Joseph Harris | Asst. Professor - Sociology - Boston University | Joseph Harris - Sociology of Global Health Research
global health research, joseph harris research, boston university, sociology research, global health sociology, politics of health policy, universal coverage research
Joseph Harris is a political sociologist who uses comparative historical methods to gain leverage on problems relevant to global health and development.
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Research

I am political sociologist who uses comparative and historical methods to gain leverage on problems relevant to global and transnational sociology; medical sociology; the sociology of development; and the sociology of human rights. My research interests lie at the intersection of sociology, political science, public health, and public policy. My articles have been featured in the Lancet; the Journal of Health Politics, Policy, and Law; Health Policy and Planning; Contemporary Sociology; the Journal of Contemporary Asia; Citizenship Studies; and The Journal of Peacebuilding and Development.

Four distinct lines of inquiry have animated my research agenda:

Politics of Health Policy in the Industrializing World

My book – Achieving Access: Professional Movements, Politics, and the Struggle for Health Universalism (Cornell University Press 2017) – explores the puzzle of how and why industrializing countries are making expensive commitments to universal healthcare and costly treatment for HIV/AIDS. My work draws out the surprising role played by elite members of esteemed professions – frequently doctors and lawyers – who draw on the offices of the state and legal expertise to forge progressive change on behalf of those in need in the face of broader professional dissent in Thailand, Brazil, and South Africa. The relative success of these “professional movements” in Thailand and Brazil and failure in South Africa highlights critical differences in the character of democratic transition and offers lessons for the United States.

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As Specialist on the Political Economy of Health Reform, I contributed knowledge to Universal Coverage for Inclusive and Sustainable Development: A Synthesis of 11 Country Case Studies. This landmark report was significant for two main reasons. First, it was one of the very first World Bank reports on universal health coverage in the industrializing world and marked a shift within the World Bank in support of universal health coverage policy. Second, rather than focusing solely on the technical aspects of policy, the report explicitly examined the political economy of universal coverage policy. As such, it was the first World Bank report of its kind to do so. The findings of the summary report were also published in this Lancet article.

My research has also explored the unintended consequences of universal coverage policy. The passage of Thailand’s universal coverage reform as a law – widely considered to be a model for the industrializing world – redrew eligibility criteria along the lines of citizenship, paradoxically disenfranchising stateless people who had enjoyed access to state healthcare programs previously and creating a major public health problem for Thailand.

I have also explored the response of the BRICS nations (Brazil, Russia, India, China, and South Africa) to the HIV/AIDS epidemic. While we found that collaborative state-civil society relations produced an aggressive response and successful outcomes in Brazil, democratic openness and state-civil society engagement has not necessarily correlated with an aggressive response or better outcomes in the other cases.

Another manuscript examines the politics of expanding access to healthcare to the poor and people in the informal sector in six high-profile cases in the industrializing world. The findings challenge existing explanations for social policy expansion and have implications for power resources theory and literature on the 21st century developmental state.

State Capacity, Bureaucratic Autonomy, and the Developmental State

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While the notion of ”regulatory capture” is typically used to describe the takeover of state agencies by outside interest groups that seek to weaken regulation for private gain, I argue that this concept can be contrasted with that of ”developmental capture” of state agencies by networks of reformist bureaucrats within the state who seek to promote inclusive state social and developmental policies of benefit to the broader populace. Arguing that existing explanations for Thailand’s universal coverage policy are insufficient, I suggest that this concept has broader relevance beyond the case of health policy in Thailand.

Another project distinguishes “developmental capture” from the classical concept of “bureaucratic autonomy.”

While we frequently assume that bureaucratic autonomy will be directed towards developmental purposes, empirical evidence suggests organizational contexts in the industrializing world should not predispose autonomous bureaucrats to promote broadly inclusive developmental policies and projects. So what explains why autonomous bureaucrats pursue development then when their organizational environments should not predispose them to do so? This paper in progress explores the conditions that lead bureaucratic autonomy to be directed towards development.

Another project examines some of the core claims of the literature on the 21st century developmental state on HIV/AIDS policy in light of the evolving political context in Thailand and China.

The Emergent Sociology of Global Health

What is the sociology of global health? Worldwide concern with “global health” has grown substantially in recent decades. Since the early 1980s, nearly 80 million people have been infected by HIV/AIDS. And between 1990 and 2005, development assistance for health multiplied from $2.5 million to $14 billion. At the same time, academic interest in global health has skyrocketed with schools, degrees, and certifications now devoted to the topic. How has American sociology engaged with the problems of global health? What does the emerging sociology of global health look like?

I am involved in three projects in this research area. One project uses content analysis and interviews with elites in the discipline to understand the role that medical sociology has played in the problems of global health over the past 30 years.

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A second project aims to open new research pathways and questions through the production of a literature review on the emergent sociology of global health. A third project explores the reasons for reluctant engagement by the social science disciplines in contemporary global health debates.

Diffusion from the Global Periphery

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Models of policy diffusion typically imagine policy models moving in top-down fashion from leading nations and international financial institutions to the global periphery. Recent work has explored global norm making as an iterative process, showing how deviations at the national level can feedback and reshape global norms. Other work in this area has examined policy innovations in the Global South, such as conditional cash transfers (CCTs), and their diffusion internationally. One project in this area explores how national models in the Global South have influenced the creation of new global norms related to healthcare provision. This paper presents a new model of global norm making that explains the transformation of neoliberal norms around healthcare provision to universalistic ones and has relevance for other cases.

Despite being a tiny nation on the global periphery, Thailand has earned international praise for its approach to a multitude of public health issues, ranging from tobacco and HIV control to access to essential medicine and universal coverage. In so doing, it has exercised outsized influence internationally on policies critical to human life, leading other countries to look to the Thai model. How has a tiny nation on the global periphery exercised such outsized influence in public health? This Fulbright-funded project examines the diffusion of Thai public health models in policy areas critical to human life from the global periphery to other nations.

If you’d like a copy of an article but do not have access, please contact me or check Researchgate or Academia.edu.