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Healthcare Systems in Comparative Perspective: Classification, Convergence, Institutions, Inequalities, and Five Missed Turns

Jason beckfield.

Harvard University

Sigrun Olafsdottir

Boston University

Benjamin Sosnaud

This essay reviews and evaluates recent comparative social science scholarship on healthcare systems. We focus on four of the strongest themes in current research: (1) the development of typologies of healthcare systems, (2) assessment of convergence among healthcare systems, (3) problematization of the shifting boundaries of healthcare systems, and (4) the relationship between healthcare systems and social inequalities. Our discussion seeks to highlight the central debates that animate current scholarship and identify unresolved questions and new opportunities for research. We also identify five currents in contemporary sociology that have not been incorporated as deeply as they might into research on healthcare systems. These five “missed turns” include an emphasis on social relations, culture, postnational theory, institutions, and causal mechanisms. We conclude by highlighting some key challenges for comparative research on healthcare systems.

INTRODUCTION

Nearly two decades have passed since the Annual Review of Sociology last published an essay on healthcare systems. Mechanic & Rochefort (1996) identified medical care as buffeted by countervailing forces of international convergence on the one hand, and institutional path-dependence on the other. In the seventeen years since, efforts to classify healthcare systems have contributed to the precise assessment of similarities and differences among healthcare systems. Still, the convergence debate has not been resolved, which reflects developments in the sociology of globalization, and provides new opportunities for a closer dialogue between sociological theory and health services research. The institutional boundaries of what constitutes a healthcare system are also up for grabs, as policy innovations in healthcare point toward the integration of healthcare into other fields, the devolution of delivery to sub-national organizations, and the development of transnational organizations devoted to healthcare. Another lively area of comparative research on healthcare systems is inequality: inter-governmental organizations, national governments, and well-funded nongovernmental organizations have set an agenda of monitoring and reducing disparities, including disparities in healthcare.

In this essay, we evaluate each of these four research themes – classification, convergence, institutional boundaries, and disparities – within the field of comparative healthcare research, highlighting the central debates that animate current scholarship. We also identify unresolved questions and new opportunities for research. At the outset, we note that we focus on sociological research, but, like healthcare systems themselves, the boundaries of comparative healthcare system research are porous. Sociologists are well represented, but are probably in the minority if health economists, political scientists, health-services researchers, epidemiologists, and public health scholars are also included (as we believe they should be, and as we try to do). Fortunately for the coherence of an essay like this, the problems and debates currently driving research on comparative healthcare systems are themselves inter-disciplinary, as scholars from many fields are engaging them. Unfortunately for sociology, we think, this area has detached somewhat from the discipline’s central theoretical and substantive developments, and so one of our goals is to encourage re-engagement (cf. Beland 2010 ; Leiber et al. 2010 ; Light 2004 ).

Before turning to our evaluation of four of the largest areas of comparative research on healthcare systems, we want to revisit why we should compare in the first place. In healthcare system research, three concerns motivate most work: (1) accurate description, (2) performance assessment, and (3) policy diffusion. The descriptive impulse is strongest in attempts to develop clusters or types of healthcare systems, on the basis of selected measures such as expenditures, performance, and organization. The performance impulse is strongest in the “health production function” tradition of health economists, in rankings of healthcare systems, and in applied policy research on the results of specific policy innovations. The diffusion impulse is strongest in work that identifies lessons from some healthcare systems for other healthcare systems ( Light 1997 ; Mechanic 2008 ; Ruggie 2011 ), and in research on globalization and healthcare.

We see a need for more work that would be motivated by general institutionalist theory: comparative healthcare systems research is especially well-positioned to investigate how institutions – the “rules of the game” – have distributional implications and generate winners and losers. That is, healthcare systems shape inequalities within and between societies. Since healthcare institutions vary so greatly across national, trans-national, and sub-national contexts, two central questions for comparative healthcare systems research should be what explains this institutional variation, and how this institutional variation matters for the distribution of population health. In other words, a person’s birth in a place with one healthcare system rather than another can be conceptualized as a sort of natural experiment ( Habbema et al. 2012 ). Given that there is so much debate among health researchers over which aspects of a person’s position in society (e.g. education, wealth, income, class) matters most for health ( Mechanic 2007 ), comparative research across healthcare systems is potentially important for developing new knowledge of how, when, and why such positions matter.

In what follows, we first review and critique four central concerns of comparative research on healthcare systems: classification (which has generated creative typologies of healthcare systems), convergence, institutional boundaries, and disparities. Next, we identify five currents in contemporary sociology that have not been incorporated as deeply as they might into research on healthcare systems. Then, we conclude the essay with a discussion of the practical challenges to comparative research on healthcare systems.

CLASSIFYING HEALTH CARE SYSTEMS

Before considering classifications, it is important to define what the healthcare system is. Quadagno (2010) sees it as “organizations that both deliver care and medical services (hospitals, physicians’ practices, clinics) and that arrange for the financing of care (governments, agencies, states, local communities, and private insurance companies).” Many configurations are possible, and the goals of comparative typological research are to reduce the massive amount of data that is available on any given healthcare system, and to identify a reasonably small set of common configurations. Recently, comparative health care researchers have taken this notion seriously and not only attempted to classify nations, but to consider how that can be done in a way that is analytically meaningful and can move our understanding of health care systems across countries forward.

Turning to different classifications, researchers have been interested in comparing health care systems, at least since Anderson (1972) set out to compare the health care systems of the U.S., Sweden and England. Early on, Field (1973) identified four ideal types, mostly based on ownership and doctors’ autonomy (the pluralistic health system, the health insurance system, the health service system, and the socialized health system). Since then, the appropriate dimensions have been debated by researchers, for example whether it should be focused on the main organizational unit ( Terris 1978 ), the form of state control over the production of medical care and the basis for the eligibility of the population ( Frenk & Donabedian 1987 ) or the functional strength and structural superiority of a specific medical tradition ( Lee 1982 ). Despite the different ways in which a classification is possible, researchers often appear to come back to two key dimensions: funding and ownership ( Wendt et al. 2009 ).

Given the great interest in trying to classify health care systems, many have attempted, although often unsystematically to do so ( Wendt et al. 2009 ). Here, some variation of the three types of the National Health Service system, social insurance system, and private insurance system has been popular within the context of rich democracies. The UK is the classic case of NHS; Germany is the classic case of social insurance; and the US is the classic case of private insurance ( Burau & Blank 2006 ; Schmid et al. 2010 ). Similarly, when including Eastern European nations, the systems have also been referred to by the name of their founder as the Beveridge, Bismarck, and Semashko health systems ( Stevens 2001 ). The systems differ by organizational configuration and by the role of three principal actors – the medical profession, the state, and the payers. The Bismarck model is financed through insurance fee and the role of the state is limited to overseeing a system of contracts among patients, providers, and insurers. The medical profession has the autonomy to make decisions about the provision of services. Countries belonging to this type include Canada, France, Germany, Japan, and the United States. In the Semashko model, universal health care is controlled directly be the state that owns facilities, finances them through the state budget, and allocates services to the population. Nations included in this type are Bulgaria, Czech Republic, Hungary, Poland, and Russia. Finally, the Beveridge model secures free access to health care in hospitals, but does not require complete state control of all facilities. In addition, the medical profession has higher levels of autonomy, and physicians can opt out of the system. Countries belonging to this system are Italy, New Zealand, Spain, Sweden, and the United Kingdom ( Lassey et al. 1997 ; Stevens 2001 ).

More recently, and in an attempt to systematically combine the dimensions of funding, service provision, and governance, Moran (1999 , 2000) proposed the concept of “healthcare state.” His scheme incorporates consumption, provision and production of health care. There are four families of health care states in his classification: the entrenched command and control state, the supply state, the corporatist state, and the insecure command and control state. In command and control states , the state controls all three governing areas. This would be the case in Scandinavian countries and the UK. In corporate healthcare states , there is a mix of public law and doctors’ association that control the health care field as is in Germany. Provider interest dominates the Supply states , and the US is the clearer example of such a state. Finally, the insecure command and control states are different from other NHS types because their nationalized hospital sector coexists with a large private sector. Greece and Portugal provide examples for this type ( Moran 2000 ).

While this framework is the most comprehensive and has the highest level of generalizability, Wendt et al. (2009) argue that it still requires some specification to meaningfully compare a larger number of countries. In order to do so, they develop a classification of 27 distinct types of healthcare systems based on the potential range of variation of financing, service provision and regulation. Focusing more on access regulation than on the balance of state and market, they then identify three ideal types: the state healthcare system , the societal health care system , and the private health care system . There are six mix-typed systems possible under each ideal type, as real health care systems will never confirm exactly to an ideal type (e.g. a system can correspond to a state health care system on two domains, but a societal health care system on one). In one of the first attempts to empirically test how health care systems cluster, Wendt (2009) analyzed 15 European healthcare systems to construct groups of health care systems expenditure, financing, service provision and access regulation in analytically distinctive ways. Using the broad categories of health expenditure and private payment, healthcare provider indices, and institutional indicators, he identifies three distinctive health care types: the health service provision-oriented type , the universal coverage – controlled access type , and the low budget – restricted access type .

Austria, Belgium, France, Germany and Luxembourg belong to the health service provision-oriented type . These countries put a high importance on service provision, especially in the outpatient sector. There is a high number of providers and a free choice of medical doctors. Patients are expected to pay only a modest out-of-pocket copayment. Importantly, and in contrast to the U.S., autonomy of patients and equal access are greatly valued and matter more than on the autonomy of the medical profession. Denmark, Great Britain, Sweden, Italy and Ireland belong to the universal coverage-controlled access type . Here, all citizens are covered through universal plans, but access to care is strictly regulated by the state. Finally, Portugal, Spain, and Finland compose the low budget-restricted access type . These are the low spenders that restricted use, due to high co-payments, and requirement of going to the same doctor for a long period of time. While this typology is theoretically and empirically ambitious, it still remains to be seen whether this typology generalizes beyond the healthcare systems included in the analysis ( Wendt 2009 ). We also note that efforts to typologize – helpful as they are as a descriptive technique for data reduction – do cut against the grain of research that tries to develop lessons for one healthcare system from others ( Rochefort & Donnelly 2012 ). Such efforts can also be criticized for oversimplifying the differences among healthcare systems ( Baldwin 2005 ).

CONVERGENCE, NEW AND OLD

There are strong pressures for the convergence of healthcare systems, and so there is a robust debate over whether, when, why, and how convergence has taken place ( Glennerster & Lieberman 2011 ; Marmor et al. 2005 ; Schmid et al. 2010 ). Most analyses of convergence examine rich democracies ( Wilensky 2002 ), operationalized as the member states of the Organization for Economic Cooperation and Development (OECD), which is among the international organizations that have been identified as potential forces for convergence. Research on the role of international organizations, including the OECD and the World Health Organization, is a prominent part of a wave of “new convergence” research that draws inspiration from the sociology of globalization ( Brady et al. 2007 ; Deleon & Resnick-Terry 1998 ; Guillen 2001 ). The Commonwealth Fund is one example of an international non-governmental organization, or INGO, that supports efforts to transfer policies across national borders ( Chalkidou et al. 2009 ). International organizations arguably generate convergence by creating ties among policymakers ( Heymann et al. 2010 ; Slaughter 2005 ), and by diffusing norms about what constitutes “appropriate” policy ( Meyer et al. 1997 ). The human rights framework is one such set of global norms ( Cuadra 2012 ; Gruskin & Dickens 2006 ); privatization of health services is another ( Holden 2005 ). The “where” of convergence has largely been overlooked, despite the pronounced regionalization of international organizations ( Beckfield 2010 ; cf. Lovecy 1995 ). Likewise, the timeframe for convergence – which moments in history generate what sort of convergence and why – remains undertheorized.

Policy diffusion need not be between nation-states; Clavier (2010) identifies instances of cross-border, local-level convergence in healthcare among communities in Denmark and France, which adopted ideas from the social determinants of health framework that has gained international prominence through the efforts of the WHO. Still, most analysis of diffusion examines national-level policy innovations, including what is known as “comparative effectiveness research” in the US, and “health technology assessment” or “evidence-informed policymaking” in other rich democracies ( Chalkidou et al. 2009 ). Schmid et al. (2010) find evidence of convergence across healthcare systems, insofar as many systems are becoming “hybrid” systems through the introduction of policies borrowed from other systems (see also Tuohy 2012 ). For instance, healthcare systems as disparate as the US, Germany, and the UK have all adopted Diagnostic-Related Groups (DRGs), though these serve different functions in each system. Focusing on the US and the UK, Glennerster & Lieberman (2011) identify elements of “hidden convergence,” as ideas about service delivery and cost containment cross the Atlantic. In a rare global-scope analysis, Weiner et al. (2008) demonstrate that managed-care organization of healthcare has been “exported” from the US to many other healthcare systems, including low-income countries (also see Jasso-Aguilar et al. 2004 ). Holden (2005) finds that the privatization of healthcare services has been adopted in many healthcare systems, although a global market for healthcare services has not emerged.

