Guide to the vibrant and



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professional associations – all hallmarks of professional

status. Civil servants are trained in universities,

and appropriate expert credentials are

prerequisites for careers in public bureaucracies.

Methods of program evaluation, cost–benefit analysis,

and the integration of legal and economic

analyses are now part of the core training of public

administrators. While such requirements vary

widely across developed and less-developed countries,

civil service professionalization has become a

de facto standard. The largest variation tends to be

at the top of public bureaucracies. Some countries,

such as France, have long-serving professional

civil servants in charge of government

bureaucracies, while other countries, such as the

United States, have senior administrators appointed

by elected leaders. Even in the latter

cases, however, lower-level bureaucrats often still

retain considerable control over administrative

decisions of vast bureaucracies – which can pose

difficulties for bureaucrats at the top. Incentives

for bureaucrats at all levels of the hierarchy to

maximize the resources under their control have

given rise to theories of the “budget-maximizing

bureaucrat.”

The theoretical underpinnings of public administration

rest on the possibility of a separation

of policy implementation from the politics of

policymaking. A science of public administration

requires the capacity for administrators to implement

policies based on calculable rules and

nonpartisan evaluation. This is a controversial assumption,

however. The goal of insulating bureaucracies

from political influence has in practice

proved exceptionally difficult. Indeed, it is perhaps

impossible in democratic societies. Integrating

political analysis into the routines of public

administration is thus an essential task, albeit a

controversial one in the world of public administration.

Budgetary pressures and calls for spending

cuts are another source of interference. A

virtually universal feature of the operating environment

of public bureaucracies in all countries,

such pressures impose further constraints on

public administrators.

One of the critical questions relating to public

administration today is the status of bureaucracies

in the less-developed world. Many observers

view persistent corruption and patronage in

the public sector as the main impediments to

development in those countries where they occur.

International lending agencies have sometimes

considered the degree of professionalization in

the civil service as a factor in the worthiness of

prospective recipient nations. Whether public bureaucracies

can attain and sustain independence in

the face of poverty and political turmoil is likely

to remain a key question in the future.

J E F F MANZA

public health

This term includes the separate notions of a perspective,

infra-structure, and philosophy of government.

In 1988, the Institute of Medicine in

the United States defined public health as “the

science and art of preventing disease, prolonging

life and promoting health and efficiency through

organized community effort.” This definition reflects

the public health thinking behind the World

Health Organization’s Alma Ata Declaration of

Health for All (1978) and the Ottawa Charter (1986)

which were endorsed by the United Kingdom Association

of Public Health and the American

Public Health Association as well as by many

governments.

The public health perspective emphasizes:

health rather than medicine; the public good

rather than that of the individual; and, prevention

rather than intervention after the problem has

occurred. Public health efforts are focused on

communities at the local, regional, and national

levels, emphasizing partnerships among government

agencies, states, municipalities, industry,

and non-government organizations. In most countries,

public health efforts are conceived and

organized under the direction of government

ministries of health and delivered by local and

regional health authorities. The role of the state

is a key variable, because public health problems

and interventions are closely linked to the larger

political economy of the nation, socioeconomic

disparities, poverty, immigration, health care

systems, and how the state builds and maintains

health infrastructures.

Public health consists of three domains: health

protection, health improvement, and health services.

Health protection involves monitoring and

oversight of clean air, water, food, infectious

public administration public health

479

diseases, emergency responses to disasters, war



and terrorism, radiation, chemicals and poisons,

and environmental health hazards. Health improvement

focuses on improving health, reducing

inequalities, employment, housing, family and

community, education, and lifestyles. Health services

refer to service planning, clinical effectiveness,

clinical governance, efficiency, research,

audit, and evaluation. The exercise of responsibility

in these domains requires a substantial

infrastructure, including a trained workforce,

knowledge and information, organizations, research

institutes like the United States Center for

Disease Control, facilities to monitor and deliver

vaccinations, and testing of air, water, food, and

the environment.

