Do politicians influence media coverage of political issues? This paper explores this question by building a comprehensive dataset of tweets, newspaper articles, and press releases related to the 2022 Quebec provincial election. Specifically, over 4000 tweets from political leaders and parties were collected during the 36-day election campaign. The texts—from tweets, newspapers and press releases—were classified using automated topic dictionaries. A series of regressions was estimated to determine the association between Twitter use by politicians and media coverage. The findings reveal that tweets on certain issues, such as immigration and energy, boost the importance of these issues in news coverage on the same day, with little to no persistence across time. The association is stronger for tweets from the incumbent leader and party, though opposition parties also have an impact on a select set of issues. Crucially, these results are robust to controlling for official press releases, past tweets, and past media coverage. Thus, the study establishes a link between Twitter activity and media coverage, indicating that Twitter serves as a tool for politicians to shape the media agenda by attracting traditional media attention. Overall, the results suggest that political actors can find ways to gain some control over the media agenda during an electoral campaign.
This article analyzes candidate nominations across France’s 577 legislative constituencies as a lens onto party strategies and their consequences, thus addressing a gap in a literature on party system change largely dedicated to electoral demand and outcomes. It draws on an original database of candidates and electoral results spanning 2012–2024 to examine the reconfiguration within the right and far-right blocs. It shows, first, that parties nominate candidates strategically based on past electoral performance: within the RN-UXD (far right) alliance, constituencies favorable to Les Républicains (mainstream right) were thus allocated to UXD candidates tied to Eric Ciotti (former LR president). Second, incumbency outweighs label effects on first-round vote shares, though running without the official LR label proved advantageous for LR-affiliated candidates. Third, in head-to-head runoffs, RN and UXD candidates performed better against left-wing opponents, with the Ciotti label providing an additional advantage. These findings confirm the RN's growing hegemony over the right-wing bloc.
The spring 2020 lockdown in France thwarted variable-based analyses: while the population largely complied with the health measure, key compliance indicators seemed to predict the opposite. How, then, can we explain the fact that the French population complied with lockdown so easily? Using simple agent-based simulations, this article tests three possible explanatory mechanisms based on two distinct conceptions of the public: atomized or interacting. By systematically comparing the results produced by the models with the actual lockdown curve, it assesses the probability of each. Social contagion model is the most likely, followed by police and media coverage models. In conclusion, the article recommends that ordinary interactions between citizens be considered to understand the implementation of public policies, and that simulation be used more systematically to study the power of the sanitary state.
In recent years, major events have impacted the economy, both at national and global levels. Most notably, poverty and inequality rose drastically, labor productivity decreased, many lost their jobs, and others, their businesses. While not everyone has been confronted with the same consequences, one phenomenon that affected most citizens is inflation. Indeed, cost-of-living issues have been at the forefront of economic discussions, both in the political sphere as well as in the citizenry. The first step to addressing citizens’ needs is to understand them. But do citizens know what they need? Using a representative sample of respondents surveyed following the 2022 Quebec provincial election, we inquire into the understanding of French Quebecers of inflation and their policy preferences on the subject. Using automated textual analysis on open-ended questions, we examine how citizens understand inflation and related cost-of-living issues. Results show that Quebecers’ understanding of inflation varies greatly based on socioeconomic characteristics, but not ideological lines. This is highly relevant to effective and representative design of public policy.
This article explores the healthcare education reform in France initiated under President Emmanuel Macron, emphasizing the abolition of the numerus clausus and the emergence of new "medical-administrative" elites as key policy insiders. Through a detailed analysis of two central figures, Lionel Collet and Isabelle Richard, we demonstrate how these actors-whose profiles diverge from traditional welfare elites-effectively navigated the decision-making landscape to enact significant reforms. By situating their roles within the Programmatic Action Framework, we highlight the sociological construction of their legitimacy and the evolution of health policy priorities from cost containment to concerns around healthcare provision and workforce management. The study underscores the necessity of considering hybrid medical-administrative profiles to fully understand contemporary healthcare policy dynamics in France.
This article presents the methodological and theoretical challenges identified by means of a collective sociological investigation focused on health centers in France. These little-known but rapidly growing structures offer an alternative to the dualism that exists between public hospitals and private outpatient care in this country. In addition to providing primary care, health centers carry out public health missions while employing all of their staff, both healthcare and non-healthcare workers. However, the statuses and operating modes of health centers are broad and varied, which means that studying them proves particularly complex, both quantitatively and qualitatively. This text presents the questions raised and attempts to overcome these difficulties. It also shows that this marginal entry point into the healthcare system is characterized by certain contradictions and unique issues, highlighting the importance of the meso-sociological scale, which is too often neglected by research in this area.
This special issue examines the paradoxes of the French health system. Contributions from francophone and anglophone scholars on both sides of the Atlantic explore these tensions through diverse analytic lenses. In this introduction, we highlight three major throughlines: that universal coverage co-exists with persistent inequalities, that the postwar elite consensus faces increasing contestation, and that the state's centralization is in fact mediated by frontline actors. Together, these contributions show that the recurring themes of French health care–liberty, equality, and crisis–are not mutually exclusive but mutually constitutive. Their frictions generate the system's distinctive and enduring paradoxes.
