Reducing social inequities in health in Norway: Concerted action at state and local levels?

Grimm, M; Helgesen, Marit; Fosse, Elisabeth

doi:10.1016/j.healthpol.2013.09.019

Cited by 31 publications

(27 citation statements)

References 6 publications

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“…However, other studies have noted that reducing inequalities may be challenging for municipalities because of cross-sectorial requirements and lack of municipal competencies. 20,22 In addition, challenges with regard to collaboration and coordination 33 among relevant actors may be another constraint. …”

Section: Discussionmentioning

confidence: 99%

“…If so, this result suggests, further, that the PHA has succeeded to some degree in bringing national policy to the local level, which an earlier study, before the act was enforced, found had happened only to a small degree. 22 In principle, municipalities do not themselves decide what services to provide, but they do decide how to organize and provision them. In addressing health inequalities, this requires municipalities to choose among competing policy approaches.…”

Section: Discussionmentioning

confidence: 99%

“…22 In addition to implementing national welfare policies and addressing public health, municipalities constitute democratic entities making decisions based on local realities, needs, and preferences. HiAP argues for the impact on health being systematically evaluated in developing and implementing local policies in all areas.…”

Section: Introductionmentioning

confidence: 99%

“…24-26 Despite this, it has been documented that the PHCs often are employed in low part-time positions, and not close to the municipal policy-making, for example within the office of medical officer in the municipal. 22 …”

Section: Introductionmentioning

confidence: 99%

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Health Promotion at Local Level in Norway: The Use of Public Health Coordinators and Health Overviews to Promote Fair Distribution Among Social Groups

Hagen

Øvergård

Helgesen

et al. 2018

Int J Health Policy Manag

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Background: Norway is internationally known today for its political and socio-economic prioritization of equity. The 2012 Public Health Act (PHA) aimed to further equity in the domain of health by addressing the social gradient in health. The PHA’s main policy measures were (1) delegation to the municipal level of responsibility for identifying and targeting underserved groups and (2) the imposition on municipalities of a "Health in All Policies" (HiAP) approach where local policy-making generally is considered in light of public health impact. In addition, the act recommended municipalities employ a public health coordinator (PHC) and required a development of an overview of their citizens’ health to reveal underserved social segments. This study investigates the relationship between changes in municipal use of HiAP tools (PHC and health overviews) with regard to the PHA implementation and municipal prioritization of fair distribution of social and economic resources among social groups. Methods: Data from two surveys, conducted in 2011 and 2014, were merged with official register data. All Norwegian municipalities were included (N=428). Descriptive statistics as well as bi- and multivariate logistic regression analyses were performed. Results: Thirty-eight percent of the municipalities reported they generally considered fair distribution among social groups in local policy-making, while 70% considered fair distribution in their local health promotion initiatives. Developing health overviews after the PHA’s implementation was positively associated with prioritizing fair distribution in political decision-making (odds ratio [OR] = 2.54; CI: 1.12-5.76), compared to municipalities that had not developed such overviews. However, the employment of PHCs after the implementation was negatively associated with prioritizing fair distribution in local health promotion initiatives (OR = 0.22; CI: 0.05-0.90), compared to municipalities without that position. Conclusion: Development of health overviews — as requested by the PHA — may contribute to prioritization of fair distribution among social groups with regard to the social determinants of health at the local level.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Health Promotion at Local Level in Norway: The Use of Public Health Coordinators and Health Overviews to Promote Fair Distribution Among Social Groups

Hagen

Øvergård

Helgesen

et al. 2018

Int J Health Policy Manag

Self Cite

View full text Add to dashboard Cite

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“…The private sector is making a growing contribution to healthcare in much of developing countries. There has been considerable interest in the growth of the private sectors in delivering of health services instead focusing on determinants of health (51)(52)(53)(54). The study suggested that the impact of macroeconomic policies on the health of people in the country must be constantly measured and before the implementation of new policies, positive or negative impacts of them must be investigated.…”

Section: Discussionmentioning

confidence: 99%

Macroeconomic policies and increasing social-health inequality in Iran

Zaboli

Seyedin

Malmoon

2014

Int J Health Policy Manag

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Background: Health is a complex phenomenon that can be studied from different approaches. Despite a growing research in the areas of Social Determinants of Health (SDH) and health equity, effects of macroeconomic policies on the social aspect of health are unknown in developing countries. This study aimed to determine the effect of macroeconomic policies on increasing of the social-health inequality in Iran. Methods: This study was a mixed method research. The study population consisted of experts dealing with social determinants of health. A purposive, stratified and non-random sampling method was used. Semi-structured interviews were conducted to collect the data along with a multiple attribute decision-making method for the quantitative phase of the research in which the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was employed for prioritization. The NVivo and MATLAB softwares were used for data analysis. Results: Seven main themes for the effect of macroeconomic policies on increasing the social-health inequality were identified. The result of TOPSIS approved that the inflation and economic instability exert the greatest impact on social-health inequality, with an index of 0.710 and the government policy in paying the subsidies with a 0.291 index has the lowest impact on social-health inequality in the country. Discussion: It is required to invest on the social determinants of health as a priority to reduce health inequality. Also, evaluating the extent to which the future macroeconomic policies impact the health of population is necessary.

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Public Health Policy to Tackle Social Health Inequalities: A Balancing Act Between Competing Institutional Logics

Kvåle

Kiland

Torjesen

2020

Transitions and Boundaries in the Coordination and Reform of Health Services

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Reducing social inequities in health in Norway: Concerted action at state and local levels?

Cited by 31 publications

References 6 publications

Health Promotion at Local Level in Norway: The Use of Public Health Coordinators and Health Overviews to Promote Fair Distribution Among Social Groups

Health Promotion at Local Level in Norway: The Use of Public Health Coordinators and Health Overviews to Promote Fair Distribution Among Social Groups

Macroeconomic policies and increasing social-health inequality in Iran

Public Health Policy to Tackle Social Health Inequalities: A Balancing Act Between Competing Institutional Logics

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