The critical functions of the public health

system are to assess potential problems, develop

policies to address these risks, and institute monitoring

and intervention strategies to assure the

health safety of the public. For example, the

United Kingdom response to “mad cow” disease,

the European attention to genetically engineered

crops, and the United States efforts to acknowledge

and react to the obesity epidemic are instances

of public health at work in western

countries where there are well-established public

health infrastructures. In non-western countries,

China has struggled with but coordinated a public

health plan to deal with SARS (Severe Acute

Respiratory Syndrome) and Asian and African

countries are struggling with the HIV (Human

Immunodeficiency Virus) and the AIDS (Acquired

Immunodeficiency Syndrome) epidemic, but often

without the resources of richer countries. Public

health efforts are also evident on a worldwide

level. Because of global warming, inexorable

growth in the world population, and increased

use of fossil fuels, the world has looming public

health problems associated with basic resources

like water, clean air, and the food supply. Familiar

diseases like tuberculosis have re-emerged in

drug-resistant forms and potential scourges like

ebola virus and new forms of influenza have

emerged to challenge global public health efforts.

The World Health Organization usually takes the

lead in such initiatives, supported by the World

Health Assembly composed of the Ministers of

Health of the United Nations member states. The

outcomes of these prevention and intervention

efforts are measured in terms of numbers of identified

cases, morbidity, disability, mortality, and

cost to the community or nation. Cost–benefit

analyses show how much benefit public-health

interventions produce on health and quality of

life outcomes per unit cost. Historically, research

on the health of nations indicates that public

health measures are the most cost-beneficial

forms of health interventions. These results are

calculated in terms of deaths, morbidity, and disability

avoided due to the application of publichealth

measures. For example, reducing the

amount of obesity in a population through education,

changes in nutrition, and exercise will save

billions of dollars of lost income and medical care

costs due to associated conditions like diabetes,

heart disease, cancer, and vision problems. At a

basic level, large improvements in the health of a

population are realized by just having a clean

water supply, sewage disposal system, vaccinations

and prophylactic drugs for infectious diseases, and

effective health education programs about maternal

and child health and reproduction.

The response to public health problems is contingent

on the resources, infrastructures, and political

economic climates of individual nations and

communities. Resources are usually measured in

terms of amount of money spent per capita on

health, the facilities, workforce, equipment, and

supplies available for the task. Infrastructures

refer to basic transportation and communication

systems, the ability to deliver public health interventions

when needed, and stable political economic

systems. Political economic systems reflect

the values, political organization, and market dynamics

of a country. For instance, the United Kingdom

is a democracy with a public health system

that is closely articulated with the National

Health Service. As a result there can be integrated

intervention efforts between the two systems to

address problems like smoking, alcohol use, road

rage, and obesity. In contrast, the United States is

a capitalist democracy where public health is organized

and delivered through government agencies

but this system is not well articulated with a

patchwork of for-profit and not-for-profit medical

care delivery organizations and institutions. In

addition, there is a heated debate in the United

States around religious values that are expressed

in discussions about sex, alcohol, drugs, and the

“right to life.” As a consequence, even though the

United States has considerable resources, sex education,

use of condoms, clean needle exchange

programs for drug injectors, and adolescent pregnancy

cannot be addressed in the United States as

they can in the United Kingdom, continental

Europe, or Japan. Public health efforts are, then,

dependent on local values and circumstances.

There is a strong interplay in theory, methods,

research, and applications between sociology and

public health public health

480

public health. Sociology analyzes the social world



in terms of the interaction between individuals,

groups, communities, and the larger social, political,

economic, and physical environment. Thus,

in methodology, there is considerable interest in

considering activity within context through

multilevel modeling, mixed models, and network

analysis. Public health uses the sociological perspective

in analyzing and pragmatically addressing

problems, dealing with the health of groups

and populations. Public health can contribute to

sociology through its development of environmental

models, focus on translating theory and research

into practice, use of participative action

research, and in research methods such as evaluation

research and statistics such as Cox regression

and mixed models. There is much to be

gained by maintaining a close working relationship

between these two fields.

