Policy briefs to increase equal health in the Nordic countries

Policy brief 1: Supporting school completion to reduce health inequalities

In the Nordic countries the level of education has become increasingly important for individual employment. Education is one of the most effective means of preventing the social exclusion of the young. There are substantial differences in the health behaviours and health outcomes of people with different levels of education.

Research indicates that most school- and community-based programmes are effective in increasing school completion. Because these programmes are commonly targeted to high-risk students and low-income communities, they are likely to narrow academic achievement gaps and advance health equity.

Recommendation

Policymakers should finance programmes helping school completion and practitioners should implement them and select those programmes that are most suitable to the local conditions. Attendance monitoring is probably the least costly and seems to be quite effective.

Policy brief 2: Employment of individuals with severe mental health problems

Severe mental health illness is a significant public health problem that is more common in socially disadvantaged groups. People in socially disadvantaged groups have a higher risk of poverty and social exclusion and they often have a low level of education and a general low standard of living. Most individuals with severe mental health problems are unemployed.

The best-documented method for a return to work is a method named individual placement and support, IPS. IPS is defined by the following principles: the inclusion of all clients who want to work, a focus on competitive employment, a rapid job search and no required prevocational skills training, paying attention to client preferences about desired work and the disclosure of mental illness to prospective employers and follow-along support after a job is obtained.

Recommendation

IPS has been consistently shown to be a better programme model than any other alternative. IPS ought to be routinely offered for individuals with severe mental disorders and should be tested with other groups with employment difficulties.

Policy brief 3: Rising tobacco taxes reduces health inequalities

In the Nordic countries, smoking is more common among people with a low level of education. That means that in the Nordic countries, if smoking among people with a low level of education could be reduced to the level of highly educated people, all inequalities in mortality would be reduced by 10 percent in men and 5 percent in women. Tackling inequalities in smoking is therefore vital to any strategy that is aimed at avoiding a further widening of socioeconomic inequalities in health.

Research shows that raising taxes on tobacco products consistently demonstrates reductions in smoking behaviour. Price increases appear to be most effective among young adults and persons of low socioeconomic status. Overall the evidence indicates that increasing the price of tobacco products is a very important intervention for tobacco control.

Recommendation

The following is recommended in the policy brief: increase taxes on all tobacco product, implement the WHO Protocol to Eliminate Illicit Trade in Tobacco Products and implement the WHO Framework Convention on Tobacco Control.

Policy briefs to increase equality in health (Nordic Welfare Centre, 2019)

The policy briefs were produced in our project Equal Health – Prerequisite at National Level. The project is a part of The Nordic Arena for Public Health Issue’s work for reducing social inequalities in health in the Nordic region. The Finnish Institute for Health and Welfare (THL) has been leading the work producing the policy briefs, in cooperation with Nordic colleagues.