Governance
About
Governance is the process of decision-making by institutions charged with managing economic, political and social affairs, and the process by which decisions are implemented or not. Governance decisions set strategic direction and objectives; make policies, laws, rules, or regulations; raise and deploy resources to accomplish strategic goals and objectives; and ensure that strategic goals and objectives are accomplished.
Relationship to health and equity
Decision-makers in public and private institutions guide many social, economic and physical factors that influence health. For example, decisions about how communities are designed have often not included the perspectives of those most impacted. State and local decisions to prioritize investments in roads and highways that promote car use instead of human-level activity decreased exercise and increased air pollution. Many cities carry the legacy of government and planning department decisions that destroyed communities of color by constructing highways in the heart of those neighborhoods. The impacts of the decisions could be different if a different governance process was used.
When decision makers put values such as effectiveness, integrity and competence into practice, it increases the likelihood that decisions will lead to positive outcomes.
Relationship to systems and structures
People leading institutions govern to make decisions about institutional practices, laws and policies. Congress used the filibuster, a governance tool, in the 1920s to delay the official vote on an anti-lynching bill. During the 1950s and 1960s, the Senate had to overcome multiple filibusters by Southern Democrats who obstructed passage of the Civil Rights and the Voting Rights Acts.
Corporate leaders have a lot of power over our economy and over government decisions – more power than civil society. As a result, many laws, policies and practices favor economic growth and profit at the expense of health and safety.
We can organize and build power together to demand change to previously harmful governance decisions and push for governance decisions that help everyone thrive in our society.
Additional Reading
- Heller, J. C., Givens, M. L., Johnson, S. P., & Kindig, D. A. (2024). Keeping it political and powerful: Defining the structural determinants of health. Milbank Quarterly, 102(2), 351-366. https://doi.org/10.1111/1468-0009.12695
- Reft, R. (2023, January 19). We mythologize highways, but they’ve damaged communities of color. Washington Post. https://www.washingtonpost.com/made-by-history/2023/01/19/interstate-highways-black-neighborhoods/
- Bedekovics, G. (2024). How the racist history of the filibuster lives on today. Center for American Progress. https://www.americanprogress.org/article/how-the-racist-history-of-the-filibuster-lives-on-today/