Community-Based Prevention and Control of Public Health Events: History
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The so-called community is a living community with stable physical boundaries and common value orientation. Compared with the more common definition of the community as a physical carrier, the community has gradually become the dominant tool to deal with public health emergencies in methodology. On the one hand, from the perspective of the physical attributes of the community, as the most normal living place for ordinary people, the community carries the temporary response to the current sudden public crisis. On the other hand, from the perspective of the social attributes of the community, the recessive resources within the community, such as the trust capital within the community, have played an assisting and supplementary role in the recovery of mental health after a public health crisis to a certain extent.

  • bureaucratic coordination
  • data driven
  • public health events
  • community-based prevention and control capacity

1. Introduction

The prevention and treatment of public health emergencies is no longer a simple medical technology issue, but a complex global governance issue. Starting from the case of COVID-19 prevention and control in China, it is of great practical significance to explore the realization process of community-based prevention and control of public health empowered by big data under the guidance of public institutions and clarify the basic characteristics and governance path of public health prevention and control mode of grassroots communities under the established political framework.

2. Community Turn of Public Health Event Prevention and Control

The COVID-19 pandemic, the rampant spread of mutant strains of the virus and the protracted epidemic prevention and control actions indicate that the community prevention and control mode of public health events has shifted from temporary intervention to long-term intervention, which also provides an opportunity for the community turn of prevention and control of public health crises. In the field of public health prevention and control, countries such as the United Kingdom and the United States have established relatively mature community-based public health medical treatment systems and facilitated cultural communication and have generally established community-centered public health participatory research strategies. In terms of community public health research, western countries divide the population of community residents to study the relationship between the political and economic status of different residents and the level of public health. For example, the possible associations between socioeconomic, cultural, lifestyle, genetics, susceptibility, etc., and the pathophysiological manifestations are explored through the data of COVID-19 and previous pandemic infections in the BAME community (Black, Asian and minority ethnic communities). Some scholars have explored the public health prevention and control measures of religious groups through the practice progress of religious communities in carrying out basic public health work . In the field of Chinese governance, the community is not only a living community in the sense of a physical carrier, but also a community department in an administrative sense. However, whether it is the outer edge of any of the above two concepts, the community turn in the prevention and control of public health emergencies is characterized by temporary and transient characteristics to a certain extent. This responsive governance model, which focuses on response and recovery, is characterized by a permanent lag in action over the course of the epidemic.

3. Governance Logic of Community-Based Prevention and Control of Public Health Emergencies

Existing research has summarized two governance logics to deal with the uncertainty of crisis events—decision logic and creation logic. The former presents a top-down responsive governance model. By responding to the social governance needs of crisis events as the core, it is essentially taking corresponding remedial and disposal measures for social crisis problems that have occurred through the bureaucratic coordination mechanism. The latter emphasizes bottom-up technological innovation and systematic application and reduces the uncertainty and harm of risks through crisis early warning. However, if these two governance logics only have a one-dimensional governance tendency, they will present strong governance dilemma and operation limit when facing the public health emergencies with large scale, long duration and wide harm. From the perspective of governance elements, this study refines the governance path of community-based public health event prevention and control through the integration and optimization of risk prevention and control elements.

3.1. Bureaucratic Coordination Model under the Decision Logic

In the process of prevention and control of public health events, the bureaucratic coordination in the context of Chinese government governance mainly adopts “pressure-based system + campaign-styled governance” to realize the optimization of governance elements. Pressure-based system refers to a system model in which lower-level political organizations operate under the pressure of the evaluation system and various indicators formulated by higher-level political organizations. In order to complete the tasks and indicators set by higher-level political organizations, political organizations at all levels will quantify and decompose tasks and indicators and push them down to lower-level political organizations and individuals. Meanwhile, the lower-level political organizations will be assessed, rewarded and punished according to the completion of tasks . The campaign-styled governance mechanism replaces the conventional process with political mobilization, adopts the method of public opinion build-up and comprehensive mobilization to stop the inertia and rhythm of the conventional mechanism, transmits the intentions and signals of the central government to various departments and fields in a short period of time, rectifies “deviations” and standardizes boundaries in the political governance of local governments at all levels so as to avoid the organizational failure of conventional mechanisms. The pressure-based system and the campaign-styled governance mechanism interact and promote each other, so that the bureaucratic coordination governance model shows the institutional advantages, such as the optimal allocation of various governance elements and the efficient completion of governance tasks in the process of public health event prevention and control. Among them, the pressure-based system efficiently mobilizes the enthusiasm, initiative and creativity of lower-level organizations and individuals through a “pressure-driven” model and ensures the completion of tasks and indicators by uniformly allocating people, finance, materials and other governance elements. Campaign-styled governance derives its legitimacy and organizational basis from national movements, which attempts to break down institutional, conventional and professional boundaries and mobilizes needed social resources through strong state mobilization. Campaign-style governance can “mobilize all positive factors” in the optimization of governance elements in the short term to achieve the goal of “concentrating efforts to do major things". In the process of bureaucratic coordination in the prevention and the control of public health events, campaign-style governance is often embedded in a pressure-based system in order to mobilize various governance elements quickly and efficiently.

3.2. Data-Driven Model under the Creation Logic

In the governance of digital age, “data driven” is defined as a data-based management decision-making model . On the one hand, the data-driven model promotes the optimization of governance elements, which in turn promotes the synergy of governance functions. By building a data resource exchange platform, establishing “one-network” services, breaking down “data barriers” and “information islands”, the cross-regional, cross-department and cross-level information sharing and coordination movement of big data resources can be fully promoted, the service process can be optimized, and multi-subject co-governance can be realized. In emergency management, data-driven governance can solve the dilemma of the “data capability gap” in bureaucratic coordination, realize “reconstruction of data capabilities”, break the professional division of bureaucratic coordination through data flow and enhance multi-department coordination in emergency response. On the other hand, data-driven construction of intelligent services improves the scientific and democratic degree of decision making and realizes the precision and intelligence of the governance process in “technical governance”. For example, by using the data technology that captures the management object, it can track and analyze its unique needs so as to realize the refinement and personalization of emergency management.

4. Current Research

Existing studies mainly focus on the evaluation of community-based prevention and control capacity, emergency response effect  and the establishment of the index system of community-based prevention and control capacity of public health events , such as the construction of urban community epidemic prevention and control information governance system, but ignores the research on the generation process of community-based prevention and control capacity of public health events in different prevention and control models. Although existing studies on community-based prevention and control capacity of public health events have focused on the role of key elements in emergency management on capacity building, for example, some scholars have analyzed early warning management behaviors and key factors in major public health emergencies, revealing the building elements of early warning management capacity, and some scholars have proposed to establish community solutions related to the driving factors affecting healthy society , but studies rarely analyze the generation process and internal mechanism of community-based prevention and control capacity of public health events from specific governance fields, and mainly focus on the static analysis of the community-based prevention and control capacity building of public health events, which is difficult to reveal the internal law of capacity building.

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