The Pan-American Health Organization is another example of an international organization involved in policy diffusion; it started in 1902 as the International Sanitary Bureau, largely under US influence, and is now a regional office of the World Health Organization ( Fee & Brown 2002 ). Latin American “social medicine” is one approach that highlights broad social conditions and social inequalities as important for understanding specific diseases ( Krieger et al. 2010 , Waitzkin 1998 ); as such, PAHO is one of the drivers of convergence of healthcare systems in the Americas, as its promotion of social medicine resonates with concerns about social inequalities evident in North American and Canadian policymaking. This regionalization of international health policy diffusion is possible elsewhere too, as the WHO organizes its efforts regionally around the world. The Bamako Initiative for primary care is an example of regional policy in West Africa ( Ridde 2011 ).

While attention to globalization produced a wave of “new convergence” research that emphasized international policy diffusion, the “old convergence” forces of aging populations, economic decline (or at least slower growth in the rich democracies), and maturing welfare states continue to put pressure on healthcare systems ( Marmor et al. 2005 ). The “common pressures” argument for convergence is that because the rich democracies face similar challenges, they will tend to adopt similar responses. For instance, Rice & Smith (2001) note that capitation, which gives a per-capita budget on healthcare spending that is sometimes adjusted for socioeconomic status, is widespread among healthcare systems of various types. High-cost cancer treatments also raise challenges of rationing care for healthcare systems ( Faden et al. 2009 ). Still, while it is certainly true that many healthcare systems face common demographic and economic challenges, healthcare systems are embedded in national sociological and cultural systems that introduce contingency and path-dependence into efforts at policy learning ( Marmor et al. 2005 ). Healthcare systems are also objects of domestic politics, as in the case of the 2007 German reforms ( Leiber et al. 2010 ).

Grignon (2012) notes that if there has been convergence of healthcare systems, any such convergence has been slow. Candidate explanations for the slowness of reform include path dependency, veto points, public opinion, and stakeholder mobilization. Marmor et al. (2005) also blame superficial comparative analysis for the slow rate of policy learning. The development of common regulations has been slow even in the European Union, given the “constitutional asymmetry” between the EU-level drive for a common political economy, and the maintenance of national-level regulatory authority over healthcare ( Permanand & Mossialos 2005 ).

INSTITUTIONAL BOUNDARIES

Where, analytically, is the healthcare system? One of the underlying issues in the convergence debate is that while healthcare systems are national, they are also international, and arguably becoming more international over time as “global health” gains attention and funding ( Dickens 2011 ; Katz et al. 2011 ; Shaffer et al. 2005 ; Tarantola 2005 ), and as patients engage in “medical tourism” ( Turner 2010 ). Even within a nation-state, it is difficult to distinguish the healthcare system from the welfare state (and indeed the provision of healthcare as a citizenship right is a conventional measure of the welfare state). Expenditures on healthcare constitute, in many rich democracies, one of the largest shares of government outlays across policy domains. Furthermore, medical care, which is usually if implicitly seen as the “core” of the healthcare system, is only part of the healthcare system, and “non-medical health policies” ( Burau & Blank 2006 :67) integrate the healthcare system with other parts of the welfare state. There have also been persistent calls for “health in all policies,” although there is little work comparing the health performance of the healthcare system to the health performance of other policy areas ( Parker et al. 2010 ). Healthcare is delivered at the local level, such that field analyses can capture the multiplicity of actors involved in healthcare ( Scott et al. 2000 ), and caregivers (most often women) face severe constraints when healthcare is delivered in the home ( Lilly et al. 2007 ), or in schools ( Silberberg & Cantor 2008 ). To put it bluntly: we are arguing that the boundedness and coherence of any “healthcare system” should not be taken for granted. Rather, its social ontology should be investigated as a research question.

The variable boundaries of what researchers call healthcare systems are apparent in cases where the organization of the polity structures healthcare systems. In Europe, the largest political change that shapes healthcare systems is arguably the introduction of multilevel governance through European integration ( Kohler-Koch 1996 ). In the US, federalism organizes the healthcare system – some functions are performed by the central government, other functions are performed by local units, and others are a blend ( Greer & Jacobson 2010 ). Sparer et al. (2011) argue that the 2010 Affordable Care Act in the United States, which devolves substantial responsibility for healthcare insurance (already fragmented by state-specific Medicare and Medicaid policies) to the US states, could follow the same path as devolution in the UK in 1999, which has sparked intergovernmental efforts at strengthening government involvement in the healthcare system. We also note that the Affordable Care Act, which marks a real change in the US healthcare system, expressly excludes undocumented immigrants, potentially reinforcing a citizenship-based axis of inequality.

Migration is one significant trend that blurs the institutional boundaries of healthcare systems. Research on migrants is usually focused on documenting disparities (see below), but research on migrants that seeks to explain the evolution of healthcare systems highlights how international migrants experience very different national institutional environments over the life course. This is particularly pronounced in the European Union, where efforts to encourage internal migration arguably blur the boundaries of healthcare systems.

In the US, Schlesinger & Gray (1998) note that managed-care organizations in the 1990s were under pressure to demonstrate a wider “community benefit” (defined in US tax code, demonstrating the connections between the national legal regime and health policy); this is an example of how policy can blur the boundary between healthcare organizations and the community it is embedded in. Such blurring has generated a debate over the role of public vs. private actors in healthcare systems ( Gran 2003 ).

DISPARITIES, INEQUALITIES, INEQUITIES

We note at the outset of this section that although most research on social inequality in healthcare appears under the rubric of “healthcare disparities research,” there is a robust debate over conceptualization ( Braveman 2006 ). Governmental and non-governmental organizations are making efforts toward reducing healthcare disparities, and advocates and researchers are interested in incorporating health inequalities research into policy ( Exworthy et al. 2006 ; Gibbs et al. 2006 ; Pittman 2006 ). This is despite the “rule of the thumb” that the healthcare system contributes no more than 10% to overall healthcare disparities; this truism is in line with longstanding work demonstrating that public-health improvements such as basic sanitation have far outweighed medical technology in the lowering of mortality rates across the advanced industrial countries, although critics argue that technology matters more in mortality reduction after 1945. Still, in a comparison of cervical cancer rates in the US and the Netherlands, for instance, Habbema et al. (2012) find little difference in rates of cervical cancer, despite dramatically higher levels of preventative services in the US.

Nevertheless, there is growing interest in the relationship between healthcare disparities and health disparities, particularly in countries that have passed the demographic transition and exhibit higher rates of chronic disease ( Wright & Perry 2010 ). There is also increased need for comparisons of how healthcare systems moderate or exacerbate different kinds of healthcare disparities. For instance, Norredam et al. (2006) and Cuadra (2012) reveal striking cross-national differences in the healthcare rights accorded to migrants in the European Union, and Schnittker & Bhatt (2008) highlight disparities in healthcare by race and income groups in the U.S. and the U.K. However, this issue would benefit from a systematic treatment of how the healthcare system variously shapes race-, gender- and class-based disparities in healthcare.

Link & Phelan’s (1995) now-classic article on “social conditions as fundamental causes of disease” has sparked a strong research tradition on the various “upstream” (cf. Krieger 2008 ) social conditions that shape disease distribution. Only some of this work has been comparative ( Elo 2009 ). One pressing question is how the healthcare system relates to other broad social conditions that matter for health and disease. King and coauthors (2009) , for instance, show that privatization of healthcare systems in the former Soviet states was associated with elevated levels of stress and reduced healthcare resources, but they find little evidence of a strong direct effect of privatization through healthcare. Turning to low-income countries, Croghan et al. (2006) find that targeted improvements to the healthcare system outweigh broader changes like economic development and governance institutions in lowering child mortality.

An alternative, and perhaps currently predominant, approach to measuring healthcare system performance is to quantify “healthy life expectancy” or the average amount of time the average person at a given age can expect to live in good health ( Stiefel et al. 2010 ). The aim of such research is to establish a single number as a policymaker-friendly measure of the performance of healthcare systems. We think this underestimates the capacity of both the policymaker and the healthcare system ( Leiber et al. 2010 ). Clearly policymakers attend to distributional issues, so they would likely attend carefully to measures that included information about the distribution of health across socially meaningful groups. Such an aggregated, summary estimate of a central tendency also potentially underestimates healthcare systems since such systems represent institutions that create winners and losers. For instance, Schuster and coauthors (2005) identify significant gaps between need and healthcare delivery, and they suggest detailed methods for monitoring the quality of health care. We note that monitoring quality and inequality is a forefront area for data collection since current data collection often fails to match the political organization of healthcare delivery ( Blewett et al. 2004 ; Gibbs et al. 2006 ).

A new controversy surrounding healthcare system “outputs” is the relationship between population-health measures such as healthy life expectancy and measures of inequalities in health ( Krieger et al. 2008 ). On one side of the debate are those who argue that social inequality in health is in part a function of improvements in population health. That is, the very things that improve population health (e.g., basic sanitation, medical technology, and healthy behaviors) are likely to increase health inequalities because those with greater socioeconomic resources will be better positioned to adopt such technologies ( Cutler et al. 2006 ; Glied & Lleras-Muney 2008 ). Conversely, others argue that advances in mortality and life expectancy will instead be associated with declining inequalities in health because such population health improvements are propelled by enhanced health prospects among previously disadvantaged groups ( Siddiqi & Hertzman 2007 ). Research on this debate has so far been mixed, with studies providing support for both claims. Moreover, some evidence suggests that the relationship between health improvements and health inequalities may differ across nations and social contexts ( Krieger et al. 2008 ). This raises the possibility that healthcare systems play a role in determining the extent to which improvements in population health are accompanied by widening or declining inequalities and suggests a prime opportunity for further cross-national research that explores linkages between population health and health inequalities.

A forefront area for comparative research on healthcare systems is variation in health disparities across nations. Research has established that the association between socioeconomic position and health outcomes varies substantially in different countries ( Beckfield & Olafsdottir 2009 ; Kunst et al. 2005 ; Stirbu et al. 2010 ). Mackenbach and colleagues (2008) evaluate this relationship in 22 European countries and report substantial cross-national differences in the extent to which education predicts mortality risk. For example, in Norway, the risk of mortality between the least and most educated men differs by a factor of two, but in Poland, this risk differs by a factor of more than four. Scholars have begun to explore the extent to which healthcare systems can account for such cross-national variation in health inequalities. One line of research uses welfare regime types (e.g., Esping-Andersen 1990 ) to represent broad differences in the nature of healthcare systems across countries ( Bambra 2007 ; Muntaner et al. 2011 ). Borrell and colleagues (2009) examine variation in the relationship between education and self-rated health across welfare regime-types in 13 European countries. They find evidence that countries classified as Social Democratic have the lowest health inequalities while reporting minimal variation between other regime-types. Other studies further develop this research (e.g. Bambra et al. 2010b ; Beckfield & Olafsdottir 2009 ; Cavelaars et al. 1998 ; Eikemo et al. 2008 ; Espelt et al. 2008 ; Navarro et al. 2006 ; Olafsdottir 2007 ), but a consensus has not yet been reached on the extent to which welfare regimes structure the relationship between socioeconomic position and health outcomes. Underlying this literature is the notion that different welfare regimes are associated with variation in healthcare systems across countries. Although this may be a valid assumption, few scholars have attempted to link particular features of national healthcare systems to cross-national variation in health inequalities. Thus, a promising area for future scholarship is research that moves beyond comparisons of welfare regimes to study how the specific policies that differentiate national healthcare systems help to explain variation in the relationship between socioeconomic position and health across countries.

Finally, healthcare systems also contribute to inequalities between countries. Stuckler (2008) examines the rise of chronic disease rates in low-income countries and argues that health inequality and economic inequality between high-income and low-income populations will grow over time if current trends continue. Other research on cross-national differences in health outcomes uses clustering techniques to identify groups of nations with comparable health outcomes and finds dramatic disparities between such groups ( Day et al. 2008 ; Ruger & Kim 2006 ). Ruger & Kim (2006) categorize countries based on mortality rates as better-off, mid-level, or worse-off. They find that countries ranked worse-off in child mortality had higher rates of extreme poverty, lower per capita expenditure on healthcare, fewer hospital beds and doctors, and lower rates of access to improved water, sanitation and immunizations (cf. Day et al. 2008 ). This suggests an important role for healthcare systems in structuring inequalities in health between countries.

FIVE MISSED SOCIOLOGICAL TURNS

Our goal in this section is to suggest some ways that comparative research on healthcare systems can use theoretical developments from other areas of sociology, and to suggest how sociologists working in other areas of inquiry might find healthcare systems of interest for their own purposes. In other words, we want to encourage conversation. How might sociologists incorporate analysis of healthcare systems into their comparative research? One approach is to use healthcare policy as a case of social policy; strong connections to political sociology and the sociology of the welfare state can thus be made. The convergence debate, for instance, has been advanced by welfare-state scholars ( Armingeon & Beyeler 2004 ; Pluemper & Schneider 2009 ), whose insights suggest a range of new hypotheses and analytical approaches for comparative healthcare system research. A second approach would be to compare healthcare policy to other areas of social policy, perhaps to demonstrate the distinctiveness or similarity of policy fields. This seems to us the road not taken; we have located very few studies that compare the healthcare system to other “systems” (pension systems, employment systems, etc.). Field-analytic studies, for instance, tend to examine the healthcare field as a case to explain its evolution; comparison is thus diachronic. One exception of the tendency to analyze the healthcare system in isolation is Lovecy (1995) , who compares the regulation of medicine to the regulation of law. A third approach is to use the comparative analysis of healthcare systems as a way to investigate broader theoretical concerns ( Beland 2010 ; Green-Pedersen & Wilkerson 2006 ). But whatever the rationale for investigating healthcare systems, there are several currents of contemporary sociological theory that seem not to have emerged as major concerns in understanding healthcare systems in comparative perspective. This may be one reason that the subfield most closely connected to the analysis of healthcare systems – medical sociology – is sociometrically distant from large subfields such as race/ethnicity, economic sociology, political sociology, cultural sociology, and theory ( Lin 2013 ).

