Boyer, Eric J., Rebecca Reid, and Dana Patton. 2022. “Does Gender Influence Leadership Styles? A View from the U.S. Nonprofit Sector.” Public Organization Review.  

This study explores the predominant leadership styles of nonprofit executives to determine if gender informs their leadership style choices. The authors analyzed over 4,000 pages of transcribed interviews with 137 nonprofit executives. Nonprofit executives identified their predominant leadership styles with approaches categorized in the “feminine” domain of the gendered leadership framework. Although individual differences in leadership styles were explained in part by gender, leaders were most likely to adopt configurations of styles that blend gendered domains of leadership. The results indicate the nonprofit sector is one where gender is less determinative of leadership styles than in other employment sectors. 

Patton, Dana, Ann Durand*, Kyle Whipple**, and David L. Albright. 2022. “Local Autonomy and Response to the COVID-19 Pandemic,” State and Local Government Review 54(2):165-73.

We examine local government response to the COVID-19 pandemic in the United States utilizing a unique dataset created by the National League of Cities. The most common action by local governments was changing administrative procedures and implementing policies aimed at prevention or “flattening the curve”. The general public was the most common population target. In addition to detailing the most common local action types, policy areas, and population targets, we analyze local response based on the autonomy granted to local governments by states. We expected local governments with greater levels of autonomy would have a greater level of response; however, some local governments did not ‘behave’ as expected based on their degree of policymaking autonomy granted by state governments. Some states with higher levels of autonomy enacted relatively few local actions in response to the pandemic, whereas some with little autonomy engaged in considerable activity to address COVID-19.

*PhD student; **MPA student

Patton, Dana and Richard C. Fording. 2020. “The Effect of Women’s Descriptive Representation on Premature Mortality in the United States.” Social Forces 99(2):820-46.

Although many studies have found that women legislators pursue policies important to women, we know relatively little concerning the effect of women’s descriptive representation (WDR) on women’s quality of life. We address this question by examining the relationship between the election of women state legislators and public health. Specifically, we estimate the effect of WDR on premature death rates from 1982 to 2010. We find that WDR serves to improve the well-being of both women and men. However, the effect of WDR on women’s health is contingent on several important factors. First, the health-improving effects of WDR are most strongly related to the descriptive representation of Democratic women. Second, the effect of Democratic WDR on women’s health, relative to men’s health, increases with the scale of the state’s Medicaid program. Finally, we estimate the mediating role of nine specific policies, finding that four policies mediate the effect of Democratic WDR on premature mortality. Overall, our results suggest that policy remedies aimed at improving the severe underrepresentation of women in government may help to improve the relatively low ranking of the United States on indicators of public health.

Patton, Dana and Joseph Smith. 2020. “Gender, Ideology, and Dominance in Supreme Court Oral Arguments.” Journal of Women, Politics & Policy 41(4):393-415.

Gender bias in political discourse has been demonstrated in many settings, including the US Supreme Court. We investigate the effects of ideology and gender in verbal interactions during Supreme Court oral arguments. We theorize that all justices possess unconscious gender schemas that lead them to speak more during presentations by women but that liberal and female justices likely have conscious egalitarian values that diminish the manifestation of gender schemas. We find that conservative justices speak more when female lawyers are arguing but that liberal justices show no such effect, suggesting that consciously held attitudes can mitigate the expression of unconscious gender schemas.

Fording, Richard C. and Dana Patton. 2020. “The Affordable Care Act and the Diffusion of Policy Feedback: The Case of Medicaid Work Requirements.” RSF: The Russell Sage Foundation Journal of the Social Sciences 6(2):131-53.

Over the last five years, many states have sought to limit access to Medicaid by adopting restrictive policies. How can we reconcile this development with studies that imply that Medicaid should be insulated from policy backlash? The answer lies in understanding the policy feedback effects that accompanied Medicaid expansion and how these effects created electoral pressure that led to policy modification. We situate our expectations within a policy diffusion framework that accounts for variation in both the content and timing of policy adoptions across states. We develop and test several hypotheses using survey data and an original dataset on gubernatorial support for Medicaid work requirements. Our hypotheses are generally supported and provide a more nuanced understanding of the policy feedback effects following Medicaid expansion.

Fording, Richard C. and Dana Patton. 2019. “Medicaid Expansion and the Political Fate of The Governors Who Support It.” Policy Studies Journal 47(2):274-299.

We provide evidence regarding potential policy feedback effects of healthcare reform by estimating the effect of Medicaid expansion on public support for the state actor most closely associated with responsibility for the expansion decision—the governor. The discretion granted to state governments concerning Medicaid expansion has created the potential for significant variation in mass feedback effects across the states. We are particularly interested in how these effects are influenced by the emerging racial polarization over healthcare policy, and how this may lead to different types of feedback effects that align with partisan, ideological, and racial cleavages. We estimate the impact of Medicaid expansion on gubernatorial approval, utilizing five waves of the Cooperative Congressional Election Study (2008–16). We find that on average, expansion led to a modest, yet statistically significant increase in gubernatorial approval. However, there is important variation both within and across states in the effect of expansion. Specifically, we find that governors were more likely to be rewarded for expansion by those who supported President Obama, and those who resided in states where the Medicaid recipient population is more likely to be white.

