Public health governance is an important part of national governance and an integral component of the comprehensive construction of a strong modern socialist country with Chinese-style modernization. The reform and opening up has pushed China’s public health to embark on a Chinese-style modernization path, providing healthy human capital support for China’s rapid economic growth. Reviewing the development path of China’s public health governance since the reform and opening up is not only to examine the modernization path of China’s public health governance characterized by the convergence of thought and practice from the perspective of thought development, but also to provide ideological and theoretical resources as well as historical and practical experience for the modernization of public health governance system and capacity in the new era.

Drawing upon the policy paradigm theory and based on China’s historical situation, this paper constructs a policy paradigm shift identification and evolution model, and comprehensively and deeply examines the modernization path of China’s public health governance since the reform and opening up under the combined effect of policy paradigm choice, governance concept change, and practice innovation. The study finds that there have been two policy paradigm shifts representing the transformation of China’s public health governance thought, which respectively established market-led and government-led policy formulation and implementation frameworks, realizing the transformation and development of public health governance concepts, governance goals, and governance methods in different historical scenarios. Meanwhile, the modernization path of China’s public health governance reflects that the development and evolution of public health governance thought not only accord with the intrinsic requirements for developing public health services, but also correspond with the development of socialist market economy and the deepening of economic system reform.

The contributions of this paper are that: First, based on the policy paradigm theory, it builds an analytical framework for the study of public health governance thought, combs and analyzes the historical development and evolution of public health governance thought at the level of economic thought, and more comprehensively summarizes the modernization path of China’s public health governance since the reform and opening up. Second, it further improves the relevant contents of the policy paradigm theory with the specific practice in China’s public health governance policy change and enhances the applicability and explanatory power of the policy paradigm theory. Third, it introduces the basic concepts and research methods of policy paradigm into the study of public health governance thought, being a useful exploration to strengthen the analytical and normative perspectives of the study of the history of economic thought.