The relational turn

The first “missed turn” we want to highlight is the relational turn in sociology ( Emirbayer 1997 ; Mische 2011 ; Tilly 1999 ). Sociologists increasingly investigate specific social relations, often through ethnography, such as eviction ( Desmond 2012 ) and social exclusion ( Silver 2007 ). In light of the strong tradition of research on doctor-patient interaction in medical sociology, it is surprising that the analysis of specific relational structures has not made more of a mark on the comparative analysis of healthcare systems. This is probably a function of method, as most of the work we have reviewed is macro-sociological. As Lutfey & Freese (2005) note, the analysis of doctor-patient interaction holds great promise for specifying “fundamental cause” theory. If placed into a comparative framework, such research could reveal the macro-institutional arrangements that condition the utility of SES in chronic disease treatment. That is, are there certain institutional arrangements – specific “rules of the game” – that make class, status, race, citizenship, and gender more or less important in the relations that constitute healthcare systems?

What exactly is comparative healthcare systems research missing, if indeed it can be argued that the field has missed the relational turn? An excellent example can be found in Annette Lareau’s work on how parents’ social class affects the way their children relate to institutions such as the healthcare system ( Lareau 2003 ; Festa 2010 ). Such research could advance the debate over class and cognition in the effects of healthcare ( Mechanic 2007 ). In missing the relational turn, research on healthcare systems has also missed the pragmatist theorization of social mechanisms ( Gross 2009 ). Such an approach can help to reveal how healthcare systems matter differently for population health in different contexts, given the variable problems that are confronted in different healthcare systems, and the variable habits that actors in different healthcare systems follow.

The cultural turn

An emphasis on social construction and on the importance of meaning contributed to a shift across disciplines where researchers begun to theorize about the social world differently. Geertz’s (1973) redefinition of culture in anthropology was an important step to what is often referred to as the cultural turn (Alexander and Smith 1992; Bonnell and Hunt 1999 ; Sewell 1992 ; Swidler 1986 ). Steinmetz (1994:1–2) refers to this development as an analysis that emphasizes: “the causal and socially constitutive role of cultural processes and systems of signification.” In response and following this development, researchers have reframed the key theoretical and methodological issues in health care utilization research ( Olafsdottir & Pescosolido 2009 ; Pescosolido & Olafsdottir 2010 ). More specifically, they have considered how the overarching cultural context of a society (or a smaller unit) impact the ways in which individuals respond when confronted with a health problem.

Along similar lines, Furedi (2006 :17) has argued that “people’s perception of health and illness are shaped by the particular account that their culture offers about how they are expected to cope with life and about the nature of human potential.” While multiple factors in society can be understood as “culture”, we have argued earlier that the social organization of the welfare state (including the health care system) provides the overarching national culture that citizens have come to expect ( Olafsdottir and Beckfield 2011 ). A serious consideration of the health care system, not only as a political institution, but as a cultural one, helps us understand the expectations citizens hold about the relationship between the state, the market, and medicine. Consequently, it can provide clues to how and why health care systems drastically change or remain the same, as well as important insights into the debate on the convergence or divergence of health care systems around the globe.

Boundaries and construction of exclusion and inclusion regarding the health care systems are key issues that are debated within and across countries. To understand this, it is fruitful to bring to bear notions of cultural categories of worth ( Katz 1986 , 1989 ; Patterson 1994 ; Steensland 2006 ). Despite health and illness being culturally bound (Angel and Thoits 1991; Kleinman 1988 ); the threat of illness is universal. Consequently, which individuals and groups are considered worthy of assistance (e.g. universal vs. targeted benefits) provides insights into the broader culture of a society with clear implication of what is expected of the health care system (e.g. how it should provide services and to whom). As an example, an analysis of media discourse surrounding mental illness in the U.S. and Iceland reveals stark differences regarding possible causes and solutions of such illness. In the U.S. discourse, mental illness is viewed as an individual problem with individual solutions, whereas in Iceland the emphasis is on mental illness as a social problem with social solutions ( Olafsdottir 2011 ). These clear cultural differences, grounded in the different social organization of welfare, likely shape mental health policymaking and provision. Therefore, understanding these cultural boundaries and frames across societies can provide a new perspective on the development and future directions of national health care systems.

Cultural sociology has made great progress toward theoretical specificity, distinguishing the concepts of symbolic boundaries, repertoires, frames, and narratives ( Lamont & Small 2008 ). Each of these cultural concepts offers a distinct set of explanations that might resolve puzzles in debates over healthcare system typologies, convergence, institutional boundaries, and disparities. While the social organization of health care is undoubtedly about politics, we argue that culture plays an equally important role as it has a key role in defining the possibilities that are available to policymakers, practitioners and other stakeholders within a given society. An examination of the role culture plays in shaping national health care systems, as well as systematic cross-national comparisons, are likely to generate new insights regarding health care systems in a comparative perspective.

For example, although public-opinion surveys are sometimes included in typologies of healthcare systems (e.g. Wendt 2009 ), the theory of symbolic boundaries could be extended to the institutionalization of healthcare disparities through the treatment of migrants and ethnic minorities by the healthcare system. Hall & Lamont (2008) illustrate one way to incorporate cultural sociology into the comparative analysis of healthcare systems. Lynch & Gollust (2010) also consider the role of culture as they link current work on moralities to changes in the healthcare system. More specifically, they identify fairness norms as a symbolic resource for US reformers. Similarly, Stone (2006) identifies moral frameworks for state policymakers in the US for policies to reduce racial disparities. Still, morality is receiving sustained theoretical attention from sociologists, arguably as a case of the ongoing development of cultural sociology.

The postnational turn

Wimmer & Glick-Schiller (2002) theorize the practice and problems of what they call “methodological nationalism” – the epistemological premise that the nation-state is the natural unit for comparative research – in social science. An exemplar of how to move beyond methodological nationalism in the comparative analysis of healthcare systems is the work of Julia Lynch (2009) , who ratchets down the level of analysis from the nation-state to the region (within Europe). Instead, in privileging the nation-state, most work in this area assumes two things it ought to set out to test: that most of the meaningful variation in healthcare systems is at the national level, and that our theories of how healthcare systems develop and what healthcare systems do apply to de-nationalized ( Sassen 2006 ) healthcare systems.

We think a post-national approach fundamentally re-frames the questions of classification, convergence, institutions, and inequalities that motivate so much research on healthcare systems. Research that classifies healthcare systems rarely incorporates information on the nation-spanning organizations and policies that shape the healthcare system as an institution. Likewise, convergence research is usually oriented to convergence of nationally-organized systems, but what if the nation-state is simply the wrong unit of analysis? And, if the rules of the game that characterize healthcare systems have distributional implications, then surely it would be important to relax the assumption that those rules are somehow inherently national.

The institutional turn

Research on social stratification in sociology has taken an institutional turn, in that the “rules of the game” as formalized in law and enforced by the state has become a central explanation for social inequalities in wages, employment, and poverty ( Esping-Andersen 1990 , Western 2006 , Beckfield 2006 , McCall & Percheski 2010 , Pettit & Hook 2009 ). Surprisingly, there is relatively little research on social inequalities in health that relates such inequalities to the healthcare system or other policies ( Bambra et al. 2010a ; Beckfield & Krieger 2009 ). One exception is Starfield et al. (2005) , who identify primary care as equality-enhancing, relative to inequality-enhancing specialty care. This suggests that healthcare systems with more emphasis on primary care should exhibit more health equality. Another exception is Bambra (2005) , who develops an index that measures decommodification in the delivery of healthcare. The International Digest of Health Legislation , along with the Health Policy Monitor , and online repositories of the World Health Organization, could serve as a useful resource for comparative analysis of health reform, which could be linked to distributional consequences. There is a need for such data for the 50 United States ( Burris 2012 ). Currently, there are several new sources of individual-level data that could be used for cross-national comparison, drawing on the Luxembourg Income Study as a model. Such data sources include the European Health Interview Survey and European Health Examination Survey ( Aromaa et al. 2003 ). These are but a few sources of data that would be useful in developing new insights into how healthcare systems (and related institutions) matter for social inequalities in health.

The healthcare system itself is an object of distributional contestation, e.g. by labor unions in the contemporary US ( Gottschalk 2007 ). Evans (1997) examines distributional coalitions in healthcare systems, and argues that health service providers have a “natural alliance” with high-income citizens that drives the demand for pro-market healthcare policy. A recent review of the literature on inequalities in access to curative care gives some empirical support for this view, finding more class inequality in specialist care, and less class inequality in primary/GP care ( Hanratty et al. 2007 ), across several healthcare systems. In the US, the UK, and the Netherlands, recent reforms of healthcare systems raise a host of new questions about distributional conflicts over healthcare, including unequal relations among stakeholders and other organized interests ( Quadagno 2010 ; Tuohy 2012 ).

The mechanismic turn

The sociological analysis of mechanisms (or sequences of events that connect causes to effects) has matured to a point that it has a programmatic statement ( Hedstrom & Bearman 2009 ). Theoretical development (the identification of causes) and analytical craft (the careful scrutiny of claims about data) have both benefitted from this mechanismic turn. We think that comparative healthcare systems research could also benefit from such an emphasis. For instance, the analysis of convergence often draws on sociological theories of diffusion, without investigating alternative mechanisms. An exception to this general “black box” tendency is Leiber et al. (2010) , who examine the 2007 reform of the German healthcare system (which introduced central government health funds that finance insurance). The German system came to resemble the Dutch system much more closely after 2007, but rather than demonstrating policy learning, Leiber et al. are able to show, through a careful process tracing, how this case demonstrates that changes to the healthcare system resulted from policymakers’ pragmatic attempts to solve political problems (in this case, the problems of the new coalition that took power in Germany in 2005).

The need for an increased emphasis on mechanisms in healthcare systems research is also highlighted by the literature on health disparities. As previously discussed, research on how healthcare systems influence the relationship between social position and health has mostly focused on broad associations between national political regimes and health inequalities ( Muntaner et al. 2011 ). Moving forward, scholars must provide more detailed explanations of the mechanisms and pathways though which healthcare systems and other social policies affect health disparities. Whitehead et al. (2000) illustrate how such an emphasis can be effectively integrated into research on health inequality with their analysis of single mothers’ health in Britain and Sweden. Their project seeks to identify the “entry points” through which policy may influence the relationship between socioeconomic position and health. After initial analyses show health disparities between single and coupled mothers to be similar in both countries, Whitehead and colleagues work to explain the mechanisms driving this association. They demonstrate notable cross-country differences in the pathways leading from single motherhood to health disadvantage, with poverty and joblessness playing a considerably larger role in Britain than in Sweden. This emphasis on the particular pathways linking single motherhood to health status not only provides a strong springboard for future research, but also provides a tangible set of takeaways relevant to social policy.

This essay reviews and evaluates recent comparative social science scholarship on healthcare systems. We have focused our essay on four of the strongest themes in current research: (1) the development of typologies of healthcare systems, with the aim of facilitating comparison and reducing the large amount of system-level data that are available; (2) assessment of convergence among healthcare systems, which tests hypotheses drawn from theories of common economic and demographic pressures, and globalization, (3) problematization of the shifting boundaries of healthcare systems, as responsibility for and costs of healthcare are shifted, and (4) the relationship between healthcare systems and social inequalities, as “disparities” have risen to the top of policy and research agendas over the past two decades. We have also identified how comparative research on healthcare systems might better incorporate new work from sociologists in the areas of relational sociology, cultural sociology, postnational sociology, social stratification research that examines political institutions as drivers of inequality, and social mechanisms.

We conclude this essay by highlighting the challenges of comparative research on healthcare systems. A major challenge is data: there is, at the same time, too much data and too little. The OECD Health Database is perhaps the canonical source for comparative healthcare system research, and while its utility for typological and convergence research is obvious, it is much less useful for analysis of institutional boundaries or social inequalities, and it is of course limited to rich democracies. To make progress on the most pressing questions in the field, researchers need access to data that is (1) comparable in the conceptualization and measurement of variables, (2) available for a wide range of healthcare systems, to avoid the truncation of institutional variability, and to facilitate assessment of generality, and (3) detailed enough to allow for the examination of specific causal mechanisms. We think the first challenge – comparability – is the highest hurdle. Comparative healthcare systems research, particularly large-N quantitative research, confronts the criticisms that (a) not enough can be known about all the healthcare systems involved to support strong causal inferences, and (b) each healthcare system is so complex and so different from other systems that each should be analyzed sui generis . Progress is possible, but requires effort at least as substantial as the Luxembourg Income Study, which sparked a generation of comparative research on income inequality. We think a similar feat is possible for healthcare disparities, and is necessary, lest the variation in healthcare systems (especially healthcare disparities) be massively under-estimated.

