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In this viewpoint article, the authors recognize the increased focus in health systems on co-design for innovation and change. This article explores the role of leaders and mangers in developing and enhancing a culture of trust in their organizations to enable co-design, with the potential to drive innovation and change in healthcare.

Using social science analyses, the authors argue that current co-design literature has limited focus on interactions between senior leaders and managers, and healthcare staff and service users in supporting co-designed innovation and change. The authors draw on social and health science studies of trust to highlight how the value-based co-design process needs to be supported and enhanced. We outline what co-design innovation and change involve in a health system, conceptualize trust and reflect on its importance within the health system, and finally note the role of senior leaders and managers in supporting trust and responsiveness for co-designed innovation and change.

Healthcare needs leaders and managers to embrace co-design that drives innovation now and in the future through people – leading to better healthcare for society at large. As authors we argue that it is now the time to shift our focus on the role of senior managers and leaders to embed co-design into health and social care structures, through creating and nurturing a culture of trust.

Building public trust in the health system and interpersonal trust within the health system is an ongoing process that relies upon personal behavior of managers and senior leaders, organizational practices within the system, as well as political processes that underpin these practices. By implementing managerial, leadership and individual practices on all levels, senior managers and leaders provide a mechanism to increase both trust and responsiveness for co-design that supports innovation and change in the health system.

This study examines the effect of female governors (gender effect) on environmental performance in terms of state-level carbon dioxide (CO2) emissions in United States.

The study used annual data from 1970 to 2020 to investigate the relationship between female political leadership and state-level CO2 emissions. Hypothesis was tested through ordinary least squares regression (OLS). The results of the study were also validated using propensity score matching and a difference-in-difference approach.

This study provides empirical insights into the relationship between female political leadership and state-level CO2 emissions. The findings indicate that female governors have a significant negative impact on state-level CO2 emissions per capita. These results suggest that female political leadership is associated with a reduction in CO2 emissions per capita at the state level. The results also show that states under the leadership of female governors experience lower levels of CO2 emissions than those with male governors, indicating female leadership’s potential to promote environmental sustainability.

The findings of this study have practical implications for policymakers, government officials, and other stakeholders involved in the formulation of strategies to promote environmental sustainability. This study highlights the significant role that female political leader play in mitigating CO2 emissions at the state level. It suggests that promoting female in political leadership positions can lead to more environmentally conscious policy decisions and actions, resulting in reduced CO2 emissions per capita. Policymakers should actively encourage women’s participation in leadership roles to utilize their potential contributions to advancing sustainability goals. Furthermore, organizations that focus on environmental issues should prioritize supporting and promoting female leaders who have demonstrated a commitment to environmental sustainability. Ultimately, this study highlights the need for female in political leadership as a potential strategy to address environmental challenges and advance a more sustainable future.

This study pioneers research on the links between female political leadership and state-level CO2 emissions. This study contributes to the literature by emphasizing the potential role of female political leaders in promoting environmental sustainability. Overall, this study enriches the social role and upper echelons theories literature through empirical evidence.