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COMPARATIVE HEALTH SYSTEMS
A Global Perspective
SECOND EDITION
Edited by
James A. Johnson, PhD, MPA, MSc
Medical Social Scientist and Professor
School of Health Sciences
Central Michigan University
Mount Pleasant, Michigan
and
Visiting Professor
St. George’s University
Grenada, West Indies
Carleen H. Stoskopf, ScD, MS
Professor and Chair
Health Management and Policy
San Diego State University
San Diego, California
Leiyu Shi, Dr PH, MBA, MPA
Professor
Bloomberg School of Public Health
Johns Hopkins University
and
Director
Johns Hopkins Primary Care Policy Center
Baltimore, Maryland
JONES & BARTLETT
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Cover Printing: RR Donnelley
Library of Congress Cataloging-in-Publication Data
Names: Johnson, James A., 1954- editor. | Stoskopf, Carleen H. (Carleen Harriet), 1953- editor. | Shi,
Leiyu, editor.
Title: Comparative health systems : a global perspective / [edited by] James Johnson, Carleen Stoskopf,
Leiyu Shi.
Other titles: Comparative health systems (Johnson)
Description: Second edition. | Burlington, MA : Jones & Bartlett Learning LCC, [2018] | Includes
bibliographical references and index.
Identifiers: LCCN 2016054758 | ISBN 9781284111736 (paper back)
Subjects: | MESH: Delivery of Health Care—organization & administration | Health Policy | Internationality
| Cross-Cultural Comparison
Classification: LCC RA441 | NLM W 84.1 | DDC 362.1—dc23 LC record available at
https://lccn.loc.gov/2016054758
6048
Printed in the United States of America
21 20 19 18 17 10 9 8 7 6 5 4 3 2 1
To Elizabeth
June 19, 1989 – March 29, 2014
Drawing by Elizabeth Johnson, University of Montevallo, ’13.
-J.A.J.
© Matvienko Vladimir/Shutterstock
Contents
Acknowledgments
Foreword by Drs. David and Kathleen Jordan
Foreword by Dr. Ted Karpf
Preface by Dr. James A. Johnson
Contributors
About the Editors
PART I Global Health and Health Systems
Chapter 1 Introduction to Health Systems
Introduction
Conclusion
Chapter 2 Global Health and Disease
Introduction
Burden of Disease
Noncommunicable/Chronic Diseases
Zoonotic Infections
Public Health and Healthcare Services
Chapter 3 Global Health Systems Politics, Economics, and Policy
Introduction
How to Think About Health Policymaking—Micro and Macro Models
Possible Responses to the Convergence of Policy Problems
The Nature of National Health Tradeoffs, Ideology, and Ethics
Conclusion: Health Policymaking Around the World—Uncertain Times and Futures
Chapter 4 Role of International Organizations in Health Systems
Introduction
Intergovernmental Organizations
Nongovernmental Organizations
PART II Health Systems by Country
The Americas Region
Chapter 5 United States
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Healthcare System
Conclusion
Chapter 6 Canada
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Healthcare System
Current and Emerging Issues and Challenges
Conclusion
Chapter 7 Mexico
Country Description
Brief History of the Healthcare System
Chapter 8 Peru
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Chapter 9 Brazil
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evolution of the Healthcare System in Brazil
Current and Emerging Issues and Challenges
European Region
Chapter 10 United Kingdom
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Healthcare System
Current and Emerging Issues and Challenges
Chapter 11 France
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Healthcare System
Current Issues in Healthcare
Chapter 12 Germany
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Healthcare System
Quality
Access
Current and Emerging Issues and Challenges
Chapter 13 Ireland
Country Description
Brief History of the Healthcare System
Evaluation of the Healthcare System
Chapter 14 Russia
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Health System
Current and Emerging Issues and Challenges
Middle East and Africa
Chapter 15 Turkey
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Health System
Emerging Challenges
Chapter 16 Jordan
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Healthcare System
Current and Emerging Issues and Challenges
Chapter 17 Israel
Country Description
History of Country
Size and Geography
Government and Political System
Macroeconomics
Demographics
Healthcare System in Israel: Organization, Financing, and Delivery
Emerging Challenges and Opportunities
An Integrated Healthcare System
Israeli Leadership in Global Health
Summary
Chapter 18 Ghana
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Healthcare System
Current and Emerging Issues and Challenges
Chapter 19 Nigeria
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Current Healthcare System
Current and Emerging Issues and Challenges
Chapter 20 Botswana
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Healthcare System