Summary of Questions Motivating Current Research on Healthcare Systems

The Luxembourg Income Study as an Exemplar for Comparative Research

The Luxembourg Income Study (see http:lisdatacenter.org ), now formally named LIS, has helped to spark original research on the institutional determinants of income inequality. Such research has enabled the development of policy-oriented research as well as the development of institutional theories of economic inequality. LIS makes freely available to the scholarly community individual-level datasets that have been harmonized to facilitate international comparison. Confidentiality concerns are overcome through the use of a remote-analysis protocol that allows LIS to retain possession of the data, as users are able to analyze the data through e-mail access to a remote server. The LIS has also made important theoretical contributions to the study of economic well-being, in its development of a cross-nationally comparable income concept. We view the LIS as a model for what comparative research on healthcare systems could be. Conceptual work is needed, for instance, to defined healthcare disparities in a way that facilitates comparative research. National-, regional-, and organizational-level data could be acquired, harmonized, and made available to the research community for remote analysis. Such an innovation could transform the field of comparative healthcare systems research by sparking institutional theory and thereby generating a new range of hypotheses.

Related Resources

  • World Health Survey: http://www.who.int/healthinfo/survey/en/
  • OECD Health Data: http://www.oecd.org/health/healthpoliciesanddata/oecdhealthdata2012.htm
  • WHO System of Health Accounts: http://www.who.int/nha/sha_revision/en/
  • INDEPTH Network: http://www.indepth-network.org/
  • Ellen Kuhlmann and Ellen Annandale, Editors. The Palgrave Handbook of Gender and Healthcare . Palgrave Macmillan: London, 2010.
  • Ellen Kuhlmann and Ellen Annandale, Editors. Transforming Health Services and Policy: New International Experiences . Current Sociology , June 2012.
  • Robert Blank and Viola Burau. Comparative Health Policy . Palgrave Macmillan: London, 2010.

Acknowledgments

The authors thank David Mechanic, Mary Ruggie, Nadine Reibling, Claus Wendt, and an anonymous reviewer for their comments. The authors retain all responsibility for any errors.

Contributor Information

Jason Beckfield, Harvard University.

Sigrun Olafsdottir, Boston University.

Benjamin Sosnaud, Harvard University.

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Comparing and Contrasting in an Essay | Tips & Examples

Published on August 6, 2020 by Jack Caulfield . Revised on July 23, 2023.

Comparing and contrasting is an important skill in academic writing . It involves taking two or more subjects and analyzing the differences and similarities between them.

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Table of contents

When should i compare and contrast, making effective comparisons, comparing and contrasting as a brainstorming tool, structuring your comparisons, other interesting articles, frequently asked questions about comparing and contrasting.

Many assignments will invite you to make comparisons quite explicitly, as in these prompts.

  • Compare the treatment of the theme of beauty in the poetry of William Wordsworth and John Keats.
  • Compare and contrast in-class and distance learning. What are the advantages and disadvantages of each approach?

Some other prompts may not directly ask you to compare and contrast, but present you with a topic where comparing and contrasting could be a good approach.

One way to approach this essay might be to contrast the situation before the Great Depression with the situation during it, to highlight how large a difference it made.

Comparing and contrasting is also used in all kinds of academic contexts where it’s not explicitly prompted. For example, a literature review involves comparing and contrasting different studies on your topic, and an argumentative essay may involve weighing up the pros and cons of different arguments.

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As the name suggests, comparing and contrasting is about identifying both similarities and differences. You might focus on contrasting quite different subjects or comparing subjects with a lot in common—but there must be some grounds for comparison in the first place.

For example, you might contrast French society before and after the French Revolution; you’d likely find many differences, but there would be a valid basis for comparison. However, if you contrasted pre-revolutionary France with Han-dynasty China, your reader might wonder why you chose to compare these two societies.

This is why it’s important to clarify the point of your comparisons by writing a focused thesis statement . Every element of an essay should serve your central argument in some way. Consider what you’re trying to accomplish with any comparisons you make, and be sure to make this clear to the reader.

Comparing and contrasting can be a useful tool to help organize your thoughts before you begin writing any type of academic text. You might use it to compare different theories and approaches you’ve encountered in your preliminary research, for example.

Let’s say your research involves the competing psychological approaches of behaviorism and cognitive psychology. You might make a table to summarize the key differences between them.

Or say you’re writing about the major global conflicts of the twentieth century. You might visualize the key similarities and differences in a Venn diagram.

A Venn diagram showing the similarities and differences between World War I, World War II, and the Cold War.

These visualizations wouldn’t make it into your actual writing, so they don’t have to be very formal in terms of phrasing or presentation. The point of comparing and contrasting at this stage is to help you organize and shape your ideas to aid you in structuring your arguments.

When comparing and contrasting in an essay, there are two main ways to structure your comparisons: the alternating method and the block method.

The alternating method

In the alternating method, you structure your text according to what aspect you’re comparing. You cover both your subjects side by side in terms of a specific point of comparison. Your text is structured like this:

Mouse over the example paragraph below to see how this approach works.

One challenge teachers face is identifying and assisting students who are struggling without disrupting the rest of the class. In a traditional classroom environment, the teacher can easily identify when a student is struggling based on their demeanor in class or simply by regularly checking on students during exercises. They can then offer assistance quietly during the exercise or discuss it further after class. Meanwhile, in a Zoom-based class, the lack of physical presence makes it more difficult to pay attention to individual students’ responses and notice frustrations, and there is less flexibility to speak with students privately to offer assistance. In this case, therefore, the traditional classroom environment holds the advantage, although it appears likely that aiding students in a virtual classroom environment will become easier as the technology, and teachers’ familiarity with it, improves.

The block method

In the block method, you cover each of the overall subjects you’re comparing in a block. You say everything you have to say about your first subject, then discuss your second subject, making comparisons and contrasts back to the things you’ve already said about the first. Your text is structured like this:

  • Point of comparison A
  • Point of comparison B

The most commonly cited advantage of distance learning is the flexibility and accessibility it offers. Rather than being required to travel to a specific location every week (and to live near enough to feasibly do so), students can participate from anywhere with an internet connection. This allows not only for a wider geographical spread of students but for the possibility of studying while travelling. However, distance learning presents its own accessibility challenges; not all students have a stable internet connection and a computer or other device with which to participate in online classes, and less technologically literate students and teachers may struggle with the technical aspects of class participation. Furthermore, discomfort and distractions can hinder an individual student’s ability to engage with the class from home, creating divergent learning experiences for different students. Distance learning, then, seems to improve accessibility in some ways while representing a step backwards in others.

Note that these two methods can be combined; these two example paragraphs could both be part of the same essay, but it’s wise to use an essay outline to plan out which approach you’re taking in each paragraph.

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Some essay prompts include the keywords “compare” and/or “contrast.” In these cases, an essay structured around comparing and contrasting is the appropriate response.

Comparing and contrasting is also a useful approach in all kinds of academic writing : You might compare different studies in a literature review , weigh up different arguments in an argumentative essay , or consider different theoretical approaches in a theoretical framework .

Your subjects might be very different or quite similar, but it’s important that there be meaningful grounds for comparison . You can probably describe many differences between a cat and a bicycle, but there isn’t really any connection between them to justify the comparison.

You’ll have to write a thesis statement explaining the central point you want to make in your essay , so be sure to know in advance what connects your subjects and makes them worth comparing.

Comparisons in essays are generally structured in one of two ways:

  • The alternating method, where you compare your subjects side by side according to one specific aspect at a time.
  • The block method, where you cover each subject separately in its entirety.

It’s also possible to combine both methods, for example by writing a full paragraph on each of your topics and then a final paragraph contrasting the two according to a specific metric.

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4.1: Introduction to Comparison and Contrast Essay

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The key to a good compare-and-contrast essay is to choose two or more subjects that connect in a meaningful way. Comparison and contrast is simply telling how two things are alike or different. The compare-and-contrast essay starts with a thesis that clearly states the two subjects that are to be compared, contrasted, or both. The thesis should focus on comparing, contrasting, or both.

Key Elements of the Compare and Contrast:

  • A compare-and-contrast essay analyzes two subjects by either comparing them, contrasting them, or both.
  • The purpose of writing a comparison or contrast essay is not to state the obvious but rather to illuminate subtle differences or unexpected similarities between two subjects.
  • The thesis should clearly state the subjects that are to be compared, contrasted, or both, and it should state what is to be learned from doing so.
  • Organize by the subjects themselves, one then the other.
  • Organize by individual points, in which you discuss each subject in relation to each point.
  • Use phrases of comparison or phrases of contrast to signal to readers how exactly the two subjects are being analyzed.

Objectives: By the end of this unit, you will be able to

  • Identify compare & contrast relationships in model essays
  • Construct clearly formulated thesis statements that show compare & contrast relationships
  • Use pre-writing techniques to brainstorm and organize ideas showing a comparison and/or contrast
  • Construct an outline for a five-paragraph compare & contrast essay
  • Write a five-paragraph compare & contrast essay
  • Use a variety of vocabulary and language structures that express compare & contrast essay relationships

Example Thesis: Organic vegetables may cost more than those that are conventionally grown, but when put to the test, they are definitely worth every extra penny.

Graphic Showing Organization for Comparison Contrast Essay

Sample Paragraph:

Organic grown tomatoes purchased at the farmers’ market are very different from tomatoes that are grown conventionally. To begin with, although tomatoes from both sources will mostly be red, the tomatoes at the farmers’ market are a brighter red than those at a grocery store. That doesn’t mean they are shinier—in fact, grocery store tomatoes are often shinier since they have been waxed. You are likely to see great size variation in tomatoes at the farmers’ market, with tomatoes ranging from only a couple of inches across to eight inches across. By contrast, the tomatoes in a grocery store will be fairly uniform in size. All the visual differences are interesting, but the most important difference is the taste. The farmers’ market tomatoes will be bursting with flavor from ripening on the vine in their own time. However, the grocery store tomatoes are often close to being flavorless. In conclusion, the differences in organic and conventionally grown tomatoes are obvious in color, size and taste.

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Rethinking secularization: a global comparative perspective.

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Social Policy in an Era of Competition: From Global to Local Perspectives

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One The competition state thesis in a comparative perspective: the evolution of a thesis

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This chapter discusses the competition state thesis. Globalisation, the decline of the Fordist model of production, and the rise of the global knowledge economy have all played their role in producing a more competitive environment in which welfare states operate. What exactly is the competition state? Where the welfare state seeks to use the tools of the economy to further the public interest and promote social justice, the competition state seeks only economic success, with welfare provisions not only secondary, but offered only when they support the primary goal of economic success. The chapter then summarises and subsequently extends previous empirical work undertaken using the competition state framework in order to assess the extent to which the core thesis is still relevant today.

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Comparative Policy Analysis and the Science of Conceptual Systems: A Candidate Pathway to a Common Variable

  • Published: 20 March 2021
  • Volume 27 , pages 287–304, ( 2022 )

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  • Guswin de Wee   ORCID: orcid.org/0000-0002-1249-1121 1  

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In comparative policy analysis (CPA), a generally accepted historic problem that transcends time is that of identifying common variables. Coupled with this problem is the unanswered challenge of collaboration and interdisciplinary research. Additionally, there is the problem of the rare use of text-as-data in CPA and the fact it is rarely applied, despite the potential demonstrated in other subfields. CPA is multi-disciplinary in nature, and this article explores and proposes a common variable candidate that is found in almost (if not) all policies, using the science of conceptual systems (SOCS) as a pathway to investigate the structure found in policy as a lynchpin in CPA. Furthermore, the article proposes a new text-as-data approach that is less expensive, which could lead to a more accessible method for collaborative and interdisciplinary policy development. We find that the SOCS is uniquely positioned to serve in an alliance fashion in the larger qualitative comparative analysis that supports CPA. Because policies around the world are failing to reach their goals successfully, this article is expected to open a new path of inquiry in CPA, which could be used to support interdisciplinary research for knowledge of and knowledge in policy analysis.

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1 Introduction

In the 1990s, comparative policy analysis (CPA) and comparative analytical studies, as a modern research tradition, joined comparative politics and comparative public administration, using the comparative method (Geva-May et al. 2020 : 368). Peters and Fontaine ( 2020 : 29) contend that the comparative method, as outlined by Lijphart, provides various opportunities for scholars of public policy to enhance their collective understanding of policy and policy processes. Peters et al. ( 2018 : 137) argue that CPA is in fact precisely designed to explain policy outcomes.

Cairney and Heikkila ( 2014 : 383) suggest that, by building on established literatures, new lenses on public policy seek to improve upon rather than compete with or replace existing perspectives. Thus, the posture taken in this article is that there are challenges in the field as well as opportunities, and this article suggests an opportunity to advance comparative public policy (Wong 2018 : 963).

