Jurisdiction Size Research Articles

The Impact of Administrator Willingness on Website E-Participation: Some Evidence from Municipalities

ABSTRACTThe rapid development of information and communication technologies (ICT) has led to the rise of e-participation, whereby governments adopt digital tools to promote citizen involvement. Disparities exist, however, among jurisdictions concerning the opportunities they offer residents; some governments have extensive online participation forums while others do not. Research to explain the diffusion of e-participation has examined the roles of various kinds of governmental capacity and some other factors, including political culture and jurisdiction size. Researchers have paid less attention to the role of administrator willingness, that is to say whether administrators want to use ICT to advance participation. With data from municipal managers/business administrators in New Jersey, this exploratory study found that administrator willingness has significant impact on e-participation offerings, both directly and indirectly. Governments where the senior administrator has stronger willingness to involve citizens and use ICT are more likely to have more extensive e-participation offerings.

Jurisdiction Scale Matters: County Size and External Political Efficacy in China

Despite considerable scholarly interest and recent advances in research, our knowledge of how jurisdiction size influences political efficacy remains fragmentary. This study contributes to the literature by exploring the linkage between the size of county jurisdiction, in terms of county population, and external political efficacy in China. Results from simple regressions indicate that, on average, external political efficacy declines with the size of county jurisdiction. Further analysis via a quantile perspective provides evidence that the influence of size upon external political efficacy varies across different parts of the outcome distribution. We observe a negative and pronounced effect in the lower tail of the distribution, but a positive and trivial effect in the upper tail. Our study highlights citizens’ divergent perceptions about the size of political jurisdiction and offers new insights into the research on jurisdictional design and political efficacy.

BiggerIsBetter: Reducing the Cost of Local Administration by Increasing Jurisdiction Size in Ontario, Canada, 1995–2010

In recent decades, the belief that larger municipalities can better capture economies of scale led to compulsory amalgamations in several countries. This article examines such a program of compulsory amalgamations in Ontario, Canada, during the late 1990s and early 2000s. By exogenously deciding on a course of municipal restructuring, and leaving a large comparison group of nonamalgamated municipalities within the same institutional framework, the Ontario reforms created a quasi-experiment on the importance of scale for local government. Using a difference-in-differences methodological approach, this article exploits the quasi-experimental setting of the Ontario reforms to examine the causal effect of jurisdiction size on the cost of local administration. The main empirical finding in this article is that increasing local jurisdiction size reduces the cost of local administration. The results provide the most convincing evidence to date that economies of scale exist in local administration and can be captured through consolidation.

Jurisdiction Size and Local Government Policy Expenditure: Assessing the Effect of Municipal Amalgamation

Across the developed world, the last 50 years have seen a dramatic wave of municipal mergers, often motivated by a quest for economies of scale. Re-examining the theoretical arguments invoked to justify these reforms, we find that, in fact, there is no compelling reason to expect them to yield net gains. Potential savings in, for example, administrative costs are likely to be offset by opposite effects for other domains. Past attempts at empirical assessment have been bedeviled by endogeneity—which municipalities amalgamate is typically nonrandom—creating a danger of bias. We exploit the particular characteristics of a recent Danish reform to provide more credible difference-in-differences estimates of the effect of mergers. The result turns out to be null: cost savings in some areas were offset by deterioration in others, while for most public services jurisdiction size did not matter at all. Given significant transition costs, the finding raises questions about the rationale behind a global movement that has already restructured local government on almost all continents.

Beyond fun runs and fruit bowls: an evaluation of the meso-level processes that shaped the Australian Healthy Workers Initiative.

