Cybersecurity governance in safety-sensitive contexts: A critical integrative review of models, accountability and public safety outcomes in the United States

Cybersecurity governance has become central to protecting safety-sensitive sectors in the United States. Digital threats now translate rapidly into operational failures and public harm. This critical integrative review synthesizes 25 peer-reviewed studies published from 2020 through 2026. It examines governance models, accountability mechanisms, and their connections to public safety outcomes in sectors such as healthcare, finance, energy, and broader critical infrastructure. Drawing on patterns across the corpus, the review identifies persistent institutional fragmentation, dominance of compliance-oriented approaches, limitations in accountability structures, and marked sectoral variation in governance maturity. These features collectively weaken adaptive capacity. They also limit the translation of governance efforts into measurable resilience against cyber incidents. The analysis reveals that current frameworks prioritize regulatory adherence over resilience-building and cross-sector coordination. This leaves safety-sensitive systems vulnerable to cascading disruptions.  The implications for regulators, operators, and policymakers are clear. They must move toward more integrated, outcome-oriented models that explicitly link cybersecurity oversight to public safety metrics. By integrating governance and safety scholarship, this review highlights structural weaknesses. It also points to targeted improvements that could strengthen national infrastructure protection.