Research seems to suggest that a common issue in comparative research is the great difficulties in comparing policies across a variety of situations/contexts, which is referred to as the problems of identifying common variables (Wong 2013 , 2016 ; Haque 1996 ; Welch and Wong 1998 ). In identifying future challenges and opportunities of the development of comparative public policy, Wong ( 2018 ) recognises the efforts made by scholars calling for collaboration and interdisciplinary research in comparative public policy, which is a problem that has for decades not been fully addressed.

A second issue in comparative public policy, and in particular CPA, is the fact that text-as-data methods have been rarely applied widely, despite their potential, which has been demonstrated in other subfields (Guy Peters and Fontaine 2020 : 203). Additionally, according to Guy Peters and Fontaine, “[t]hey have not created new text-as-data approaches as such.”

Peters ( 2020 : 21) argues that there is a clearly a need to utilise other methods and techniques to make comparisons. According to Peters and Fontaine ( 2020 : 14), CPA is in itself multi-disciplinary and as such more akin to multi-methods than any social sciences area. As a candidate to remedy this gap in literature, this article suggests the science of conceptual systems (SOCS) and in particular the use of integrative propositional analysis (IPA) methodology to examine the structure/structural logic of policy models as a way to provide a ‘common variable’ in CPA.

The SOCS is aimed at the pursuit of knowledge and understanding of conceptual systems using rigorous methodologies (Wallis 2016 ). Conceptual systems are defined as any collection of interrelated concepts found in theories, models, policy models, axioms, laws, strategic plans, and so on, which have a set of interrelated propositions. Generally, all conceptual systems from social sciences to hard/natural sciences have one aspect in common: they have some level of structure, which makes them amenable to an IPA-based analysis or evaluation. We will delve into the IPA in detail below.

Part of the motivation for this study is the critique and necessity for the systems-based approach of the SOCS. This is the problem of linear and simple policymaking (Sabatier 1999 ), which causes a mismatch between how real-world systems work and how we think of them (Cabrera and Colosi 2008 ). The simplistic models used to make decisions in complex systems lead to “worse outcomes than the previous status quo” (Beaulieu-B and Dufort 2017 : 1) and shortsighted practices (Sterman 2012 : 24). As such, implicitly the article also uses the SOCS and IPA as a vehicle to carry out the impact of systems thinking and its benefits in policy analysis.

The contribution of this article is twofold. Firstly, it explores how the structure that is found in each policy model or conceptual system can serve as a common variable when comparing policy. Secondly, the article provides a text-as-data approach with rigour and greater accessibility, which can be easily acquired and applied by policy makers, practitioners, and scholars. The article will specifically illustrate this by explaining how policy as a unit of analysis can be used to integrate theory, policy and research based on a ‘common language’ of structure , which will potentially allow for comparative analysis across systems.

To achieve this, the article is structured in three sections. Firstly, there is a review of comparative public policy and comparative analysis. Secondly, the article provides a background of the SOCS. Thirdly, the article illustrates how and why policies (policy models) are amenable to evaluation based on their structure, which will be shown to generate novel insights into the ability of IPA to improve CPA across different systems.

2 Comparative Policy Analysis

Lasswell ( 1971 ) made a distinction between knowledge of and knowledge in the policy process. However, both are very important for the purpose of this article. With regard to knowledge in the policy process, Radin and Weimar ( 2018 : 8) state that this perspective looks at “how can analysis improve the content of public policy?” This was premised on how the political process affects policy content application and so on. This current article looks at the structure of policy implementation, and in turn examines how the data that underlie the structure of a policy influence the structure of the policy.

Policy analysis is defined as the use of reason and evidence to choose the best policy among a number of alternatives (MacRae and Wilde 1979 : 14). Dror ( 1983 : 79) defines policy analysis as a “profession-craft clustering on providing systematic, rational, and science-based help with decision-making”. Brans et al. ( 2017 ) argue that what is central to policy analysis has always been the principle that decision-making should be systematic, evidence-based, verifiable and evaluative (transparent and accountable). Geva-May et al. ( 2020 ) maintain that evidence-based policymaking also implies, by definition, the search for evidence ‘elsewhere’ for historical, international, disciplinary, or other comparisons of data, facts, and events. Policy analysis also refers to analysis for public policymaking, such as the activities, methodology and tools used to assist and advise in the policymaking context (Parsons 1996 ; Hogwood and Gunn 1984 ; Mayer et al. 2004 ; Dunn 1994 ; Fishcer et al. 2007 ). This is also referred to as the interventionist branch of the policy science tree (Enserink et al. 2012 ). As such, policy analysis, as interventionism, likened to other disciplines, needs to bridge the gap between science and action (Latour 1987 ).

Reviewing the literature above, two aspects of policy analysis become very evident. Firstly, policy analysis is a means to improve decision-making supported by evidence and secondly, evidence can also be found elsewhere as argued by Geva-May et al. ( 2020 )—it does not always have to involve conventional policy analysis methods. It is fundamental to note here that the approach and methodology suggested in this article will support other existing forms of analysis, allowing for greater understanding of policy outcomes or the development of better policies.

Radin and Weimer ( 2018 : 8) support this idea by arguing that at the most general level, science in many disciplines produces policy-relevant research that can inform policy design. Guy-Peters et al. ( 2018 ) also concur with this idea, maintaining that in understanding the various alternatives for comparison, it provides interested researchers with flexibility in explaining policy outcomes, although this requires us to be thorough and to avoid bias. Additionally, Radin and Weimer ( 2018 : 2) note that researchers in many fields contribute to knowledge that is potentially relevant to public policy. Guy-Peters and Fontaine ( 2020 : 14) agree that because of the multidisciplinary nature of CPA, it is more akin to multi-methods than any other social sciences areas. It is clear that policy analysis, as an interdisciplinary field, always leaves the door open for alternative knowledge that would improve evidence supporting decision-making. In this article, we explore how the structure found in policies can add insight to our comparative studies.

Drawing on the reviewed literature for this current article, the perspective of ‘ other comparisons of data ’ or alternative knowledge will be taken, by using the emerging SOCS as a pathway to suggest the structure of policies as a common variable for CPA and by extension provide an alternative text-as-data method to policy analysis.

It is important to note that policy analysis methods are used to help analysts to design and assess policy alternatives systematically (Radin and Weimer 2018 : 8). Building on the idea that we can use other evidence to aid analysis, Guy-Peters et al. ( 2018 ) suggest that in comparative work, when focusing on the nature of policy itself, it is amenable to either quantitative or qualitative methods.

The next section conceptualises a public policy as a conceptual system and explains why and how it is amenable to the SOCS. Van de Ven ( 2007 : 278) holds that investigating and analysing the internal logics of policies can broadly be seen as a form of design science, policy science, or evaluation research.

2.1 Public Policy/Models/Theory as Conceptual Systems

Public policies can be viewed as policy design and the output of analysis (Kingdon 1997 ), which means that the documents representing the content of policies can be viewed as shared understanding. These generally include wordy or text-based design artefacts, such as legislation, guidelines, pronouncements, court rulings, programs, and constitutions (Ingram and Schneider 1997 ). These policy designs (their content) can be seen as abstract representations of physical world systems (Schwaninger 2015 , p. 572), which is intentional in approximating physical systems by building an artificial system (Simon 1969 )—this artificial system, can also be found in our conceptual systems.

Policy design as conceptual systems can be conceptualised in the following manner: A system can be seen as a set of elements or parts with interactions among the components of the pattern/structure (Meadows 2008 ). Policy designs as conceptual systems have a structural logic existing of elements (variables/concepts/boxes) and the patterns (causal relations/arrows in a diagram) in which the elements of the policy will occur (Mohr 1987 ). Now, as suggested by Schneider and Ingram ( 1988 ), because we can diagram a sentence linking together parts of speech, it is also possible to diagram the structural logic of a policy. A key assumption of this article is that more useful/effective policies will be more structured.

Wallis ( 2020b ), drawing on Warfield ( 2003 : 515), defines a system as “any portion of the material universe which we choose to separate in thought from the rest of the universe for the purpose of considering and discussing the various changes which may occur within it under various conditions”. He further makes the distinction between the ‘material’ universe as being separate from the ‘conceptual’ universe and emphasises the useful relationship between the two. The SOCS can thus be seen as an extension of systems thinking to describing, investigating, and understanding policy designs as conceptual systems (again extending systems thinking to policy analysis at the conceptual level).

This distinction and maybe more importantly the relationship between the two universes allow for a more holistic view to policies, thus not only studying the material universe “policy environment” systematically, but also making sure that we study our conceptual universe systematically. This is premised on Ashby’s law of Requisite Variety, building on the idea that the control mechanism (policy) must have greater or equal complexity with regard to the system it intends to control, or in this case the environment it intends to address (Ashby 1957 ). This premise suggests benefits of looking at policy models as conceptual systems.

One key benefit of viewing public policy models as conceptual systems is that, by building a policy map, it enables investigations into the likelihood of negative policy interactions (Siddiki 2018 ). Moreover, using the systemic mapping approach to facilitate more readily policies that are built on interdisciplinary theory as the study of policy design as conceptual systems allows us to investigate the policy (and perhaps why it failed) in its entirety, instead of a reductionist approach—as outlined in the introduction.

It was already briefly suggested earlier that the structure of our policies or our conceptual systems has an impact on the practical application or implementation of our policies. As such, drawing from the emerging SOCS, and remembering that policy analysis knowledge can be drawn from various types of evidence or scientific evidence, we now turn to the new science to explore how it can be a common variable in CPA.

2.2 The Importance of Causality for Structure

Causality in this sense can be understood as the relationship between the concepts in ae conceptual system. Additionally, it can be argued that these causal relationships create the structure by connecting different concepts. According to Sloman and Hagmayer ( 2006 : 408), who draw on Bayer’s nets theory, “studies of learning, attributes, explanation, reasoning, judgement and decision making suggest that people are highly sensitive to causal structure.” What is important here is the understanding that causality is essential, and Wallis ( 2016 ) suggests that we can improve the structure of policy by improving the causal relationships between concepts.

With regard to structure, we look at the relationships between the concepts (causal logic); even though in our map’s causal logic (concepts without any causal relation) forms part of the structure. However, the more relationships there are (arrows between boxes/circles) the more structured and the more useful diagram/conceptual system is. In this science, we look at usefulness. Wallis ( 2020c ) makes a good argument for this, drawing on Saltelli and Funtowicz ( 2014 ) for whom “all models are wrong, but some are useful”. This is evident because some policies/theories fail, and others are useful for their purpose. According to Wallis ( 2020c ), the structure of policies represents a kind of usefulness. This has been seen in over 30 years of science investigating structure.

2.3 The Science of Conceptual Systems: A Brief History

Briefly, Cabrera ( 2006 : 3) argues that concepts exist in a system made out of other concepts which has interconnected patterns and is a conceptual ecosystem. These concepts are bound by causal connections, which form propositions that are examples of “a declarative sentence expressing a relationship among some terms” (Van de Ven 2007 : 117) and that create a set of statements understandable to others by making predictions about empirical events (Baridam 2002 : 7). At the elemental level, policies like theories have concepts and causal relations with underlying data that create propositions as understandable statements, which implies that they are commutable and public (Baridam 2002 ). Like theories, we use policies to make predictions about empirical events, such as implementing COVID-19 regulations and measures (problems and solutions on paper) in the hope of stopping infections and eventually having a virus free country (empirical event), such as New Zealand and others.

According to Wallis ( 2016 ), the SOCS is aimed at the pursuit of knowledge and understanding of conceptual systems whilst using rigorous methodologies. At least three streams of research on structure suggest that structured knowledge is useful for changing the world positively and reaching desired goals. These streams are as follows:

In the field of education/human development, “Systematicity” is used to evaluate the structure of maps and evidence. This suggests that beginners create simplistic low structured maps compared with the more structured and complex maps of experts (Novak 2010 ).

In the field of political psychology, the measure of Integrative Complexity has been used for the past 30-years (Suedfeld et al. 1992 ; Wong et al. 2011 ).

The third stream of research on structure involves studies of formal theories and policy models within and between multiple disciplines (Wallis et al. 2016 ).

The third stream, which is of great significance for this current article is IPA.

2.4 The IPA Method

According to Wallis ( 2016 ), IPA is primarily used to analyse conceptual systems from text on paper to determine their structure (Wallis 2016 ). The IPA methodology uses the policy document’s text itself as data (Wallis 2016 : 585). This process includes the following six steps: (1) Identify propositions within one or more conceptual systems (models, etc.). (2) Diagram those propositions with one box for each concept and arrows indicating directions of causal effects. (3) Find linkages between causal concepts and resultant concepts between all propositions. (4) Identify the total number of concepts (to find the Complexity). (5) Identify concatenated concepts. (6) Divide the number of concatenated concepts by the total number of concepts in the model (to find the Systemicity).

For a very brief and abstract example, consider Fig.  1 . The figure has three variables/concepts (A, B, C), therefore, the Complexity is C = 3. There is one concatenated concept (C). So, the Systemicity is C = 0.33 (the result of one concatenated concept divided by three total concepts).

figure 1

Abstract example of a model for demonstrating IPA

Concepts (relating to variables) are enumerated to show the Complexity or explanatory breadth of the conceptual system. The causal interconnectedness of those concepts is evaluated for their Systemicity (structure, or explanatory depth). Systemicity is measured on a scale of zero to one with one being the highest (Wallis and Valentinov 2017 : 109). Using IPA, Complexity, on its own, is seen as a weak indicator of success for a conceptual system, building on the idea of the SOCS. The main concern for this measurement of structure is that those theories, policy models and general conceptual systems with a higher level of structure are more useful for practical application and implementation.