Issue addressed The Australian National Partnership Agreement on Preventive Health (NPAPH) charged states and territories with the development and implementation of the Healthy Workers Initiative (HWI) to improve workplace health promotion. Most evaluation efforts focus on the setting (micro) level. In the present study the HWI at the meso-level (state program development) was examined to understand how jurisdictions navigated theoretical, practical, and political priorities to develop their programs, and the programmatic choices that support or hinder perceived success. Methods Interviews with HWI program coordinators and managers across seven Australian jurisdictions explored decision-making processes related to developing and implementing the HWI and the impact of defunding. Interviews were audio-recorded, transcribed and analysed using thematic analysis. Results Despite taking a variety of approaches to the HWI, jurisdictions had common goals, namely achieving sustainability and capacity for meaningful change. These goals transcended the performance indicators set out by the NPAPH, which were considered unachievable in the given timeframe. Four ways jurisdictions sought to achieve their goals were identified, these were: 1) taking an embedded approach to workplace health promotion; 2) ensuring relevance of the HWI to businesses; 3) engaging in collaborative partnerships with agencies responsible for implementation; and 4) cultivating evolution of the HWI. Conclusions This meso-level evaluation has provided valuable insights into how health promotion program coordinators translate broad, national-level initiatives into state-specific programs and how they define program success. The study findings also highlight how broader, contextual factors, such as jurisdiction size, political imperatives and funding decisions impact on the implementation and success of a national health promotion initiative. So what? When evaluating the translation of complex initiatives, a meso-level analysis can reveal valuable principles for informing program effectiveness and sustainability. It can also identify alignment between macro- and meso-level goals and where macro-level specifications may hinder or assist those goals.

Public Health Staff Development Needs in Informatics: Findings From a National Survey of Local Health Departments.

Public health practice is information-intensive and information-driven. Public health informatics is a nascent discipline, and most public health practitioners lack necessary skills in this area. To describe the staff development needs of local health departments (LHDs) related to informatics. Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in collaboration with the National Association of County & City Health Officials. A total of 324 LHDs from all 50 states completed the survey (response rate: 50%). Outcome measures included LHDs' specific staff development needs related to informatics. Predictors of interest included jurisdiction size and governance type. Areas of workforce development and improvement in informatics staff of LHDs included using and interpreting quantitative data, designing and running reports from information systems, using and interpreting qualitative data, using statistical or other analytical software, project management, and using geographical information systems. Significant variation in informatics training needs exists depending on the size of the LHD population and governance type. Substantial training needs exist for LHDs across many areas of informatics ranging from very basic to specialized skills and are related to the size of LHD population and governance type.

Clinical Data Systems to Support Public Health Practice: A National Survey of Software and Storage Systems Among Local Health Departments.

Numerous software and data storage systems are employed by local health departments (LHDs) to manage clinical and nonclinical data needs. Leveraging electronic systems may yield improvements in public health practice. However, information is lacking regarding current usage patterns among LHDs. To analyze clinical and nonclinical data storage and software types by LHDs. Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in collaboration with the National Association of County and City Health Officials. A total of 324 LHDs from all 50 states completed the survey (response rate: 50%). Outcome measures included LHD's primary clinical service data system, nonclinical data system(s) used, and plans to adopt electronic clinical data system (if not already in use). Predictors of interest included jurisdiction size and governance type, and other informatics capacities within the LHD. Bivariate analyses were performed using χ and t tests. Up to 38.4% of LHDs reported using an electronic health record (EHR). Usage was common especially among LHDs that provide primary care and/or dental services. LHDs serving smaller populations and those with state-level governance were both less likely to use an EHR. Paper records were a common data storage approach for both clinical data (28.9%) and nonclinical data (59.4%). Among LHDs without an EHR, 84.7% reported implementation plans. Our findings suggest that LHDs are increasingly using EHRs as a clinical data storage solution and that more LHDs are likely to adopt EHRs in the foreseeable future. Yet use of paper records remains common. Correlates of electronic system usage emerged across a range of factors. Program- or system-specific needs may be barriers or facilitators to EHR adoption. Policy makers can tailor resources to address barriers specific to LHD size, governance, service portfolio, existing informatics capabilities, and other pertinent characteristics.

Workforce Competencies in Syndromic Surveillance Practice at Local Health Departments.

