Health inequalities increase in the Nordic countries despite well-functioning cooperation between ministries

Lack of cooperation between different governmental departments might be an explanation. Our new study shows, however, that cross-sectoral cooperation is working well. The main problem might instead be a lack of comprehensive and effective measures.

The purpose of this qualitative study was to assess the extent of cross-sectoral cooperation at the national ministerial level, with focus on reducing health inequalities and to identify factors that might promote or hinder such cooperation.

The main results of the study are:

• A substantial number of measures that are supposed to promote health equity had been initiated at the national level in Finland, Norway and Sweden
• Cooperation between the ministries was, in general, well-functioning
• Knowledge about and implications of the WHO’s Health in All Policies were mainly lacking, except in Finland, while the UN’s Sustainable Development Goals were well-known in all three countries
• General factors that might promote or hinder cooperation between ministries were identified

– Thus, according to this study, a substantial number of measures that are supposed to promote health equity are initiated and cooperation between the ministries is well-functioning. Yet, the health gap is still increasing, says analyst and associate professor Karin Guldbrandsson at the Public Health Agency of Sweden and Karolinska Institutet.

Potential weaknesses

During recent years, a large number of measures to reduce health inequalities have been initiated in the Nordic countries. Several of these measures have been designed in cooperation between different governmental departments. Some potential weaknesses, mainly lack of effectiveness and insufficient magnitude, could however be distinguished.

To give one example, reduction of unemployment and low-income rates were proposed. Both measures are promising for the reduction of health inequalities. Yet, both require considerable financial resources. The allocated funds were probably insufficient to affect the health gap between educational and income groups.

Another weakness relates to the size of the target groups. Some measures target individuals with disabilities and aim to increase the individual’s capacity to work. Such measures are also promising. But if the target groups are small, health inequalities in the population in total will probably not be affected. Another potential limitation is lack of evidence for effects on health inequalities of the proposed measures.

– From what we can see in this study the officials are doing their work, but there is a need for a stronger political commitment when it comes to health equality. The political level must prioritize measures that are sufficiently comprehensive to really affect the health gap in the population, project manager Helena Lohmann at the Nordic Welfare Centre states.

The study was conducted by the Nordic Welfare Centre and implemented within the framework of The Nordic Arena for Public Health Issues. The Public Health Agency of Sweden contributed by financing parts of the study.