It can be argued that the external validity of the methodology has been established. Firstly, the findings suggest that theories in the natural sciences have high levels of structure (Systemicity) and are proved to be effective and useful in application, such as Ohm’s Law (Wallis 2016 , b ; Wallis 2010a , b ). In contrast, theories in the social sciences have a Systemicity generally of less than 0,25, including theories of conflict, psychology, and very important for this article, policies (Wallis 2010a , b , 2011 ; 2013 ; Shackleford 2014 ; Parmentola et al. 2018; Wallis et al. 2016 ; de Wee 2020 ; de Wee & Asmah-Andoh, in press). Correlating with these findings, Light ( 2016 ) found that policies in the United States of America only succeed 20% of the time. This is parallel to the 0, 25 Systemicity generally found in social sciences, which essentially translates to a 75–80% chance that most of our policies could fail.

2.5 The Conceptual System: A Basis for Comparison

Briefly, in SOCS, using IPA, we quantify and diagram the structural logic of the policy, and find links between the measure (percentage providing a predictor) of the policy structure and its usefulness in the real world. As a brief example, one could consider Figs.  2 and 3 that are maps of different theories, one from physical science and the other from social science. These propositions are mapped out to indicate how we can use the structure found in any policy as the basis of comparison.

Georg Ohm developed the propositions: An increase in resistance and an increase in voltage would result in an increase of current, which will cause a decrease in resistance. An increase in current causes an increase in voltage that would result in an increase in resistance, which will cause a decrease in current.

The democratic peace proposition has many possible empirical and theoretical forms. One of these holds that “the more democracies there are in a region or the international system, the more peaceful the region or international system will be” (Reiter 2012 )

figure 2

The structural logic of Ohm's law as a practical map (Wright and Wallis 2019 , p. 152)

figure 3

Source : Authors own compilation

The structural logic of the democratic peace proposition as a practical map.

The two brief examples were created using IPA steps 1–3 (to diagram) and the person reading these propositions from any country who reads the English language can see the causal relations between the concepts. This is the benefit and perhaps the most important contribution of the SOCS and IPA to CPA. Firstly, the examples indicate how IPA takes a “common denominator” approach by presenting theories graphically in an easily understandable format of concepts (in boxes/circles) and causal arrows (indicating the direction and causality) (Wallis 2020a , b , c ). The key contribution here is that with IPA we have an objective and rigorous method we can use to evaluate, analyse, and develop policies based on their structural logic, which was first suggested by Schneider and Ingram ( 1988 ); however, without a clear measure. Furthermore, it also provides a “common language” for interdisciplinary work, which is important for policies if they are to be successful, remembering of course that no problem in policy is ever addressed using only ‘one’ policy. As Siddiki ( 2018 ) found, policies that are used to address a problem often led to inter policy conflict that causes problems with “policy coherence”, which May et al. ( 2006 ) refer to in terms of how well policies with similar objectives fit or go together.

Additionally, IPA and the SOCS can be of great benefit for policy design and CPA. Applying the IPA’s steps 4–6 to Figs.  2 and 3 , their level of structure differs significantly. Ohm’s law has a structure/Systemicity of 1 (100% usefulness in application) and the democratic peace proposition, has a structure/Systemicity of 0. In the real world, Ohms law has been very successful, and the democratic peace theory has numerous shortcomings.

For years, it has been accepted that policy designs are “copied, borrowed or pinched” from similar policies in other locales (Schneider and Ingram 1988 : 62) which makes policy design less a matter of invention than of selection (Simon 1981 ) involving large stores of information and making comparisons. However, this led to suboptimal situations where policy layering and patching is done haphazardly (Van der Heijden 2011 ) leading to a palimpsest-like mixture of incoherent or inconsistent policy (Howlett and Rayner 2007 ; Carter 2012 ). Again, perhaps using IPA and viewing policies as conceptual systems allows one to create coherent policies more easily, which are argued to be more effective in application (Siddiki 2018 ).

Based on the case made earlier, this stream of research seems to provide policy analysis with policy-relevant research that can inform policy analysis (Geva-May et al. 2020 ; Guy-Peters et al. 2018 ; Radin and Weimer 2018 ). Hence, it provides this current article the basis for suggesting the evaluation of the structure of policy as a common variable to be used in CPA, additionally because this “on paper” analysis provides a new text-as-data approach. Although other aspects of policymaking and analysis, such as empirical data and the implementation process, are important, we suggest focussing on the structure of policy in comparative analysis. This article suggests the different but allied perspective that this stream of research provides, which will be explained later.

Extending on the above, pragmatically, inter-rater evaluation can be done, where scores of the analysis can be compared and the consensus of the raters measured through agreement or concordance (Bless et al. 2016 : 226). Prior studies indicate how a repeated study using the same data would have stable findings over repeated observations, which confirms its external validity, or generalisability (de Wee 2020 : 135).

In the followings section, we turn to IPA and the application of the method on conceptual systems including policy. The section not only demonstrates the methodology but also the use of the method on policy in previous research. Additionally, it indicates how less “financially demanding” the method is than the computational and statistical models. Based on using textual analysis (IPA) on policy, the article suggests that this is an alternative or new pathway to compare, analyse and evaluate policies. The next section discusses text-as-data and the SOCS compatibility with it.

2.6 A New Text-as-Data Approach: The Basis for Collaboration and Interdisciplinary Policy Development

Current research (Fisher et al. 2013 ; Leifeld 2013 ; Guy-Peters and Fontaine 2020 ; Leifeld and Haunss 2012 ) indicates the prevalence of qualitative text analysis methods in policy analysis, including the discourse networks that rely on text analysis to measure discourse coalitions quantitatively through network analysis. Guy-Peters and Fontaine ( 2020 : 204) argue that text-as-data-methods for CPA can include new theories and methods relevant to public policy and policy analysis.

Guy-Peters and Fontaine ( 2020 ) identify the different directions text-as-data application is currently developing. Firstly, there is causality, with Egami et al.’s ( 2018 ) framework of estimating causal effects in sequential experiments. Owing to limited space, this process will not be explained in full (see Egami et al. 2018 ). Secondly, there is computer science research on word embedding and on artificial neutral networks, which is what they call ‘deep learning’ (LeCun, Bengio & Hinton 2015 ). From the findings of Guy-Peters and Fontaine ( 2020 ), it becomes apparent that the use of statistical and computational analysis is a challenge in the discipline, especially because there are no globally best methods for retrieving certain information from text. Secondly, with manual approaches, this is practically impossible because of the prohibitive costs (Guy-Peters and Fontaine 2020 : 213).

This article suggests a key benefit of viewing the IPA method as part of the SOCS when doing CPA as a new “text-as-data” technique. IPA objectively evaluates structure, and it provides a way for comparison. Additionally, the text-as-data method outlined in the most current literature tends to have two key problems: firstly, it is difficult to use and secondly, it is expensive and practically impossible. To the field of CPA, IPA provides a method that can be used easily and with rigor, which is not mentally taxing or too expensive. To the text-as-data method, this article provides accessibility. The IPA method is more accessible and can be applied with ease by scholars and practitioners from various countries and various disciplines to improve the policies they design. This method also provides a basis from which interdisciplinary work on policy can branch out.

As such, when analysing policy, one can do a within-case analysis and thereafter a cross-case comparison, to generalise findings further, whilst considering the context. However, we will explore this further in the next section.

2.7 Collaboration and Interdisciplinary Perspectives Based on Policy Structure

In fact, the IPA methodology and the resources to assist in the application are readily available online at https://projectfast.org/ , where there are additional tools to enhance the analysis, which can introduce more collaboration. Collaboration can be achieved, through analysing a policy individually and outcomes. Or you can build or analyse the policy together using the six-steps of IPA on the free online social network analysis software KUMU ( www.kumu.io ). This platform allows participants in policy analysis or policy making to organise complex information (concepts and causal relations of a policy based on IPA), to diagram graphically, to build and to analyse policies based on their structure. This platform is open for multiple participants globally who are given permission to participate. Potentially, all participants can have the same policy or empirical data/research and can build a policy or map on this platform; however, this article will present more on this topic in the section on future research areas and implications .

This article argues that when exploring integration studies and literature around interdisciplinary research or problem solving, it becomes apparent that we can use an interdisciplinary approach, which can clarify the observer’s standpoint, define and orient the observer to a problem. Moreover, this approach can be used to map the full social and decision-making context and apply multiple methods to generate, evaluate and implement solutions (Clark 2002 , 2011 ).

Ideas, concepts, and methods around interdisciplinary tools of the policy sciences to problem solving have been available for decades (Lasswell 1971 ; Brunner 1996 ); however, they have not been effectively used it seems. It has been recognised that the current complex problems cannot be resolved with just theories and policies but require contextual interdisciplinary understanding (Clark et al. 2011 ). One of the interdisciplinary questions to policy problems is “what is the common problem that underlies the increasingly apparent disconnect between real world problems and the knowledge and skills currently offered by policy makers?” For this article, the answer lies in the fact that we have policies that are developed but do not reflect our context enough, most of which are often imported from somewhere else and do not address the complexity of the environment.

For example, Wright and Wallis ( 2019 ) wrote a paper on poverty and the various explanations for poverty in the United States. These various “theories” on why there is poverty were then integrated using IPA, which led to a more coherent and interdisciplinary explanation as to why poverty exists. The benefit of the study suggests that by using IPA, one can synthesise various theoretical/data perspectives and create an interdisciplinary explanation to guide policy. A second and a more recent example is the study on responses to COVID-19 by Fink and Wallis ( 2020a , b , c ), where they looked at the models used to combat the disease. Two countries (Germany and New Zealand) handled the crisis the best, as their policies were built on a structured scientific model compared to that of the US and the UK, where the leadership generally rejected scientific results and responded with single values, which caused the US to have the largest number of infections. Here the simple single value approach coupled with a general denying of scientific data led to the US struggling in combating the virus. Again, this feeds back to the problem of having models that are not equal or at least the same as the complexity of the virus.

These two examples are used to indicate how interdisciplinary research can be used to improve CPA and policy development in general. Due to space, a complete case study is not possible. However, evidence seems to suggest that complex and structured plans/policies supported by good interdisciplinary data could lead to better action and decisions by our leaders in attempting to improve the human condition. Thus, the contribution of this article is to indicate that there is an accessible and rather easier method one can use to improve our society.

Echoing the words of Le´le´ and Norgaard ( 2005 ), this article suggests we identify the structure or lack thereof, of policies as a common variable. As demonstrated by Wallis ( 2019 ), “based on the structure of policies we can pull together what is known about a problem from academic and practical experience” (Bammer 2013 :6) and produce a more accurate and complete understanding for more effective action (Newell 2001 : 22). Theoretically this is sound, but pragmatically how can this be done in CPA?

2.8 A Few Practical Points for Collaboration and Interdisciplinary Work

The text-as-data approach of IPA, which is part of the larger SOCS, can be advanced as an answer to the call made by Wong ( 2018 ) for more interdisciplinary research.

Two policies can be comparatively analysed in two different (or multiple) states, for example, a drug policy in South Africa and another in the United States of America. The structure can be measured and compared. This allows us to trace how a design evolves over time.

Using IPA, you can design policies, map them out and see where there are concepts/variables (represented by circles/blocks) on your map that might have no arrows leading to any other box. Moreover, you can apply “gap analysis” by filling the gap with concepts (supported by data) and creating links with the other concepts.

Addressing “unknown unknowns”, Wallis ( 2020a ) argues that practically speaking, something that is unknowable for one person, or in one policy environment, system, or country, can be known by another. Thus, when we look at the systemic structure of policies comparatively, we can identify and determine when something is “missing” in our understanding (based on the diagram) and use different policies and policy empirical data to supplement our own map.

Finally, drawing from the discussion in this section, the idea of using IPA as a text-as-data methodology is supported by the assertion of Guy-Peters and Fontaine ( 2020 : 203) that like other inductive analysis procedures, IPA also makes it possible to discover new phenomena, concepts, and relations from the latent dimension of a text. This notion of new concepts and relationships is supported by Geva-may et al. ( 2020 :368) who state that the comparative perspective at micro- or macro-levels is paramount to effective and efficient policy development. Moreover, this novel idea based on the SOCS is one that can potentially advance effectiveness and efficiency. Using IPA in concert with other conventional CPA methods can improve policy analysis.

Next, the article places IPA as a potential method to be used in qualitative comparative analysis (QCA).