As the science and practice of syndromic surveillance (SyS) evolve, it has increasing utility for public health surveillance at the local level. Local health departments (LHDs) require specific organizational and workforce capabilities to use SyS data. In 2013, more than half of the LHDs reported using SyS, although little has been reported about LHD workforce capabilities in SyS. To conduct an assessment of self-reported knowledge and skills in SyS tasks to effectively target technical assistance to different levels of LHD need. A stratified sampling design based on LHD jurisdiction population and SyS status was employed. Data were drawn from the 2015 Biosurveillance Needs Assessment Survey, which captured variables related to LHD use of SyS, management of systems, and self-reported proficiencies in a typology of SyS functionalities developed by a workgroup of subject matter experts in SyS. Respondents were US-based LHD public health practitioners. Estimation weights were applied during analysis to determine the national representation of the responses. Respondents self-reported proficiency in 26 SyS tasks within 5 categories, analyzed by LHD jurisdiction size and respondents' years of SyS experience. SyS expertise varied widely across LHDs. Less than 50% of workers who have access to SyS demonstrated overall proficiency within any of the task areas: communication, data use, data analysis, quality monitoring and assurance, and system design and development. SyS users were strongest in data use tasks. Proficiency in SyS practice corresponded directly with respondents' years of SyS experience and the LHD jurisdiction size. SyS practitioners display a wide range of proficiencies both within and across SyS tasks. Considerable gaps in proficiencies of all areas of SyS practice indicate a need for technical assistance and knowledge dissemination to improve SyS practice as an important component of an LHD surveillance strategy.

The size of political jurisdictions: A model with some evidence from a fascist consolidation

We present a model that explains how population movements reflect the welfare properties of local jurisdiction size. Then, we use the consolidation of municipalities brought about by the fascist dictatorship in Italy during the 1920s to provide some suggestive evidence on theory's predictions. Our empirical findings hint that the consolidation was associated with net welfare gains for the communities involved.

Forensic Pathologist Consensus in the Interpretation of Photographs of Patterned Injuries of the Skin.

Forensic pathologists are commonly asked to evaluate injuries on the basis of photographs. Members of the National Association of Medical Examiners were asked to participate in an online survey in which they were presented with 68 patterned injuries of the skin and asked to make a diagnosis ranging from very general (e.g., "blunt" vs. "sharp") to specific (e.g., "baton blow"). This was not the case. Consensus for general diagnosis averaged 0.77 and 0.72 for specific diagnosis. While there was a strong correlation between consensus and confidence in aggregate, individual correlations were poor. Consensus diagnosis was inversely correlated with age, and positively correlated with jurisdictional size, medical degree, and whether or not the respondent was actively performing autopsies as a job function. A subsequent survey is exploring possible reasons for lack of consensus in low-consensus questions. The high correlation between confidence and consensus at the aggregate level and low correlation at the individual level may have implications for quality assurance protocols.

Large and Influential: Firm Size and Governments’ Corporate Tax Rate Choice?

Theory suggests that large firms are more likely to engage in lobbying behaviour and have better bargaining positions against their host governments than smaller entities. Conditional on jurisdiction size, public policy choices are thus predicted to depend on the shape of a jurisdiction's firm size distribution, with more business-friendly policies being enacted if economic activity is concentrated in a small number of entities. We empirically assess this prediction studying local business tax choices of German municipalities. Exploiting rich and quasi-experimental variation in localities' firm size structures, we find evidence for an inverse relationship between the concentration of economic activity and communities' business tax choices. The effect is statistically significant and quantitatively relevant, suggesting that the rising importance of large businesses may trigger shifts towards a more business-friendly design of (tax) policies.

Local Health Departments' Activities to Address Health Disparities and Inequities: Are We Moving in the Right Direction?

Context: Health disparities are among the critical public health challenges. Objectives: To analyze the extent to which local health departments (LHDs) perform activities for addressing health disparities, changes in proportion of LHDs’ performing those activities since 2005, and factors associated with variation in such engagement. Methods: We used the 2013 National Profile of LHDs Survey to perform Logistic Regression of activities LHDs performed to address health disparities. Results: About 20 percent of LHDs did not perform any activity to address health disparities. Significant decreases occurred since 2005 in the proportion of LHDs that performed health disparity reduction/elimination activities for four activities. LHD characteristics significantly associated (p≤0.05) with the increased likelihood of performing activities to address health disparities were: recent completion of community health assessment, community health improvement plan and agency wide strategic plan. Other significant positive impacts on such activities included per capita expenditures, local governance, having one or more local boards of health, larger population size and metropolitan status of the LHD jurisdiction. Conclusions: Reduced infrastructural capacity of LHDs has resulted in fewer LHDs addressing health disparities in their jurisdictions. LHD characteristics associated with higher performance of activities for health disparity reduction identified by this research have important policy implications.

