KU Rep Students

Nathan Brophy, 2023, Political Institutions and Public Health: Patterns of Democracy and COVID-19 Policy Response

What is the relationship between political institutions, policy investments, polarization, and COVID-19 health outcomes? This question is of enormous importance because we need to know whether the effects of the pandemic unfold with equal fervor across different systems or whether specific institutional contexts shape more effective responses than others. Some impressionistic evidence suggests that differences in institutional structures seem to influence health outcomes. In Germany’s federal and decentralized system, the sub-national Länder governments implemented heterogenous measures with little direction from the national government. Despite this varied response, however, Germany controlled its surging death rate. In contrast, France pursued swift action in Macron’s highly centralized government by instituting stringent lockdown procedures as early as March 15, 2020. Even with these measures, France experienced much worse outbreaks than Germany registering over 20,000 deaths by April that same year compared to Germany’s roughly 4,800. Is this pattern from two countries generalizable? Do these institutional differences then matter for the distribution of potentially scarce across different regions? Do some institutional factors (i.e., party systems and government ideology) matter more than others in addressing COVID-19 outcomes? Using a unique data set that integrates institutional features, polarization indicators, and health policy outcomes, some preliminary findings suggest that while leaders may boast about certain policy arrangements necessary to stem the tide of the virus, forces and structures outside their immediate control ultimately constrain their ability to maneuver towards an effective policy response. The goal of my dissertation will be to unpack these intertwined— and often complicated—relationships that exist at the core of how nation-states address a global crisis.