Current and Emerging Challenges
Asia and Pacific Region
Chapter 21 Bangladesh
Country Description
Brief History of the Healthcare System
Chapter 22 India
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Healthcare System
Current and Emerging Challenges and Opportunities
Chapter 23 China
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Current Healthcare System
Current and Emerging Issues and Challenges
Chapter 24 Japan
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Healthcare System
Current and Emerging Issues and Challenges
Chapter 25 Korea
Country Description
Introduction
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Healthcare System
Current and Emerging Issues and Challenges
Chapter 26 Australia
Country Description
Brief History of the Healthcare System
Description of the Current Healthcare System
Evaluation of the Healthcare System
Current and Emerging Issues and Challenges
PART III Challenges, Innovations, and Opportunities
Chapter 27 Small Country Innovations
Introduction
Cuba
Singapore
Taiwan
The Netherlands
Costa Rica
Concluding Commentary
Chapter 28 Health Systems in Crisis and Disaster
Introduction
Geophysical Disasters
Biological Events
Climate Events
Health Systems Response
Conclusion
Chapter 29 Comparative Global Challenges and Opportunities
Introduction
International Health Policy, Globalization, and Privatization
Decentralization
Health Care as an Increasing Portion of GDP
Injuries and Violence
Mental Illness
Aging Population
Environmental Impact/Climate Change
Refugees, Displaced People, and Humanitarian Crises
Glossary of Health Systems Terms
Index
© Matvienko Vladimir/Shutterstock
Acknowledgments
We would like to thank all of the authors from around the world for their invaluable and insightful
contributions to this book. We also want to thank Danielle Bessette for her exceptional job and hard work
as associate editor. Danielle brought her own perspectives and much appreciated professionalism to this
project, often serving in the valued role of fourth editor. We also want to thank George Jacob and Athena
Lakri for their valuable and skillful input. Additionally, we thank Michael Brown of Jones & Bartlett
Learning for his support as we worked our way through this multifaceted international undertaking.
© Matvienko Vladimir/Shutterstock
Foreword
Drs. David and Kathleen Jordan
As we write this foreword, we are viewing a world with global climate change, income inequalities, gaps in
educational opportunities for girls, societal unrest, and an unprecedented number of refugees who are
seeking personal and economic safety from war-torn regions from around our world. Any of these social
determinants has a direct effect upon the health of individuals in every corner of the globe—from the
remote steppes of Mongolia to the bourgeoning urban settings in South America and Asia. Health care is
no longer a local or even a national phenomenon; it is a global network of disparate groupings of
practitioners, systems, facilities, governmental funding approaches, non-governmental organizations,
shamans, midwives, technological wonders, and cultural beliefs. To attempt to understand the myriad
aspects of global health care is akin to unraveling the untold mysteries of human DNA and the very
essence of what makes us human.
Understanding global health systems, outcomes, and practices is a complex and multidimensional
exercise worthy of social scientists capable of grasping both the balcony views and the ground-level
realities of the social determinants that affect the health of the world’s 7.4 billion men, women, and
children. Dr. James Johnson is one such individual who has spent a lifetime attempting to make sense of
the multiple metrics which contribute to our understanding of global health systems. This latest edition of
Comparative Health Systems provides an important reference for practitioners, scholars, academics,
researchers, and students whose work rests in understanding global health care.
We are social entrepreneurs, college educators, and health and human service executives and are deeply
invested in addressing economic, social, and healthcare outcomes in underresourced countries around
the world. We work in areas of the developing world where natural and child mortality rates are
frustratingly high.
The second edition of Comparative Health Systems, edited by James Johnson, Carleen Stoskopf, and
Leiyu Shi, offers one of the few comprehensive sources of both statistical information and anecdotal
narrative behind the data. This new edition will replace our current dogged-eared copy of the first edition
and will gain its new place in our library bookshelf in the years to come. It is—much like James himself—a
treasure to us both. He has been an invaluable mentor, former professor, and trusted friend over the
years.