How to make the metropolitan area work? Neither big government, nor laissez-faire

We study how administrative boundaries and tax competition among asymmetric jurisdictions interact with the labor and land markets to determine the economic structure and performance of metropolitan areas. Contrary to general belief, cross-border commuting need not be welfare-decreasing in the presence of agglomeration economies that vary with the distribution of firms within the metropolitan area. Tax competition implies that the central business district is too small and prevents public policy enhancing global productivity to deliver their full impact. Although our results support the idea of decentralizing the provision of local public services by independent jurisdictions, they highlight the need of coordinating tax policies and the importance of the jurisdiction sizes within metropolitan areas.

Jurisdiction Size and Director Compensation in Connecticut Local Health Departments

Objective: To examine if the compensation of local public health directors responds to organizational size in the same manner found for other types of for-profit, not-for-profit, and public managers. Design: Panel data ordinary least squares with fixed effects for the local health department and time period. Control variables include median household income, the unemployment rate, and the part-time versus fulltime and independent versus district status of the local public health department. Setting: Sample of Connecticut local health departments over the period from 2001 to 2011. Main Outcome Measures: Annual wage of the local public health director and population in the jurisdiction of the local public health department. Results: The size elasticity of local public health director equals 0.2. Full-time directors are paid more than part-time directors and directors managing district health departments are compensated more than those directing independent health departments. Directors are paid more if they manage health departments in jurisdictions with higher levels of income. Conclusions: The findings for the size elasticity of compensation for local public health directors compares very closely to the size elasticity estimates found for other types of for-profit, not-for-profit, and public managers, perhaps suggesting that local public health directors are similarly motivated.

Adopting open source software in public administration: The importance of boundary spanners and political commitment

Open source software (OSS) adoption in public administrations around the world has been uneven. Despite the substantive economic and efficiency-related implications of OSS adoption, there is surprisingly little research into the determinants of the diffusion of OSS across public sector jurisdictions. In this article we explore the variation in OSS adoption among Dutch local administrations. The Dutch central government adopted a policy to stimulate the use of OSS in the public sector, but the non-mandatory character of the policy resulted in great differences in the degree of adoption of OSS at the local level. Using data from a new survey of municipalities in the Netherlands and proportional odds statistical models to analyze the data, we show that the degree of OSS adoption crucially depends on the presence of boundary spanners and political commitment within the local government. On the other hand, oft-suspected factors like financial stress and jurisdiction size have no discernible effects. Our findings have implications for understanding the spread of OSS in the public sector and for public policies designed to encourage OSS diffusion.

Relationships among providing maternal, child, and adolescent health services; implementing various financial strategy responses; and performance of local health departments.

We explored the relationships between local health department (LHD) structure, capacity, and macro-context variables and performance of essential public health services (EPHS). In 2012, we assessed a stratified, random sample of 195 LHDs that provided data via an online survey regarding performance of EPHS, the services provided or contracted out, the financial strategies used in response to budgetary pressures, and the extent of collaborations. We performed weighted analyses that included analysis of variance, pairwise correlations by jurisdiction population size, and linear regressions. On average, LHDs provided approximately 13 (36%) of 35 possible services either directly or by contract. Rather than cut services or externally consolidating, LHDs took steps to generate more revenue and maximize capacity. Higher LHD performance of EPHS was significantly associated with delivering more services, initiating more financial strategies, and engaging in collaboration, after adjusting for the effects of the Affordable Care Act and jurisdiction size. During changing economic and health care environments, we found that strong structural capacity enhanced local health department EPHS performance for maternal, child, and adolescent health.

Regulatory enforcement and fiscal impact in local health agencies.

