What makes organizations so similar? We contend that the engine of rationalization and bureaucratization has moved from the competitive marketplace to the state and the professions. Once a set of organizations emerges as a field, a paradox arises: rational actors make their organizations increasingly similar as they try to change them. We describe three isomorphic processes-coercive, mimetic, and normative—leading to this outcome. We then specify hypotheses about the impact of resource centralization and dependency, goal ambiguity and technical uncertainty, and professionalization and structuration on isomorphic change. Finally, we suggest implications for theories of organizations and social change.

The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields (Chinese Translation)

The cardiovascular complications of acute coronavirus disease 2019 (COVID-19) are well described, but the post-acute cardiovascular manifestations of COVID-19 have not yet been comprehensively characterized. Here we used national healthcare databases from the US Department of Veterans Affairs to build a cohort of 153,760 individuals with COVID-19, as well as two sets of control cohorts with 5,637,647 (contemporary controls) and 5,859,411 (historical controls) individuals, to estimate risks and 1-year burdens of a set of pre-specified incident cardiovascular outcomes. We show that, beyond the first 30 d after infection, individuals with COVID-19 are at increased risk of incident cardiovascular disease spanning several categories, including cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, myocarditis, heart failure and thromboembolic disease. These risks and burdens were evident even among individuals who were not hospitalized during the acute phase of the infection and increased in a graded fashion according to the care setting during the acute phase (non-hospitalized, hospitalized and admitted to intensive care). Our results provide evidence that the risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial. Care pathways of those surviving the acute episode of COVID-19 should include attention to cardiovascular health and disease. 

/pdf/long-term-cardiovascular-outcomes-of-covid-19-944tnk84.pdf

Long-term cardiovascular outcomes of COVID-19

The COVID-19 outbreak is a global pandemic with community circulation in many countries, including the United States, with confirmed cases in all states. The course of this pandemic will be shaped by how governments enact timely policies and disseminate information and by how the public reacts to policies and information. Here, we examine information-seeking responses to the first COVID-19 case public announcement in a state. Using an event study framework for all US states, we show that such news increases collective attention to the crisis right away. However, the elevated level of attention is short-lived, even though the initial announcements are followed by increasingly strong policy measures. Specifically, searches for "coronavirus" increased by about 36% (95% CI: 27 to 44%) on the day immediately after the first case announcement but decreased back to the baseline level in less than a week or two. We find that people respond to the first report of COVID-19 in their state by immediately seeking information about COVID-19, as measured by searches for coronavirus, coronavirus symptoms, and hand sanitizer. On the other hand, searches for information regarding community-level policies (e.g., quarantine, school closures, testing) or personal health strategies (e.g., masks, grocery delivery, over-the-counter medications) do not appear to be immediately triggered by first reports. These results are representative of the study period being relatively early in the epidemic, and more-elaborate policy responses were not yet part of the public discourse. Further analysis should track evolving patterns of responses to subsequent flows of public information.

https://www.pnas.org/content/pnas/117/21/11220.full.pdf

Evidence from internet search data shows information-seeking responses to news of local COVID-19 cases.

Tests the Dixit and Londregan model on Swedish data for the years 1981-1995. Studies the distribution of intergovernmental grants from the central to the local government level. Proposes and uses a new method of estimating the number of swing voters, and concludes that intergovernmental grants are used to win votes.

Intergovernmental grants as a tactical instrument : empirical evidence from Swedish municipalities / Eva Johansson

Physical distancing has been the primary strategy to control COVID-19 in the United States. We used mobility data from a large, anonymized sample of smartphone users to assess the relationship between neighbourhood income and physical distancing during the pandemic. We found a strong gradient between neighbourhood income and physical distancing. Individuals in high-income neighbourhoods increased their days at home substantially more than individuals in low-income neighbourhoods did. Residents of low-income neighbourhoods were more likely to work outside the home, compared to residents in higher-income neighbourhoods, but were not more likely to visit locations such as supermarkets, parks and hospitals. Finally, we found that state orders were only associated with small increases in staying home in low-income neighbourhoods. Our findings indicate that people in lower-income neighbourhoods have faced barriers to physical distancing, particularly needing to work outside the home, and that state physical distancing policies have not mitigated these disparities.

/pdf/neighbourhood-income-and-physical-distancing-during-the-3z2mpy6ww6.pdf

Neighbourhood income and physical distancing during the COVID-19 pandemic in the United States.

The difference in difference (DID) design is a quasi-experimental research design that researchers often use to study causal relationships in public health settings where randomized controlled trials (RCTs) are infeasible or unethical. However, causal inference poses many challenges in DID designs. In this article, we review key features of DID designs with an emphasis on public health policy research. Contemporary researchers should take an active approach to the design of DID studies, seeking to construct comparison groups, sensitivity analyses, and robustness checks that help validate the method's assumptions. We explain the key assumptions of the design and discuss analytic tactics, supplementary analysis, and approaches to statistical inference that are often important in applied research. The DID design is not a perfect substitute for randomized experiments, but it often represents a feasible way to learn about casual relationships. We conclude by noting that combining elements from multiple quasi-experimental techniques may be important in the next wave of innovations to the DID approach.

Designing Difference in Difference Studies: Best Practices for Public Health Policy Research

Treatment effect estimates from a regression discontinuity design (RDD) have high internal validity. However, the arguments that support the design apply to a subpopulation that is narrower and usu...

Regression Discontinuity and Beyond: Options for Studying External Validity in an Internally Valid Design

Colombia’s duality between the relative strength of the central government and the broad process of decentralization towards subnational and local governments has shaped the country’s response to the COVID-19 pandemic. Substantial tensions have arisen between the national and subnational governments in the handling of the crisis. Thus, blurred policy boundaries challenge multi-level government coordination. Yet, intergovernmental relations and multi-level governance have worked at some extent. Meanwhile, leadership styles, the level of political support, the local governance environment and the level of local institutional capacity have affected the strategies of local government leaders and their success to tackle the pandemic. Moreover, uneven healthcare capacity across the Colombian territory posits further challenges for a national response to the pandemic that ensures both effectiveness and equity.

/pdf/the-costs-and-benefits-of-duality-colombia-s-10j690wu5q.pdf

The costs and benefits of duality: Colombia’s decentralization and the response to the COVID-19 pandemic

Interacting Capacities: The Indirect National Contribution to Subnational Service Provision

Multilevel governance offers different settings to study executive decision-making and delegation. Associations of municipalities (AoMs), which are collaborative partnerships, are understudied arra...

Ricardo A. Bello-Gomez

Papers

Designing Difference in Difference Studies: Best Practices for Public Health Policy Research

Regression Discontinuity and Beyond: Options for Studying External Validity in an Internally Valid Design

The costs and benefits of duality: Colombia’s decentralization and the response to the COVID-19 pandemic

Interacting Capacities: The Indirect National Contribution to Subnational Service Provision

Mayoral preferences for delegation in collaborative arrangements: issue salience and policy specificity