolve differently depending on the type of national healthcare
system. Further research can transfer the concepts introduced in
this article to the analysis of other policy challenges, such as immi-
gration or environmental protection.
1|INTRODUCTION
For many years, researchers and policy-makers have dealt with the problem of public sector coordination. Some
have even referred to it as an eternal question for public administration research (Peters 1998, 2015; 6 2004). In
recent times, scholars have shown increased interest in this topic and have analysed how decentralized, fragmented
policies can be ‘joined-up’to deal with new policy challenges after a period of decentralization and delegation
(6 2004; Bogdanor 2005). Researchers have pointed out that existing policy sectors can be brought together, for
example in boundary-spanning policy regimes that cross various sectors or subsystems (Jochim and May 2010) or
functional regulatory spaces that include institutions that connect sectors, levels of government, and borders
between countries (Varone et al. 2013).
1
New integration of old sectors often occurs by layering (Rayner and How-
lett 2009b, p. 100; Mahoney and Thelen 2010). Regarding explanations for policy integration, authors have pointed
out that the broader governance structure behind a specific policy problem determines the capacity to integrate pol-
icy sectors (Rayner and Howlett 2009a, p. 168). Nevertheless, there remains a demand for more comparative and
1
See Tosun and Lang 2017; Trein et al. 2017.
DOI: 10.1111/padm.12323
744 © 2017 John Wiley & Sons Ltd wileyonlinelibrary.com/journal/padm Public Administration. 2017;95:744–758.
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