publications

Despite widespread participation in the International Health Regulations (2005) and coordinated efforts by various stakeholders to increase surveillance capacities of states, why do some states continue to delay reporting novel disease outbreaks to the World Health Organization? I argue that the target of disease blame attribution by the domestic public of the reporting state matters. When a state perceives the likely target of disease blaming by the public to be externally facing towards the “other,” namely foreign nationals, they will be more likely to report a disease outbreak. However, this effect is conditional on whether there is internal domestic opposition within the incumbent government. I argue that presence of domestic opposition affects the persuasiveness of the “other” blaming. I analyze data from the World Health Organization’s Disease Outbreak News reports to identify how the size of a foreign population within a state increases the rate of reporting. But, when there are internal divisions within the incumbent government, the size of a foreign population within a state decreases the rate of reporting. The findings highlight that, beyond legal obligations under international treaties and improvements in surveillance capacity, domestic blame attribution dynamics significantly impact global health coordination efforts.

Armed conflict poses a major threat to child health, and growing research highlights how political and social structures may moderate its effects, though the full range of relevant effect modifiers remains incompletely understood. This study examines how the relationship between conflict severity and under-5 mortality rates varies depending on patterns of ethnic political representation. Using data from 99 countries from 2000 to 2017 at the first administrative level (ADM1), it tests the hypothesis that conflict severity has a stronger adverse effect on child mortality where ethnic groups that lack political representation reside. Multivariate linear regression models with ADM1 and year fixed effects provide evidence that lack of ethnic political representation operates as an effect modifier of the conflict-mortality relationship. The results remain robust across alternative measurements, covariates, model specifications, and matching techniques. These findings contribute to understanding how political inequality shapes the health consequences of conflict, with implications for both conflict-affected health interventions and policies addressing political representation.