3 Qualitative Comparative Analysis and the CPA

QCA approaches focus on not only the independent variable and its necessity or sufficiency for an outcome of the dependent variable; it also focuses on how an outcome can be achieved by various configurations or combinations of independent variables (Schneider and Wagemann 2012; Guy-Peters and Fontaine 2020 : 43). Guy-Peters and Fontaine ( 2020 ) continue that based on this idea, QCA is similar to most-similar and most-different systems design, as they are also based on the concepts of necessity and sufficiency. QCA can produce empirically well-grounded, context-sensitive evidence about policy instruments (Pattyn et al. 2019 ), such as IPA when looking at policy models as conceptual systems. An advantage of QCA for public policy analysis is that it enhances analysists’ ability to capture the outcomes of decision-making, implementation and evaluation accurately.

Guy-Peters and Fontaine ( 2020 : 7) argue the following: “If we take political science, economics, and sociology as the “heartland” of CPA, then existing methodological discrepancies among scholars may not be too extreme”. However, these are not the only disciplines contributing to CPA. It is argued that many other new disciplines bring complementary approaches, hence new insights on causality and causation. Here they refer to various disciplines, such as anthropology, law and history with their techniques, which “…are other sources of evidence (that) contribute to the development of CPA” (Guy-Peters and Fontaine 2020 : 7). It is clear that CPA draws on various disciplines, and as such, it is sufficient to argue that with the insight of the emerging SOCS, IPA can also be used when analysing policy.

The suggestion is that this methodology of evaluating the structure of the policy against the implemented results can sit comfortably with the QCA method of which the “primary goal is to discover empirical relationships that can help theoretical proposals” (Anckar 2020 : 43). Of course, one has to remember that QCA is premised on the idea that an outcome (a certain value on the dependent variable) can be reached by several combinations of conditions (i.e., independent variables) (Anckar 2020 : 43). The contribution of this article is to propose a new dimension to the present methods, specifically focusing on analysing and evaluating policy documents (policy models or policy-like documents), based on their level of structure, which can be done across policy fields.

From the above, it is clear that for CPA and for the advancement of policy development itself, there is a need for the triangulation of methods and theory that can provide evidence to enhance effective decision-making. Thus, this article agrees with Guy-Peters and Fontaine (2020: 14, emphasis added) that future studies must ‘ think about triangulation and the use of multi-methods as a means of gaining a more complete picture of the policy issue under scrutiny”. Next, the article suggests potential future research areas in CPA.

4 Implications and Future Research

Although this is a preliminary exploration, conclusions can be drawn and taken from this article, as it is a starting point to a conversation about finding a common variable in CPA and introducing a new text-as-data approach.

The conceptual principles drawn and the introduction of a new potential field in CPA, using structure as a common variable, can be a starting point for future studies aiming to test the usefulness of applying IPA in CPA empirically. Scholars can analyse and evaluate policies from different environments, bearing in mind not to sample only a dependent variable based on successful (implementation) cases, which will take away the idea of an ‘inferential felony’ (Geddes 2003 ). IPA can be used in QCA, comparatively analysing policy outcomes with other analysis methods to test if the hypothesis of IPA holds, and potentially falsify it, which will advance the literature about IPA.

Two key deductions can be made. Firstly, comparing a policy based on its structure (coherence) can improve both the implementation success and understanding of a policy environment. Secondly, based on the ‘common denominator’ of IPA (applicable to all theories/policy models) we now have a ‘common language’ we can use for CPA when designing policies for policy relevant research, which in turn provides a good platform for interdisciplinary research.

Most studies of policy analysis compare concepts/elements (in policy) to the real world. However, such a reflective hermeneutic approach can only study selected chunks of policy situations comparatively. Using the text-as-data, or textual hermeneutic approach, analysists can use IPA to evaluate the policy, and identify potential gaps in the policy (where there are concepts with no causal relation to other concepts or where there is just a fuzzy implied causality). These gaps between concepts can be identified as potential reasons, which can pinpoint where analysis can be done. As such, future studies that aim to do comparative analysis can use the policy document (and its internal logic structure) itself as a lynchpin to determine or pinpoint potential areas that could have led to policy failures or success. A broader number of variables for comparative studies can be identified, which could require more interdisciplinary research to make for a more nuanced understanding of policy outcomes, which has for decades not been fully answered (Wong 2018 ). Thus, the article has interdisciplinary implications for scholars from various disciplines producing policy relevant evidence.

Because of limited time, space and resources, there are various aspects of CPA that were not covered in this attempt to introduce IPA to this relevant branch of research. However, because this is a preliminary exploration, future studies should cover more of the field. Additionally, the conversation through academic articles can be advanced to position the SOCS and IPA better in CPA.

5 Concluding Remarks and Limitations

Premised on the fact that it draws on the long history of the SOCS, attempts to answer longstanding calls for a common variable in CPA and suggests a new text-as-data method for CPA, this article is somewhat exploratory in nature. Moreover, this article is preliminary, in that it wants to locate the SOCS as a possible pathway to compare, analyse and evaluate policies based on their structure to improve both policy development and how we compare across systems. Depending on more extrapolation, this article presents CPA as a start to a new area for comparison.

The article explored avenues that could potentially contribute an answer to the calls for “a common variable” method that facilitates interdisciplinary and collaborative research and a new accessible text-as-data tool. In its exploration of the literature, the article established that the SOCS and the measurement of structure is a candidate for a common variable, as all policies in the world (dare we say) are written on paper. Additionally, the article provides an existing and developing method (IPA) as a tool to analyse policies and suggests the practical benefits of this tool to CPA (see future research areas and implications).

The use of the structure of the policy in CPA as a lynchpin in analysis or policymaking can bring various variables, concepts, and ideas into play. This approach enables policymakers, academics, practitioners, and other interested participants to find and manage potential “unknown unknowns” about a certain field of policy, such as health and the economy, because of the interdisciplinary, integrative and collaborative characteristic of the SOCS and IPA. Moreover, this could potentially improve our policy feedback, and policy learning in cross system comparative analyses.

What is important to take away here, which is in line with the findings of MacRae and Wilde ( 1979 ), Dror ( 1983 ), Brans et al., ( 2017 ) as well as Geva-May et al. ( 2020 ) is the fact that based on the structure of a policy as a variable, one can develop systemic and evidence-based policy. This is because IPA measures how structured a policy is and how well it reflects the real world. Furthermore, it is evidence based, as it identifies where possible shortcomings can be, where we can add information, collaborate and have interdisciplinary knowledge. Additionally, it is verifiable since interrater reliability can be used across systems, and it is evaluateable because it suggests measurable and actionable propositions in policies, which can be measured and as such keep government accountable. Moreover, using policy feedback, the evaluation of these propositions can improve policy through policy lessons that will advance its sustainability/longevity.

This article does not come without limitations. Firstly, IPA as a method does not consider the ‘off-the-page’ aspects of policy analysis such as data, the mood of analysts or if the implementation followed the policy to the letter. However, locating IPA within the larger QCA methods, the fact that CPA draws on various disciplines and the fact that the IPA provides CPA the means to use the policy structure as the lynchpin for policy analysis all mean that these conventional and existing methods can be used to fill that void. They will be building a stronger and more reliable alliance (to identify the gaps in policy structures and make sure they are measurable, as this will make evaluation and transparency easy).

This article also does not empirically test or compare policies; it is theoretical and grounded in a review of literature. Moreover, as proposed in the section above, an empirical approach would make findings more concrete and verify the strength of the ideas presented here.

Lastly, there is the problem of language, as it is clear that not all countries will have their policies written in English, which could serve as a limitation. However, the measuring of structure could be done using IPA in different languages. Additionally, most countries in the world use English in their academic institutions and publications, and thus translations could be done by language experts. This could help advance the IPA methodology and CPA.

In conclusion, echoing the words of Fuchs and Hofkirchner ( 2005 ), we have an ethical responsibility to develop new knowledge and new understandings to deal with issues. This exploration has opened a new pathway to improve how we develop policy and our ability to compare policies across systems, and essentially by extension improve the human condition.

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The SEC’s Final Climate Disclosure Rule: Key Requirements, and the Materiality Threshold

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The rule expands public companies’ disclosure requirements to include certain greenhouse gas (GHG) emissions data and information regarding climate-related financial risks. Advocates , critics , and journalists have written extensively about the final rule, its legitimacy, and its importance. This post is the first in a series of three that will address specific legal features of the rule.

Part One, below, offers a summary of the final rule, and delves into the materiality threshold that was added throughout the rule, including for emissions disclosure.

Part Two will delve into the SEC rulemaking process, looking back at the SEC’s decision to finalize its climate disclosure rule, and looking ahead to how the rule could be strengthened over time.

Part Three will contextualize the SEC’s final climate disclosure rule alongside California’s recent climate-disclosure laws and the EPA’s GHG emissions reporting regime . The blog will explore the interplay of those three regimes in the U.S. and the question of field preemption under the Constitution’s Supremacy Clause.

Requirements of the SEC’s Final Rule

The final rule adopted last week requires public companies to disclose information in three key areas: (1) climate-related financial risks, (2) GHG emissions, and (3) any climate-related targets or transition plans.

With respect to the first category, registrants must disclose climate-related risks that are reasonably likely to have a material impact on the registrant’s business strategy, operational results, or financial condition. Firms must also disclose the actual and potential material impacts of any identified climate-related risks on their strategy, business model, and outlook. Any board oversight, processes and management related to climate-related risks must also be disclosed. However, any board area expertise with respect to climate need not be disclosed, a requirement that was included in the March 2022 proposed rule but does not appear in the final version.

Registrants must also disclose several financial impacts incurred as a result of severe weather events and other natural conditions, subject to a 1% change threshold in a note to financial statements. If the estimates or assumptions the corporation uses to produce their financial statements were materially impacted by climate risks, a qualitative description must be included. And, if a registrant has undertaken any climate mitigation efforts, then those efforts must be disclosed as well, including a quantitative and qualitative description of material expenditures, plus any material impacts on financial estimates and assumptions that stem from those mitigation efforts.

With respect to GHG emissions disclosure, large accelerated filers (LAFs) and accelerated filers (AFs) – meaning , companies with a publicly traded equity value of $75 million or more – must file information about their material Scope 1 and 2 emissions. These disclosures are subject to progressively stronger audit requirements, first to limited assurance and eventually reasonable assurance.

Finally, registrants must disclose any targets or goals related to climate change that materially affect the registrant’s business. Included in this requirement are any material expenditures and impacts on financial estimates and assumptions that result from the target or goal. Additionally, filers must include financial impacts related to carbon offsets and renewable energy credits or certificates (RECs) if used as a material part of their disclosed climate-related targets or goals. Relatedly, the rule also mandates disclosure of a registrant’s use (if any) of transition plans, scenario analysis, and internal carbon pricing.

The rule will be phased in over an extended period. LAFs must comply with most disclosures for fiscal year beginning (FYB) 2025, FYB 2026 for GHG emissions and the remaining required disclosures, and reach limited assurance for their GHG emissions disclosures for FYB 2029. In practice, this means initial disclosures under the regime will be filed in 2026. AFs and other registrants will follow suit as required on a more delayed timeline . While most disclosures are due in annual reports, reporting of GHG emission information can be delayed to the second quarter of the fiscal year after the emissions occurred.

The rule also includes a “safe harbor” provision that protects issuers from private liability for forward-looking climate-related disclosures pertaining to transition plans, scenario analysis, carbon pricing, and any stated climate goals. This “safe harbor” addresses opponents’ concerns about legal liability for forward-looking statements about climate-related issues.

Key Changes from the Proposal

As previewed by SEC Chair Gary Gensler, the final rule was significantly scaled back from the proposal published by the Commission in 2022. Notably, the final rule does not require any registrants to disclose their Scope 3 GHG emissions, meaning that public companies will not have to disclose their supply chain emissions. This was a significant concession to the rule’s opponents. Scope 3 emissions comprise up to 80% of many companies’ aggregate GHG emissions, and regulators in many other jurisdictions have concluded that these disclosures are critical for investors to understand a company’s full climate-related financial risk.

The revised rule also only requires Scope 1 and 2 GHG reporting for LAFs and AFs, so smaller publicly traded companies are now exempt from the obligation to report their emissions at all. And, as detailed below, the final rule also includes a new materiality qualifier for this Scope 1 and 2 GHG emissions information as well as other climate risk disclosures.

The final rule also removes the line-item disclosure requirement that was meant to show the impact of transition activities on a company’s bottom line. Further, the impact of severe weather events, which was originally required as a footnote disclosure in a firm’s Regulation S-X reporting, has been shifted to Regulation S-K. This is a non-trivial shift, as these numbers will no longer be subject Reg S-X’s audit requirements.

The Materiality Qualifier

One area where the final rule looks dramatically different from the proposed rule is the inclusion of a materiality threshold for Scope 1 and 2 GHG emissions disclosure and for various climate risk and transition disclosure requirements throughout. Materiality is described in the rule as “defined by the Commission and consistent with Supreme Court precedent.” The SEC goes on to explain in the rule that, “a matter is material if there is a substantial likelihood that a reasonable investor would consider it important when determining whether to buy or sell securities or how to vote or such a reasonable investor would view omission of the disclosure as having significantly altered the total mix of information made available. The materiality determination is fact specific and one that requires both quantitative and qualitative considerations.”