If you are a student trying to broaden your understanding of global health, a practitioner researching
information on a country in which you may work, or a researcher attempting to understand the dynamics
associated with health care around the globe, this is the text you need in your backpack, your office, or in
the hands of your students.
—Dr. David A. Jordan and Dr. Kathleen M. Jordan
Founder/President (David) and
Executive Vice President (Kathleen)
Seven Hills Foundation
© Matvienko Vladimir/Shutterstock
Foreword
Dr. Ted Karpf
This is a most timely book. Drs. Johnson, Stoskopf, and Shi have anticipated and documented the core
concerns faced by nations. Health and health care are at the forefront of international concern, especially
in a time of global financial turmoil and insecurity. This book is absolutely essential to understanding
what’s at stake and to charting a path through the maze of issues confronting healthcare planners and
healthcare recipients, healthcare professionals and financing managers, politicians, and bureaucrats. It’s
more than a matter of systems and approaches; it is about the security of the global community.
According to Dr. Margaret Chan, director-general of the World Health Organization:
Healthy human capital is the very foundation for productivity and prosperity. Equitable distribution of health care and equity in the
health status of populations is the foundation for social cohesion. Social cohesion is our best protection against social unrest,
nationally and internationally. Healthy, productive, and stable populations are always an asset but they must especially be so during
a time of crisis.
The recipients of health care must be heard above the din of competing claims of equity and
effectiveness:
The people have the right and duty to participate individually and collectively in the planning and implementation of their health care.
Primary health care… requires and promotes maximum community and individual self-reliance and participation in the planning,
organization, operation, and control of primary health care, making fullest use of local, national, and other available resources; and
to this end develops through appropriate education the ability of communities to participate.” (Declaration of Alma-Ata International
Conference on Primary Health Care, Articles IV and VII, Alma-Ata, Khazakhstan, USSR, September 6–12, 1978)
Obtaining decent care, which acknowledges the voice of the people through the values of agency and
dignity, interdependence and solidarity, subsidiarity and sustainability, raises the ante a bit higher.
Political and healthcare leaders, financial managers, and medical and healthcare professionals must be
reminded amidst the policy debate that when the people are invested in their own care, the formulas for
success and sustainability change. When the people are engaged in determining the levels and resource
allocations for care, there is also more decision latitude than those charged with determining formulas can
imagine.
The healthcare debate must finally factor in the people who it claims are to be served and sustained with
improved health. Then the various financial models and healthcare systems will still not bring us the longneeded satisfaction and support we need today. Nobel Laureate and former U.S. president Barack
Obama stated repeatedly that “health care is a right.” This notion, enshrined three decades ago at AlmaAta, changes the rules and reorganizes the lines of accountability along with our thinking and
expectations. Where health is a right, social responsibility will lead to an enhanced commitment to
improved health. The formula ceases to be about “those people” or “their problems” and becomes about
us!
As we proceed through these pages it will be important to ask how this approach will help ensure that the
people are heard and heeded.
—Dr. Ted Karpf
International health advocate (retired),
World Health Organization, and author of
the book Restoring Hope: Decent Care
in the Midst of HIV/AIDS
© Matvienko Vladimir/Shutterstock
Preface
Dr. James A. Johnson
Over the past two decades, I have taken graduate students to Geneva, Switzerland, each summer to
study global health. While there, we always spend time at the World Health Organization (WHO), which is
receiving updates on global health and interacting with senior scientists, health practitioners, and leaders
in the mission of “health for all.” In addition to being spellbound by descriptions of the many initiatives and
great successes of the WHO, we repeatedly hear of one major limitation that continues to impede even
the greater progress. That is the poor state of health systems in many parts of the world. There are
models of success as well as models of failure. Most health systems are oriented toward disease care,
and many are underfunded and understaffed, whereas some countries expend large portions of their
national resources on health. Some health systems are operated by governments, and others are more
involved in the private sector. Regardless of scope or scale, every program, every initiative, every policy,
and every course of treatment are imbedded within a particular country-specific health system.