We used a cross-sectional, retrospective study design to analyze the association between local health agency regulatory activities and revenues from nonclinical fees and fines (NFF). We extracted data from the 2010 National Association of County and City Health Officials (NACCHO) Profile Survey, the most recent report including NFF information, and used 2-part multivariable regression models to identify relationships between regulatory activities and revenue. We also interviewed LHD directors on access to revenue from fines. NFFs generated substantial revenue for most LHDs, increasing in scope and amount with jurisdiction size for all but the largest municipalities. The greatest proportion of net revenue came from public pools, campgrounds and recreational vehicles, and solid waste disposal. For small and mid-sized LHDs, enforcement activities generated revenue in a dose-response pattern, with higher returns for increased activities. LHDs in decentralized governance states collected more NFF revenue than those in centralized states. States vary regarding LHD access to revenue from sanctions. The fiscal impact of changes in regulatory activity needs careful assessment to avoid unanticipated consequences of applicable law.

How Connecticut health directors deal with public health budget cuts at the local level.

We investigated the perspectives of local health jurisdiction (LHJ) directors on coping mechanisms used to respond to budget reductions and constraints on their decision-making. We conducted in-depth interviews with 17 LHJ directors. Interviews were audio recorded, transcribed, and analyzed using the constant comparative method. LHJ directors use a range of coping mechanisms, including identifying alternative revenue sources, adjusting services, amending staffing arrangements, appealing to local political leaders, and forming strategic partnerships. LHJs also face constraints on their decision-making because of state and local statutory requirements, political priorities, pressures from other LHJs, and LHJ structure. LHJs respond creatively to budget cuts to maintain important public health services. Some LHJ adjustments to administrative resources may obscure the long-term costs of public health budget cuts in such areas as staff morale and turnover. Not all coping strategies are available to each LHJ because of the contextual constraints of its locality, pointing to important policy questions on identifying optimum jurisdiction size and improving efficiency.

Municipal sizes and municipal restructuring in Japan

In this article, we quantitatively analyze changes in the size distribution of municipal jurisdictions in Japan by using their rank-size distribution to capture the changes. In Japan, the central government sometimes enacts large-scale municipal mergers, aimed at creating municipalities of a certain size. Japan’s local governance policy allocates tax revenues to municipalities based on the financial shortages of each municipality, which is designed to ensure financial equality among municipalities so that the central government can evenly maintain public services, especially in rural areas. Thus, if the central government eases population discrepancy among municipalities and creates a large number of uniformly sized municipalities, then the central government can reduce subsidies to local governments. The government’s previous policies on municipal mergers were enacted to foster this sort of efficiency. We examine changes in the distribution of municipal jurisdiction sizes to determine the actual effect of municipal merger policies. We obtain the result that the great municipal mergers of the 1950s Showa era made the municipalities more equal in size, which shows that the Municipality Merger Promotion Law of 1953 had an impact on the change of the size distribution of municipalities.

Public Health Agencies' Level of Engagement in and Perceived Barriers to PHAB National Voluntary Accreditation

This study examines local health departments' (LHDs') and state health agencies' (SHAs') engagement, LHDs' perceived barriers, and factors associated with level of engagement in accreditation. The study design is observational, cross-sectional, and based on census design surveys of all state and local health departments. Data from the National Association of County & City Health Officials' 2013 profile of LHDs and the Association of State and Territorial Health Officials' 2012 profile of SHAs were analyzed in 2014. Logistic regression was performed with 2 levels of engagement as the outcome variable. Six percent of LHDs and 27% of SHAs had either submitted an application or statement of intent, whereas 15% of LHDs and 4% of SHAs had decided not to pursue accreditation. Significant factors associated with higher level of LHD engagement in accreditation included population size of the LHD jurisdiction, state and shared governance (vs local), MD degree of top executive, absence of a local board of health, LHD's collaboration with other organizations, per capita expenditures, and performance of 2 of the Public Health Accreditation Board accreditation prerequisites, namely, a community health improvement plan and an agency-wide strategic plan. The most frequently reported reasons for LHDs not pursuing accreditation were the time/effort required for accreditation exceeding the benefits (72%), the fee being too high (54%), and the standards exceeding the capacity of their LHD (39%). Accreditation is expected to provide pathways to accountability, consistency, and better fit between community needs and public health services. National strategies targeting rapid diffusion of accreditation among public health agencies should include elements that address the needs of LHDs with varying degrees of intent to pursue accreditation.