GARY L . ALBRECHT AND MARK SHERRY

public opinion

This concept describes either a single set or the

sum of shared beliefs, assessments, and attitudes

within a given society. In modernity, public opinion

has reflected common or prevalent convictions

among the population of nation-states.

However, we find illustrations of the existence

and significance of public opinion from the ancient

world in the Athenian polis, the rhetorical

manipulation of public opinion by Marcus Cicero

(106–43BC) and the early Renaissance where the

notion of “public opinion” plays an important role

in foundational work on the state and social

organization.

Not least because of the adaptation of the concept

of public opinion across different disciplines

and by theorists of distinct and contradictory

philosophical foundations, an absence of a common

definition of public opinion is widely acknowledged.

The differences concern the question

of how public opinion is constituted and what

purpose public opinion serves. In its liberal interpretation,

public opinion functions as a regulatory

control of state actions through the need of executive

powers to base their actions on public support,

as is evident in parliamentary democracies, where

public opinion is assumed to form the basis of

voters’ electoral decisions. In this interpretation,

public opinion is in fact the sum of private

opinions which might not actually be articulated

in the public realm and which are measured

through quantitative surveys conducted by polling

institutes. This assumption of a free formation

of public opinion in contemporary indirect

democracies is rejected in Ju¨rgen Habermas’s

criticism in The Structural Transformation of the

Public Sphere (1962 [trans. 1989]), in which he

sketches out the decline of public discourse

as the basis on which rational opinion can be

formed. Habermas draws in this context on

C. Wright Mills’s distinction between “public”

and “mass” to illustrate how the formation of

public opinion shifts from an unrestricted communicative

environment to a state of mass

communication in which opinions are expressed

by a small elite, excluding the public from the

opinion-making process.

Such concerns are shared at the other end of the

political spectrum, where they form the basis of a

very different conclusion. Grounding her work in

social-psychological assumptions about the individual’s

need to conform with the views of a

larger social group, Elisabeth Noelle-Neumann

has coined the notion of the Spiral of Silence (1980

[trans. 1984]). According to Noelle-Neumann the

opinion leadership of largely liberal mass media

creates a climate in which individuals are reluctant

to voice diverging opinions (about, for instance,

ethnicity, migration, or the welfare state)

breaking a seemingly dominant social consensus.

Opinion polls thus account not for respondents’

actual opinions but for those they believe to be

socially acceptable. These polls are subsequently

misconstrued as evidence of a dominant public

opinion as favored by opinion leaders, which in

turn further deepens the spiral of silence.

The extent to which public opinion can be

formed freely and how it can be measured continues

to form the key sociological concerns in

public opinion research. CORNEL SANDVOS S

public policy

The sociology of public policy has been strongly

conditioned by the different ways in which policymaking

has been organized and conducted. In

North America, the public sphere has been comparatively

smaller, and the state less interventionist,

than in many European countries, and this

has had an influence on how sociologists and

other social scientists have come to approach the

subject.

In North America, a separate discipline of policy

analysis emerged after World War II in an attempt

to improve the effectiveness of government and

public administration. Based on rationalist and

pragmatic assumptions, the study of public policy

was often linked fairly closely to the practice of

policymaking, and in particular to efforts to

extend the scale and scope of the public sphere

public opinion public policy

481

in relation to the private sector. With precursors



in both the progressive era at the turn of the

century and the New Deal era of the 1930s, students

of public policy have tended to share a

common commitment to social reform and to

the importance of scientific expertise in the

making of public policy.

There are institutions of policy analysis both

inside and outside the universities, and practitioners

tend to conceive of their field as an applied,

rather than a basic, or academic, science. In

Europe, the legacy from the nineteenth century’s

more theoretically minded sociologists contributed

to giving the study of public policy a

somewhat more “critical” identity, with its practitioners

often attempting to keep a certain

distance from the actual policymakers. The applications

of policy research were more to be found

in the separate policy sectors, which, because of

the more ambitious role of the state in many

European countries, were usually more substantially

developed than in North America.