Several years ago, my friend and colleague Dr. Carleen Stoskopf joined me on one of the trips to
Geneva. While there, we discussed the need for a book that would describe a range of health systems so
that students could better understand the limitations and opportunities offered in the diversity that we had
each seen in our own international work. We felt that one of the best ways for students to learn about the
range of systems would be through comparative study. As with many invigorating sidewalk café
conversations in Europe (and elsewhere), we set this idea aside and returned to the busy activities of our
academic positions at the time—Carleen, a department chair at the School of Public Health at the
University of South Carolina in Columbia, South Carolina, and myself, a department chair at the Medical
University of South Carolina in Charleston. A few years later, however, at a meeting of the American
Public Health Association in Boston, in a conversation with publisher Michael Brown, the topic came back
up and momentum for such a book grew quickly.
We conceptualized the book as a text to be used in courses in international health, comparative studies,
global health, international affairs, health administration, and public health. In an increasingly
interconnected and interdependent world comprised of wide variations in health delivery systems,
practices, and policy, the book was developed to offer students some understanding through comparative
study.
In seeking to achieve this goal, we enlisted contributors from many countries to write about the systems
that they had worked in and were familiar with. Thus, every chapter that describes a health system is
written by at least one person from that country. Chapters also ended up having U.S.-based coauthors
because we used our own professional networks in schools of public health, medicine, administration,
and policy to identify chapter contributors. Needless to say, the book project emerged as a significant
multicultural undertaking involving authors from every continent and from the largest possible range of
health system types. This led to the publication of the first edition of Comparative Health Systems: Global
Perspectives in 2010.
Over five years later, we were asked by the publisher to write the Second Edition. For this undertaking, I
asked another friend and colleague that goes back to our South Carolina days to join Carleen and me.
This third editor is Leiyu Shi, now at Johns Hopkins University. He brought his usual high energy and
global viewpoint to the project.
Following the conceptual structure of the First Edition, we continued to use the framework Carleen and I
had previously developed. This framework for each chapter allows students to compare and contrast such
divergent systems as Canada, India, Japan, Nigeria, Germany, Australia, Mexico, and many others. The
framework used to develop each chapter country focused includes the following:
Country Description
History
Size and geography
Government and political system
Macroeconomics (GDP, OECD)
Demographics (including religion, gender, and poverty)
Brief History of the Healthcare System
Description of healthcare system
Facilities
Workforce
Technology and equipment
Evaluation of the Healthcare System
Cost
Quality
Access
Current innovations and emerging challenges
Although these chapters were developed by in-country authors and their collaborators, additionally,
working with colleagues, we developed other chapters that are overarching. This includes a chapter that
describes health systems and one that provides an overview of disease. Dr. Walter Jones contributed a
very useful chapter discussing health policy and economics. My son, Dr. Allen Johnson, and coauthors
contributed a chapter describing the role of non-governmental organizations (NGOs) as an important,
though sometimes overlooked, component to health systems and global health. Dr. Caren Rossow and I
also added a chapter on health systems in crisis and disaster response. Additionally, Carleen and I
included a chapter that outlines future challenges. There is also a glossary of health systems terms that
should be useful to students and professors.
Having worked in or traveled to over 45 countries myself, I can say with great confidence that this book
will serve to broaden the reader’s understanding. It will also likely change their perspectives on global
health. They will learn that although highly developed countries continue to offer profound breakthroughs
in medical science and technology, as well as reform and continuous improvement of health systems, the
best solutions do not always emerge in the wealthiest countries. In the Harvard International Review, Dr.
Vanessa Kerry, founder and CEO of Seed Global Health, stated “I think the most important thing is for
people to realize that to be in global health, you can come from any field or background. In order to have
an impact on global health, we need to, again, realize that there is a fundamental breakdown of the
system on any number of levels in different countries.”
As stated by Dr. Barry Bloom, former dean of the Harvard School of Public Health, the huge disparities in
health that exist between countries remain some of the great moral and intellectual problems of our time.
This book can serve as one tool among many that will be needed to empower students to become
change agents in this ongoing challenge.