As noted in this definition, materiality is an objective standard and particular to each company’s unique total mix of information. In 1999, the SEC released a Staff Accounting Bulletin and then adopted it as interpretive guidance, making clear that materiality is a qualitative test, not subject to any bright line threshold test for financial impact. This is supported by Supreme Court precedent from Basic v. Levison , 485 U.S. 224 (1988) and TSC Indus. V. Northway, Inc ., 426 U.S. 438 (1976). Basic stated that materiality should remain a high enough standard to prevent investors from being buried in “an avalanche of trivial information” which would be “hardly conducive to informed decision making.” Indeed, in TSC , the court held that one of the key features of materiality is that the piece of information would have actual significance to a reasonable shareholder’s deliberations.

As former Acting Chair of the SEC Allison Lee has observed , some argue – incorrectly – that the SEC is prohibited from requiring specific disclosures unless it can demonstrate that each disclosure is individually material to the bottom line of every public company. One source of confusion about materiality may be the different standard applicable to anti-fraud provisions. Under Rules 10b-5 and 14a-9 of the Exchange Act, courts have indeed held that materiality is required for these scienter-based anti-fraud rules. However, this requirement is not broadly applicable to the SEC’s disclosure authority. Nowhere in Section 7 of the Securities Act of 1933 does it say that the SEC can only require “material” disclosures. Rather, the section authorizes the SEC to require disclosures in the public interest and for the protection of investors. The same holds true for the 1934 Securities Exchange Act Sections 12, 13 and 15.

Indeed, the SEC has a clear history of requiring disclosures that may not always be material. As Commissioner Lee noted, Regulation S-K has traditionally required a broad array of information that may not be material for every company, given materiality is an analysis that is determined on a case-by-case basis and can vary from moment to moment for a corporation.

For example, in Reg S-K, the SEC requires any registrant that is an operator of a mine, without any reference to size or financial import, to disclose a variety of safety and operating metrics that may have limited impact on the corporation’s bottom line. This is predicated on the fact that the safety of mine workers is an important public policy issue and merits disclosure in keeping with the SEC’s mandate, regardless of whether the mine is material to the overall operations of the registrant. Additional topics have included share buybacks, related party transactions, environmental proceedings, and executive compensation, all without materiality because they are important to investors and to corporate transparency.

And yet, the SEC decided to impose a materiality qualifier throughout the final rule. Some advocates in the sustainability community support this threshold, arguing that a looser standard could lead to an unintelligible sea of information, not unlike the avalanche of information the Court warned against in Basic . And in an Investor Advisory Committee panel the day after the rule was released, Lynn Turner stated that he believes the materiality threshold is crucial to the rule’s legal durability. Turner was one of the original drafters of SAB 99, the internal guidance the SEC still relies for assessing materiality. He indicated that a reviewing court’s deference to the Agency’s interpretation underpinning the rule may be increased by tying the climate disclosures to materiality for investors. However, just because the rule may be more durable in court does not mean that approach is without risk.

Risks of Applying the Materiality Threshold

There are two significant risks in applying materiality qualifiers to the final climate rule: (1) uncertainty for companies making internal materiality assessments and (2) an implication that the SEC’s disclosure authority may be limited to material information, ultimately reducing comparability for investors.

During the same recent panel on materiality, Professor George Georgiev stated that he does not believe the materiality qualifier will significantly change how many registrants ultimately disclose their GHG emissions, because an incorrect finding of immateriality comes with legal risk. A materiality determination is costly and complex, and companies are vulnerable to liability, including lawsuits from their own shareholders, if their assessment is wrong. Given these costs and risks, the materiality qualifier may ultimately not be an advantageous provision for most firms.

Further, as Allison Lee noted upon the rule’s release, including a materiality qualifier sets questionable precedent, potentially suggesting the SEC’s authority is cabined to requiring disclosure of material information. While the Commission likely made a strategic decision here to hinge emissions disclosure on materiality in order to withstand the scrutiny of more conservative circuits, they may have created risk for future rules to be challenged if they seek novel or less quantitatively measurable information. If the SEC’s authority is limited to a regime dominated by materiality analyses, comparability will also be destroyed, due to the fact-intensive nature of a materiality inquiry. As Commissioner Lee noted, this would be at odds with modern capital markets, which seek comparability and consistency in disclosures without regard to the unique circumstances of each registrant. Tying the SEC’s hands with materiality requirements could ultimately undermine the consistency and comparability of data that disclosure rules, like this one, are meant to provide for investors.

comparative perspective thesis

Chloe Field

Chloe Field is the Initiative on Climate Risk and Resilience Law Fellow at the Sabin Center for Climate Change at Columbia Law School.

  • Chloe Field https://blogs.law.columbia.edu/climatechange/author/chloefield/ The SEC’s Final Climate Disclosure Rule Must Respond to Emerging Legal Risks
  • Chloe Field https://blogs.law.columbia.edu/climatechange/author/chloefield/ Banking Regulators Act in the Face of Headwinds to Address Climate Risk

comparative perspective thesis

Cynthia Hanawalt

Cynthia Hanawalt is the Director of Climate Finance and Regulation at the Sabin Center for Climate Change Law.

  • Cynthia Hanawalt https://blogs.law.columbia.edu/climatechange/author/cynthiahanawalt/ A Comparative Analysis of the SEC’s Climate Disclosure Proposal
  • Cynthia Hanawalt https://blogs.law.columbia.edu/climatechange/author/cynthiahanawalt/ The SEC’s Final Climate Disclosure Rule Must Respond to Emerging Legal Risks
  • Cynthia Hanawalt https://blogs.law.columbia.edu/climatechange/author/cynthiahanawalt/ The Major Questions Doctrine is a Fundamental Threat to Environmental Protection. Should Congress Respond?
  • Cynthia Hanawalt https://blogs.law.columbia.edu/climatechange/author/cynthiahanawalt/ New Report Highlights the Complex Intersection of Antitrust Law and Sustainability Goals

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Art exhibit: 'Rowena Finn-7000 Pieces of Me: Visual Essays on Identity and Belonging'

12 Mar 2024

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From: Perspective Gallery

Rowena Frederico Finn is an award-winning artist living in Virginia whose artwork has been shown extensively.

Finn is a passionate and outspoken activist for the rights and needs of underrepresented and underserved communities and has served on multiple advisory boards. Finn also shares her talents by teaching painting and drawing. 

This exhibition has been created in collaboration with the VT Asian Pacific Islander Desi American (APIDA) + Center, which will host Finn as a visiting artist April 3-5. The exhibition employs the tactle language of textiles, shells, beads, wood, paper, and more to convey the nuanced struggle of grafting Filipino/FilipinoX cultures onto pre-existing Amercan cultural norms. 

An artist's reception and talk will be held at the Perspective Gallery on Thursday, April 4, from 5-7 p.m. with the talk beginning at 5:30 p.m. The talk is sponsored by the Office of the Associate Provost for the Arts, Diverse Voices and Perspectives Lecture Series. 

All events in the gallery are free and open to all. Gallery hours can be found on the Perspective Gallery Website

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  1. (PDF) A Short Introduction to Comparative Research

    A comparative approach is a methodology that analyses phenomena by putting them together to establish points of similarity and difference between them (Shahrokh & Miri, 2019). This technique is ...

  2. PDF The Comparative approach: theory and method

    The comparative approach must be elaborated in terms of its theoretical design and its research strategy on the basis of a goal-oriented point of reference, i.e. what exactly is to be explained. A way of accomplishing this is to argue for a more refined concept of 'politics and society' and develop concepts that 'travel' -- i.e. are ...

  3. 15

    Summary. In contrast to the chapters on survey research, experimentation, or content analysis that described a distinct set of skills, in this chapter, a variety of comparative research techniques are discussed. What makes a study comparative is not the particular techniques employed but the theoretical orientation and the sources of data.

  4. PDF 70 EDUCATION, PHILOSOPHY AND THE COMPARATIVE PERSPECTIVE

    criteria which a comparative perspective makes available for consideration. Similarly, in relation to (3), a philosophical critical evaluation of educational practices, principles and the like, a comparative dimension is an important resource in the enrichment of the range of possibilities and justifi catory arguments open to view.

  5. PDF How to Write a Comparative Analysis

    To write a good compare-and-contrast paper, you must take your raw data—the similarities and differences you've observed —and make them cohere into a meaningful argument. Here are the five elements required. Frame of Reference. This is the context within which you place the two things you plan to compare and contrast; it is the umbrella ...

  6. Comparative Philosophy

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    izes comparative research. In all three perspectives, several dimensions are always present. A survey of the recent literature reveals that the state in empirical research is op-erationalized in terms of specific institutions and actors. Thus, for example, the state of Argentina in the late 1970s is coterminous with the military, while

  8. Healthcare Systems in Comparative Perspective: Classification

    This essay reviews and evaluates recent comparative social science scholarship on healthcare systems. We focus on four of the strongest themes in current research: (1) the development of typologies of healthcare systems, (2) assessment of convergence among healthcare systems, (3) problematization of the shifting boundaries of healthcare systems, and (4) the relationship between healthcare ...

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    Tracing the historical timeline in a comparative perspective allows the examination of institutions created at the formative years of each state. At state building, institutions were formed by elites who saw their policies as more or less compatible with public will. The purpose of process tracing is to illustrate just how public will drift ...

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    The thesis demonstrates that such a communication perspective explains the thinness of populist ideology, its harmony with processes of mediation and its varied forms around the globe. In combination with the comparative approach it reveals insights into the populist mode of political representation and its implications for democracy.

  11. PDF (2016) Central and Yanbian in comparative perspective. thesis ...

    Yanbian Korean in Comparative Perspective Simon George Barnes-Sadler Thesis submitted for the degree of PhD 2016 Department of the Languages and Cultures of Japan and Korea . 2 SOAS, University of London Declaration for SOAS PhD thesis

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    In a 1965 article 'Educational ideals and practice in a comparative perspective', on the other hand, Brodbelt , used a comparative method to propose that only when 'myth and fact' in a nation's policy goals agree, has it 'reached its ideal system of education'. He illustrated his hypothesis by referring to the USA's failure to ...

  13. Comparing and Contrasting in an Essay

    In the block method, you cover each of the overall subjects you're comparing in a block. You say everything you have to say about your first subject, then discuss your second subject, making comparisons and contrasts back to the things you've already said about the first. Your text is structured like this: Subject 1. Point of comparison A.

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    throughout this thesis make healthcare affordable and accessible for their residents. These healthcare systems consistently earn better ratings than the United States' current healthcare system. The contents of Chapter Two targets some of the more outstanding problems in the

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    The second and third categories of research add to this long-existing stream of scholarly work by using the comparative method to advance our understanding of the policy process. To achieve this, research focusing on the theories of the policy process includes two emerging trends: comparing theories across institutional configurations (how ...

  16. Comparative Literature

    Harvard's Department of Comparative Literature is one of the most dynamic and diverse in the country. Its impressive faculty has included such scholars as Harry Levine, Claudio Guillén, and Barbara Johnson. You will study literatures from a wide range of historical periods and cultures while learning to conduct cutting-edge research through ...

  17. 4.1: Introduction to Comparison and Contrast Essay

    The key to a good compare-and-contrast essay is to choose two or more subjects that connect in a meaningful way. Comparison and contrast is simply telling how two things are alike or different. The compare-and-contrast essay starts with a thesis that clearly states the two subjects that are to be compared, contrasted, or both.

  18. PDF JUDICIARIES IN COMPARATIVE PERSPECTIVE

    978--521-19060-2 - Judiciaries in Comparative Perspective Edited by H. P. Lee Frontmatter More information Understanding South Africa's Transitional Bill of Rights (1994, with L. du Plessis); editor of Essays on Law and Social Practice in South Africa (1988); Democracy and the Judiciary (1989); Controlling Public Power (1995, with

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    Rethinking Secularization: A Global Comparative Perspective. Building on his earlier work in Public Religions in the Modern World, José Casanova here takes up the substantial task of analyzing the differentiation of the sacred and secular spheres beyond Western Europe. Even within Western societies, multiple paths to such differentiation ...

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    In comparative policy analysis (CPA), a generally accepted historic problem that transcends time is that of identifying common variables. Coupled with this problem is the unanswered challenge of collaboration and interdisciplinary research. Additionally, there is the problem of the rare use of text-as-data in CPA and the fact it is rarely applied, despite the potential demonstrated in other ...

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    Few would deny that comparative literature is rapidly moving from the periphery toward the center of literary studies in North America, but many are still unsure just what it is. The Comparative Perspective on Literature shows by means of twenty-two exemplary essays by many of the most distinguished scholars in the field how comparative literature as a discipline is conceived of and practiced ...

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    Nearly two years and 24,000 public comments after its proposal, the Securities and Exchange Commission (SEC) released its final climate disclosure rule last week, formally titled "The Enhancement and Standardization of Climate-Related Disclosures for Investors." The rule expands public companies' disclosure requirements to include certain greenhouse gas (GHG) emissions data and ...

  24. Art exhibit: 'Rowena Finn-7000 Pieces of Me: Visual Essays on Identity

    An artist's reception and talk will be held at the Perspective Gallery on Thursday, April 4, from 5-7 p.m. with the talk beginning at 5:30 p.m. The talk is sponsored by the Office of the Associate Provost for the Arts, Diverse Voices and Perspectives Lecture Series. All events in the gallery are free and open to all.