Patton, Dana and Joseph L. Smith. 2017. “Lawyer, Interrupted: Gender Bias in Oral Arguments at the U.S. Supreme Court.” Journal of Law and Courts 5:337- 361.

We examine gender bias in political institutions through a novel lens: oral arguments at the US Supreme Court. We ask whether female lawyers are afforded less speaking time during oral arguments compared to male lawyers. We posit that justices, while highly educated and more aware than most of laws requiring equal treatment, may be influenced by gender schemas that result in unconscious biased treatment of male and female lawyers. Applying automated content analysis to the transcripts of 3,583 oral arguments, we find that female lawyers are interrupted earlier, allowed to speak for less time between interruptions, and subjected to more and longer speeches by the justices compared to their male counterparts. However, this pattern is reversed during oral arguments involving gender-related cases. Our most novel and significant theoretical finding is that gender negates the well-documented positive effect of being on the winning side of a case.

Patton, Dana, Julia F. Costich, and Niklas Lidströmer. 2017. “Paid Parental Leave Policies and Infant Mortality in OECD Countries: Policy Implications for the United States.” World Medical & Health Policy 9:6-23.

Infant mortality is an important indicator of a nation’s overall health and well-being because of its association with education, availability and accessibility of health services, and income inequality. In this paper, we examine the effect of job-protected paid parental leave on infant and post-neonatal mortality rates in 19 OECD countries from 1960 to 2012. We utilize a generalized least squares model controlling for a host of variables traditionally examined in studies of infant mortality rates, as well as year fixed effects, country fixed effects, and country time trends. We find a statistically significant association between job-protected paid parental leave and a reduction in both infant mortality rates and post-neonatal mortality rates. The findings are particularly relevant for policymakers in the United States, the only industrialized democracy in the world that does not provide job-protected paid parental leave to working women and men.

Patton, Dana. 2014. “State Policy and Health Disparities: An Examination of the Impact of State Offices of Minority Health”. Journal of Health Care for the Poor and Underserved 25:1982-2002.

For over two decades, a concerted effort has been underway to tackle health disparities. State Offices of Minority Health (OMH) have led efforts in data collection, training, and policy development. Yet, little evidence exists regarding the effectiveness of these efforts. I address this dearth of knowledge by examining the impact of state Offices of Minority Health on Black infant mortality rates. I perform a longitudinal regression analysis controlling for political, economic, and policy variables. I find that state OMHs are associated with a decrease in Black infant mortality rates. Furthermore, when Medicaid spending is low, the implementation of a state OMH decreases Black infant mortality over time. As Medicaid spending increases, however, the effect diminishes. State OMHs and Medicaid are important tools to decrease Black infant mortality rates. States that invest relatively little in health care for the poor should consider increasing investments in their Offices of Minority Health.

Patton, Dana and Sara Zeigler.  2014. “Under My Thumb: National Control of State Interest Group Affiliates and its Policy Implications.”  Journal of Political Science 42:81-104. 

We survey state affiliates of two prominent interest groups, Concerned Women for America and the National Organization for Women, to better understand their tactics and the structural relationship between the national office and the state affiliates. We find that the two national organizations differ starkly in how they relate to their state affiliates. We suggest this difference in the structure of the relationship may shape the formulation and delivery of policy messages to state legislators, thus potentially affecting policy proposals and adoptions in the American states.

Costich, Julia F., and Dana Patton. 2013. “Enforcement: Linking Policy and Impact in Public Health.” Jurimetrics, The Journal of Law, Science, and Technology 53:293-307.

Public health law, even optimally developed and implemented, can fall short of its goals if it is not enforced. Enforcement theorists note four considerations in framing relevant law: likelihood that infractions will be detected, liability standards, sanction types, and penalty size. By these standards, enforcement provisions in public health law are variable, and somewhat inconsistent. Recent public health funding cutbacks threaten public health agencies' ability to execute enforcement duties. In addition, enforcement can be controversial when its targets feel it infringes on their ability to act in their own interests. We present examples in current practice and identify cost-effective enforcement strategies that support objectives of public health law. We apply enforcement theory to four specific objects of public health regulation that experience enforcement challenges: all-terrain vehicles, motor vehicle safety belts, child passenger safety, and driving under the influence.

Costich, Julia F., and Dana J. Patton. 2012. “Local Legal Infrastructure and Its Association with Population Health.” American Journal of Public Health 102:1936-1941.

Objectives. We explored the association between the legal infrastructure of local public health, as expressed in the exercise of local fiscal and legislative authority, and local population health outcomes.

Methods. Our unit of analysis was public health jurisdictions with at least 100 000 residents. The dependent variable was jurisdiction premature mortality rates obtained from the Mobilize Action Toward Community Health (MATCH) database. Our primary independent variables represented local public health’s legal infrastructure: home rule status, board of health power, county government structure, and type of public health delivery system. Several control variables were included. We used a regression model to test the relationship between the varieties of local public health legal infrastructure identified and population health status.