The proportion of women in harm reduction centers has been stable since the 1990s. Over the period, they have averaged a quarter of service users while the share of women among drug users has continued to increase. Therefore, a gap can be observed between the share of women in harm reduction centers and the share of women who use drugs. This article addresses this paradox by drawing on 32 interviews with healthcare and harm reduction professionals and experts in drug-related public health policies in Bordeaux and Montreal. First, the article analyzes how the French universalist model results in a gender-blind approach, hindering the creation of single-sex spaces that would encourage women’s participation in harm reduction centers. Secondly, it examines the situation in Montreal, where the community-based model has promoted a gender-sensitive approach. Single-sex spaces are more widely accepted in Montreal than in Bordeaux. However, due to a lack of resources, there is a discrepancy between intention and implementation. Thirdly, the article discusses how both sets of initiatives primarily focus on two subgroups: pregnant women (or mothers) and sex workers who use drugs. This article concludes by highlighting the need to rethink gender in public health policies through a gender-transformative health approach, emphasizing the importance of women-centered actions in health promotion.
This article analyzes the universitarization of nursing education in France, a state-led reform aimed at enhancing the profession’s status and addressing primary care shortages. Despite its centralized structure, the French state did not employ a top-down strategy. Instead, a series of “oblique tools”—such as adding layers of technical complexity—proved effective in maintaining control over a process involving multiple actors at different levels of government. The goal was not to make winners and losers but to realign incentives to bypass the entrenched politics of institutions and professions. State power, simultaneously concentrated in decision-making and fragmented in implementation, reveals a distinctive model of “negotiated centralism.” The reform’s politics are not unique to France. Consolidated interest groups (physicians insistent on protecting their practice autonomy and limiting skill supply), conflicted interest groups (frontline nurses versus elite nurses), and fiscal constraints on care echo similar dynamics of change in public administration. This study challenges simplistic models of state power. It demonstrates that, in contested fields like healthcare, effective reform requires the state to act less as a commander and more as an astute political negotiator, orchestrating consent where it cannot command obedience.
This article examines why the French government chose to establish new advisory bodies during the Covid-19 pandemic, despite having robust public health agencies. President Macron created six new advisory bodies, three focused exclusively on the vaccine strategy. This study explores the motivations behind this institutional redundancy, revealing that it was driven by political considerations and perceived limitations in existing agencies. Using elite interviews, in-depth study of primary and secondary sources, cluster analysis, and policy analysis grounded in an original dataset, this article explores the advisory dynamics between the executive branch, the Haute Autorité de Santé (HAS), and the ad hoc Conseil d’Orientation de la Stratégie Vaccinale (COSV). Findings indicate that elected officials perceived HAS as too rigid and transparent, which limited their strategic control, and sought more flexible advisory bodies aligned with their objectives. COSV was preferred for its ability to deliver rapid recommendations, occasionally bypassing the more formalized, independent, and transparent processes required of HAS. The study identifies key institutional traits—agency capacity and autonomy—that shape how policymakers choose expert advisors, particularly when facing crises and reelection pressures. Although ad hoc bodies provided agility, they also circumvented established governance principles, potentially compromising accountability and public trust.
This article explores the healthcare education reform in France initiated under President Emmanuel Macron, emphasizing the abolition of the numerus clausus and the emergence of new “medical-administrative” elites as key policy insiders. Through a detailed analysis of two central figures, Lionel Collet and Isabelle Richard, we demonstrate how these actors—whose profiles diverge from traditional welfare elites—effectively navigated the decision-making landscape to enact significant reforms. By situating their roles within the Programmatic Action Framework, we highlight the sociological construction of their legitimacy and the evolution of health policy priorities from cost containment to concerns around healthcare provision and workforce management. The study underscores the necessity of considering hybrid medical-administrative profiles to fully understand contemporary healthcare policy dynamics in France.
This paper explores the tension at the heart of French Social Security between the expansion of healthcare coverage and the control of health insurance expenditure. The paradox of the French system lies in its effort to reconcile two seemingly irreconcilable imperatives: guaranteeing universal access to care while maintaining budgetary balance. Although successive reforms are justified in the name of urgency, efficiency, and morality, they have progressively redefined universality. Instead of disappearing, it has become fragmented and conditional, while existing as an ideal invoked to legitimize financial discipline. In practice, these reforms have shifted part of the financial burden from collective solidarity to households and complementary insurers, reinforcing inequalities of access. The article argues that this redefinition of universality results from a long-term process of reframing cost containment as an act of preservation rather than retrenchment.
This symposium presents the proceedings of an Author Meets Critics round table devoted to Isabel M. Perera's The Welfare Workforce: Why Mental Health Care Varies Across Affluent Democracies (Cambridge University Press, 2025), chaired at the 2025 APSA Annual Conference in Vancouver. Drawing on a structured paired comparison of the United States, France, Sweden, and Norway, Perera argues that alliances between organized public-sector workers and independently organized managers generate the political coalitions necessary to sustain and expand mental health services — especially where beneficiaries lack the capacity to advocate for themselves. Four distinguished scholars — Daniel Béland, Ellen M. Immergut, Alan M. Jacobs, and Kimberly J. Morgan — engage critically with the book's theoretical framework, methodological contributions, and avenues for future research, before Isabel M. Perera offers her response.
In 2017, the French Ministry of Health announced the extension of children’s vaccination mandates in the midst of repeated vaccine crisis and administrative pressure. The reform marked a major turning point for French vaccination policy, whose experts advocated for the abandonment of legal requirements in favor of an individualized approach. The medical elite, alongside the ministry, framed the new mandates as their last effort against growing reluctance towards vaccination from the general public. The success of the reform, however, led to a retrospective assessment of medical practitioners’ responsibility for declining coverage rates, as well as stricter regulations on professional practices. A socio-historical analysis of this sequence offers insight into the processes involved in implementing health programs as well as the role played by vaccination within these public policies.
