ADAPTIVE GOVERNANCE FOR HEALTH AND SOCIAL EQUITY: A CASE STUDY OF HANGZHOU'S XIAOYING ALLEY

A CASE STUDY OF HANGZHOU'S XIAOYING ALLEY

Abstract

By 2050, 68% of the world's population will be living in cities (United Nations, 2019). The sprawl of cities has raised concerns about environmental pollution, health inequalities, and many other health issues (Burris et al., 2007; Corburn, 2009). Governance is generally considered as the interaction and decision-making process in which government, market, and civil society work together to deal with public affairs (Rhodes, 1997; Healey, 2006), and identified to be an important approach in health promotion and health inequality issues (Kickbusch & Buckett, 2010). To address various health challenges, there has been an increasing number of studies in recent years that focus on how urban governance can be adapted in the health domain.

Existing research is mainly rooted in Western countries, with less discussion on China's system and focuses mainly on the macro level, with a lack of attention to grassroots communities. This paper explores the adaptive governance process of a Chinese community in the health domain to bridge the gap. Adaptive governance originated in the field of environmental governance field as a strategy for regulating the social conflict in the management of complex ecosystems and aims to examine how different agents respond to highly complex and rapidly changing governance contexts (Chaffin et al., 2014; Folke et al., 2005). This paper conducts a case study based on the Xiaoying Alley community in Hangzhou. In 1958, Chairman Mao Zedong inspected the Patriotic Health Campaign in Xiaoying Alley, and since then the community has been famous for its health promotion work in China for a long time and was approved as a healthy community by the World Health Organization in 2013. The poor built environment and aging population bring many challenges to the community's health governance, and there are more health inequities than in other communities. The case study helps us understand how grassroots communities in the Chinese context mobilize a variety of actors to govern from a relatively poor conditions to promote health and reduce health inequities. This paper employs a policy arrangement framework to examine the characteristics of its health governance mode and its shifts in different phases and summarizes the main findings of this paper.