路径依赖、关键节点与近代广州公共卫生制度变迁——基于历史制度主义的分析

Path Dependence,Critical Juncture and Changes in Modern Guangzhou’s Public Health Institution——Based on the Analysis of Historical Institutionalism

公共卫生制度是近代广州城市管理制度体系的重要组成部分,历史主义为我们认识其发展变迁的制度逻辑提供了理论视角。广州公共卫生制度变迁分为传统城市卫生制度路径锁定和近代公共卫生制度突变两个时期,传统城市卫生管理虽然制度设计不完善,逐渐与社会发展不相适应,但是由于其在时间序列上占优,并在治理中不断强化,因此造成了城市卫生治理中的路径依赖。1894年的特大鼠疫成为广州公共卫生制度变迁的关键节点,为了应对鼠疫带来的严重危机,政府开始承担城市公共卫生管理,开启了近代广州公共卫生制度的一系列突破。通过对两个时期的制度环境、行动者和制度安排进行分析,可以清晰地看出近代广州公共卫生制度变迁的轨迹。由政府主导的公共卫生制度变迁凸显了国家管理的特征,在一定程度上达成了城市的卫生治理。

Public health institution is an important part of modern urban management system in Guangzhou, and historicism provides a theoretical perspective for us to understand the institutional logic of its development and changes. The changes of public health system in Guangzhou can be divided into two periods: the path locked-in of traditional urban health institution and the sudden change of modern public health institution. The institution design of traditional urban health management was not perfect, and it gradually failed to adapt to social development. However, due to its advantages in time series and continuous reinforcement in governance, it caused path dependence in urban health management. The great plague outbreak in 1894 became a critical juncture in the changes of public health institution in Guangzhou. In order to cope with the severe crisis caused by the plague, the government began to take charge of urban public health management and make a series of breakthroughs in modern Guangzhou s public health institution. Through the analysis of the institutional environment, actors and institutional arrangement of the two periods, the track of the changes of public health system in modern Guangzhou can be clearly seen. The changes of public health system dominated by the government have highlighted the characteristics of national management and achieved urban sanitation to some extent.