—Dr. James A. Johnson
© Matvienko Vladimir/Shutterstock
Contributors
Musah Sugri Alhassan, MSA
Ghana National Association of Teachers—GNAT
Tamale, Ghana
Stephanie Baiyasi, DVM
University of Denver
Denver, Colorado, United States
Antonio Pires Barbosa, PhD, MD
Universidade Nove de Julho
São Paulo, Brazil
Steven D. Berkshire, EdD, MHA, FACHE
Central Michigan University
Mt. Pleasant, Michigan, United States
Raul Chiquiyauri, MD, MPH, PhD
Centro de Investigación de Enfermedades Tropicles
Instituto Nacional de Salud
Sede Iquitos, Peru
Omur Cinar Elci, MD, PhD
St. George’s University School of Medicine
True Blue, Grenada
Maria Creavin, RD, SM, MAS
Central Michigan University
Mount Pleasant, Michigan, United States
Mark Anthony Cwiek, JD, MHA
Central Michigan University
Mount Pleasant, Michigan, United States
Gary E. Day, DHSM, MHM, RN, EM, FGLF, FCHSM
School of Medicine, Griffith University
Southport, Queensland, Australia
José Delacerda-Gastelum, PhD, MILR
ITESO University
Guadalajara, Mexico
Linda F. Dennard, PhD
Auburn University Montgomery
Montgomery, Alabama, United States
James E. Dotherow IV, MPA
So They Can (NGO)
Babati, Tanzania
Mazwell Droznin, BA
Rollins College
Winter Park, Florida, United States
R. Paul Duncan, PhD, MS, BA
University of Florida
Gainesville, Florida, United States
Sharon R. Elefant, DHAc,
Central Michigan University
Mt. Pleasant, Michigan, United States
Harry Flaster, MD
University of Washington Medical Center
Seattle, Washington, United States
Leonard Friedman, PhD, FACHE
George Washington University
Washington, DC, United States
Lesego Gabaitiri, PhD, ScM, MSc, BA
University of Botswana
Gaborone, Botswana
Sheyna Gifford, MD, M.Sc., MA, MBA
St. Louis Science Center
St. Louis, Missouri, United States
Octavio Gomez-Dantés, MD, MPHA
Carso Health Institute
Mexico City, Mexico
Mikiyasu Hakoyama, PhD
Central Michigan University
Mt. Pleasant, Michigan, United States
Whiejong M. Han, PhD
University of South Carolina
Columbia, South Carolina, United States
Umar Haruna, PhD, MPhil
University for Development Studies
Upper West, Ghana
Kuo-Cherh Huang, DrPH, MBA
Taipei Medical University
Taipei, Taiwan
Manzoor Hussain, MBBS, FRCP, FRCPCH
Bangladesh Institute of Child Health
Dhaka, Bangladesh
Styn M. Jamu, DHA, MPA
Stepping Stones International
Gaborone, Botswana
Allen Johnson, DrPH, MPH
Rollins College
Winter Park, Florida, Untied States
Walter J. Jones, PhD, MHSA, MA
Medical University of South Carolina
Charleston, South Carolina, United States
Kalu Kalu, PhD, MBA
Auburn University Montgomery
Montgomery, Alabama, United States
Bernard J. Kerr Jr., MHA, MBA, MPH, MIM, EdD, FACHE
Central Michigan University
Mt. Pleasant, Michigan, United States
Sophie Kobouloff, DHA, MBA, EDHEC MBA
Saddle Implant Technologies
Geneva, Switzerland
Hailun Liang, MS
Johns Hopkins School of Public Health
Baltimore, Maryland, United States
Gerald Ledlow, PhD, MHA, FACHE
University of Texas Health Science Center Northeast
Tyler, Texas, United States
Osnat Levtzion-Korach, MD, MHA
Hadassah Medical Center
Jerusalem, Israel
Marcus Longley, PhD
Welsh Institute for Health and Social Care
University of South Wales
Pontypridd, Wales, United Kingdom
John Lopes, Jr., DHSc, PA-C
Central Michigan University
Mt. Pleasant, Michigan, United States
Ning Lu, PhD, MPH
Governors State University
University Park, Illinois, United States
Hala Madanat, PhD, MS
San Diego State University
San Diego, California, United States
Linda A. McCarey, MS, BSN, RN
Haliburton, Kawartha, Pine Ridge Health Unit
Haliburton, Ontario, Canada
John E. McDonough, DrPH, MPA
Harvard University
Cambridge, Massachusetts, United States
Hani Michel Samawi, PhD, MS
Georgia Southern University
Statesboro, Georgia, United States
Amal K. Mitra, MD, MPH, DrPH
Jackson State University
Jackson, Mississippi, United States
Michael E. Morris, PhD, MPH, MPA
University of Florida
Gainesville, Florida, United States
Adrienne Nevola, MPH
University of Arkansas
Fayetteville, Arkansas, United States
Marcia Cristina Zago Novaretti, PhD, MD