In Europe the study of public policy has been

subdivided into its various component parts – formulation,

implementation, evaluation, assessment,

contention – as well as into its various

societal sectors – for example, health policy, education

policy, environmental policy, innovation

policy, economic policy.

As a result, instrumental approaches, such as

rational choice theory and cost–benefit analysis,

that have been widely used in the United States,

have been comparatively less influential in

Europe. Instead, the study of public policy outside

North America has generally made use of theories

and concepts that are not specifically oriented to

policymaking.

The differences began to dissipate in the 1970s,

and in recent decades, particularly with the expansion

of the European Union, the domain of

public policy has tended to grow more uniform.

At the same time, there has been a challenge to

public policy in general in the name of privatization

and deregulation. This is most evident in

politically charged fields such as the environment

and health, where the various policy discourses

have become a popular subject for social scientists.

In recent years, there has been an interest,

throughout the world, in what are sometimes

called “post-positivist” approaches to the study of

public policy, which make use of one or another

form of discourse analysis, as discussed in Frank

Fischer’s Reframing Public Policy (2003).

ANDREW JAMISON

public sphere

Referring to the institutions and spaces within

which public opinion is formulated outside the

government, this term acquired a specific historical

significance in Ju¨rgen Habermas’s The Structural

Transformation of the Public Sphere (1962

[trans. 1989]), in which he argued the concept

was specific to late seventeenth-century Britain

and eighteenth-century France. A public sphere

presupposes urbanization, the evolution of civil

society and civic culture, and the spread of literacy.

These developments were important for the

creation of debating societies, literary clubs,

salons, and coffee houses where intellectuals

would assemble for discussion and debate. In England,

the philosopher Edmund Burke (1729–97),

on the eve of the French Revolution, argued that

in free societies there was more public wisdom in

shops and the workplace than among princes and

their cabinets. This public wisdom came to have

the modern meaning of public opinion in 1781,

according to the Oxford English Dictionary. In

Germany, similar associations developed such as

the “table societies” (Tischgesellschaften) and “literary

societies” (Sprachgesellschaften). In political

terms, these societies created spaces for the rising

middle class to give expression to their social and

economic interests.

This association between the bourgeoisie as

a social class and the public sphere is clear in

German whose bu¨rgerliche O¨ffentlichkeit is translated

as “bourgeois public sphere.” In fact

Habermas distinguished between the liberal model

of middle-class associations of the educated social

strata and the plebeian public sphere of the

working class. This public sphere of the uneducated

lower class was characterized by, for example, the

Chartist Movement, the working-class Protestant

chapels, craft guilds, and eventually trade unions.

This plebeian alternative was associated in France

with the French Revolution and the revolutionary

Maximilien de Robespierre (1758–94). In social history,

a brilliant account of these plebeian associations

has been given by E. P. Thompson in The

Making of the English Working Class (1963) according

to which, for example, the Methodist chapels provided

educational and associational opportunities

for working-class communities.

The bourgeois public sphere has declined

with changes to education, the monopolistic ownership

of the media, the impact of television on

reading habits, and the decline of voluntary associations.

Habermas argues that in the “socialwelfare

state” there is an increasing rationalization

public policy public sphere

482

of the lifeworld and, as a result, public life is



managed by the state through its civil servants,

scientists, and experts, rather than through the

informal network of associations in civil society.

Habermas recognized that this situation could

change under the impact of new social movements

which articulate new needs around environmentalism,

sexual identity, animal rights, and

globalization. Habermas’s provocative and broad

analysis of modern society has given rise to a

general debate on new social movements, citizenship,

democracy, and the changing nature of

social participation and political engagement in

civil society, for example in Jean L. Cohen and

Andrew Arato, Civil Society and Political Theory

(1994). BRYAN S. TURNER

public sphere public sphere

483

Q

qualitative data analysis



– see qualitative research.

qualitative research

These methods are comprised of a diverse array

of epistemological orientations (such as positivism,

realism, and social constructionism), data

gathering techniques (for instance participant

observation, interviews, audio and video tape




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