The Independence of Ontario's Public Health Units: Does Governing Structure Matter?

Lyons, Joseph

What follows proceeds in five sections: The first provides some background on Ontario' s public health system and connects the debate over health unit governance with the multilevel governance literature. The second justifies case selection and explains the study' s hypothesis in more detail. The third reports the results of a comparison between the municipal levy and total costshared program spending increases of the MLHU and HPHS with the operating expenditure increases of their main municipal funders. In Ontario, the costs of most public health programs are shared between the province and municipal governments. The MLHU provides services within the City of London and the County of Middlesex, but the City of London is, by far, its biggest municipal funder. The City of Hamilton is HPHS' s only municipal funder. The fifth section discusses the study' s findings. The conclusion discusses the relevance of these findings for decision-makers and in relation to the findings from the literature on multilevel governance.