Universidade Nove de Julho
São Paulo, Brazil
Qwolabi Ogunneye, MD, FRCP, FASN
Covenant Healthcare
Saginaw, Michigan, United States
Yetunde Ogunneye, MD, DHAc, MPH
Central Michigan University
Mt. Pleasant, Michigan, United States
Elena A. Platonova, PhD, MHA
University of North Carolina, Charlotte
Charlotte, North Carolina, United States
Hugo Rodriguez, MD, MPH
Hospital Iquitos
Iquitos, Peru
Caren Rossow, DHA, MSA, RN, FACHE
Indiana University
South Bend, Indiana, United States
Alexander V. Sergeev, MD, PhD, MPH
Ohio University Department of Social and Public Health
Athens, Ohio, United States
Neelam Sharma, MD
Newark-Wayne Community Hospital
Newark, New Jersey, United States
Hatice Simsek, MD, PhD
Dokuz Eylül University School of Medicine
İzmir, Turkey
Douglas A. Singh, PhD
Indiana University, South Bend
South Bend, Indiana, United States
James H. Stephens, DHA, MHA
Georgia Southern University
Statesboro, Georgia, United States
Reyhan Ucku, MD, MPH
Dokuz Eylül University School of Medicine
Izmir, Turkey
Stalin Vilcarromero, MD, MPHc
Naval Medical Research
Iquitos, Peru
Matthew W. Walker, DrPH, MPH
U.S. Food and Drug Administration
Silver Spring, Maryland, United States
Sudha Xirasagar, PhD, MBBS
University of South Carolina
Columbia, South Carolina, United States
Kapil Yadav, MD
Tulane University
New Orleans, Louisiana, United States
© Matvienko Vladimir/Shutterstock
About the Editors
James A. Johnson, PhD, MPA, MSc, is a medical social scientist and professor of health administration
and international health at the Dow College of Health Professions, Central Michigan University, and
visiting professor at St. George’s University, Grenada, West Indies. He was previously chairman of the
Department of Health Administration and Policy at the Medical University of South Carolina. Dr. Johnson
teaches courses in health organization development, international health, systems thinking, and
comparative health systems. His publications include over 100 journal articles, most of which are peer
reviewed, and 15 books on a wide range of healthcare and organizational issues. His most recent books
include Public Health Administration: Principles of Population-Based Management; Introduction to Public
Health Management, Organizations, and Policy; Multisector Casebook in Health Administration,
Leadership, and Management; and Organizations: Theory, Behavior, and Development. He is also
coeditor of the widely used Handbook of Health Administration and Policy. Dr. Johnson has also served
as editor of the Journal of Healthcare Management, published by the American College of Healthcare
Executives; editor of the Journal of Management Practice; and founding editor of the Carolina Health
Services and Policy Review. He is a contributing editor for the Journal of Health and Human Services
Administration. He has served on the Board of Directors for the Association of University Programs in
Health Administration and the Scientific Advisory Board of the National Diabetes Trust Foundation. Dr.
Johnson has worked and traveled in 45 countries, including Tanzania, Zimbabwe, South Africa, Nepal,
China, Belize, Peru, Ethiopia, Turkey, and Mexico and has lectured at Oxford University (England),
University of Dublin (Ireland), Beijing University (China), and University of Colima (Mexico). He also works
on projects with the WHO and the Belize-based NGO, Heart to Heart and is active in the Organization
Development Institute. He completed his PhD in 1987 at the Askew School of Public Policy and
Administration at Florida State University and his MPA in health administration at Auburn University.
Carleen H. Stoskopf, ScD, MS, is Professor of Health Management and Policy and Division Head in the
Graduate School of Public Health at San Diego State University, where she also served as School
Director for 7 years. Dr. Stoskopf held academic appointments at the Arnold School of Public Health at
the University of South Carolina for 19 years, advancing to Chair of the Department of Healt