Results. The analyses suggested that public health legal infrastructure, particularly reformed county government, had a significant effect on population health status as a mediator of social determinants of health.

Conclusions. Because states shape the legal infrastructure of local public health through power-sharing arrangements, our findings suggested recommendations for state legislation that positions local public health systems for optimal impact. Much more research is needed to elucidate the complex relationships among law, social capital, and population health status.

Patton, Dana, Charles E. Moon, and Jeff Jones. 2011. “Describing Local Boards Health: Insights from the 2008 National Association of Local Boards of Health Survey.” Public Health Reports 126:410-420.

Objectives

We examined findings from the 2008 National Association of Local Boards of Health Survey to provide information about this understudied entity to the public health community.

Methods

The survey instrument consisted of 196 items covering five parts: (1) demographics; (2) composition and organizational structure; (3) roles, responsibilities, and authorities; (4) telecommunications infrastructure; and (5) concerns and needs. The survey was sent to chairs of local boards of health (LBHs) in 2008 (n=3,276). After six months of follow-ups and reminders, and a month of data cleaning and screening, the final sample consisted of 870 respondents, for a return rate of 27%.

Results

LBHs tend to represent smaller communities and are primarily appointed. Governing and policy-making boards are more prevalent than advisory boards. Most boards do not have official websites or e-mail addresses of board members available to the public; however, most report the capability to receive training via webcasts. Boards express concerns and needs in a variety of areas, particularly public health law, strategic planning, and accreditation.

Conclusion

Little is known about the more than 3,000 LBHs across the United States that are often charged with making and enforcing public health law. This article is a first step toward providing the public health community with information about LBHs based on survey data.

Patton, Dana J. and Kendra B. Stewart. 2010. “Choices and Challenges: Sustaining a Rural Health Network when Funding Vanishes”. In Strategic Collaboration in Public and Nonprofit Administration, ed. Dorothy Norris-Tirrell and Joy A. Clay. Taylor and Francis Publishers.

This chapter highlights two issues that are likely to affect numerous nonprofits seeking to build collaborative agreements to serve individuals in rural areas: funding challenges; and challenges presented by the rural landscape. Rural communities face specific barriers in health-care delivery due to some common characteristics of nonmetropolitan areas. On average, residents of rural communities are older, less educated, and less likely to be insured, report poorer health conditions, are more likely to be unemployed, and lag behind in their use of technology. Rural communities also face a shortage of health-care providers, leaving residents with fewer options for care as well as transportation challenges in seeking care elsewhere. The federal government has designated the majority of rural communities as health professional shortage areas. It is predicted that access to health care in rural areas will only get worse as health-care consumption continues to rise due to an aging population while the health-care workforce continues to shrink.

Patton, Dana. 2007. “The Supreme Court and Morality Policy Adoption in the American States: The Impact of Constitutional Context.” Political Research Quarterly 60:468-488.

Morality policy studies are generally constructed around the theoretical perspective of democratic responsiveness, whereby factors such as religious affiliation of citizens, public opinion, and partisanship affect adoption. The author expands morality policy theory to include the U.S. Supreme Court. She creates a measure of the "constitutional context" state legislators are faced with when debating morality policy proposals and develops a series of hypotheses regarding its effect on morality policy adoption. She tests these hypotheses by employing an event history model of state abortion policy adoptions from 1973 to 2000. The results indicate that the constitutional context has a significant effect on abortion policy adoption; however, its effect is conditioned by the state political environment.

Fording, Richard C., Penny Miller, and Dana J. Patton. 2003. “Reform or Resistance? Local Government Responses to State-Mandated Ethics Reform in Kentucky.” Publius: The Journal of Federalism 33:1-15.

Although several studies have examined state and federal regulation of political corruption and ethics reform, few studies have extended their focus to local governments. In this study, we examine the local government response to state-mandated ethics reform in Kentucky during the 1990s. Based on a quantitative analysis of local government ethics codes in 288 cities, we conclude that local compliance with state-mandated ethics reform has been largely driven by local political factors. Cities with relatively developed democratic institutions, characterized by high levels of electoral competition and a strong media presence, were significantly more likely to construct strict ethics ordinances, as were cities reflecting moralistic political cultural values.

Canon, Bradley, Matthew Gabel, and Dana J. Patton. 2002. “External Grants and Publication: Sources, Outlets and Implications.” PS: Political Science & Politics 35:743-750.

External funding is a common indicator of research productivity in political science. Comparing departments, university administrators often use external funding as an indication of the quality of research. While this can simply reflect administrators' desire for departments to obtain grants that provide overhead for the institution, this metric also rests on an assumption that external funding is a measure of quality research.

Scutchfield, F.D., J. Lee, and D. Patton. 1997. “Managed Care in the United States.” Journal of Public Health Medicine 19:251-254.

Increasingly, in the United States, public and social insurance plans are turning to managed care as a method to control health care expenditure. Some government insurance plans, such as Medicare and Medicaid, also increasingly offer managed health options. The trend, for now, in the United States increases enrollment in managed care plans. Although this is occurring at a rapid pace, managed care will probably not be the final solution to provision of medical care in the United States.