ArticleFrontiers in public health2026
What drives urban pandemic control performance in China? A configurational analysis of the resource-performance paradox.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The COVID-19 pandemic revealed a stark governance paradox in China: some resource-rich cities experienced governance failures, while relatively resource-scarce cities achieved effective control. This phenomenon challenges traditional linear resource determinism. Methods: To deconstruct this complexity, this study applies the Technology-Organization-Environment (TOE) framework and employs fuzzy-set qualitative comparative analysis (fsQCA), a configurational method capturing asymmetric causal relations, couple with Bootstrap analysis. Using data from 23 key Chinese cities from 2020 to 2022, we explore the conditions driving urban pandemic control performance. Results: The analysis identifies two distinct patterns leading to high performance. First, the "digital empowerment under resource constraints" pattern reveals that in resource-scarce contexts, digital governance capacity plays a core compensatory role, empowering prevention efforts despite material deficiencies. Second, the "holistic social synergy under resource abundance" pattern demonstrates that in resource-rich cities, effective resident wellbeing is the primary driver. Notably, digital governance assumes only a peripheral role in this configuration. Conclusion: These findings confirm that no single factor guarantees success; rather, performance depends on the alignment of governance strategies with local resource endowments. This study advises city managers to prioritize digital infrastructure in resource-scarce areas while focusing on social trust maintenance in affluent regions.
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