Vallgårda Signild
Department of Health Services Research, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.
Scand J Public Health. 2007;35(2):205-11. doi: 10.1080/14034940600858433.
To identify how public health problems are identified, explained, and addressed in Scandinavian public health programmes.
Recent public health white papers from Denmark, Norway, and Sweden have been studied asking the following questions. How are policies and activities justified? Which problems and causes are identified? What is to be done? To what extent are the interpretations and suggested interventions in accordance with liberal or social democratic political ideals?
The programmes studied give similar reasons for dealing with public health, namely the wish to create good lives for citizens and to improve the economy of society. The health problems identified are almost the same: cancer, heart disease, diabetes, musculoskeletal diseases, and mental illness. The Danish programme differs from its Norwegian and Swedish counterparts with regard to explanations and suggested solutions to the problems. It may be characterized as more liberal. While the Danish programme stresses the importance of individual behaviour, responsibility, and autonomy, the two others emphasize social relations, living conditions, and participation in addition to behavioural factors. Political responsibility for the health of the population is emphasized in the Norwegian and Swedish programmes. The Swedish programme, in particular, stresses common values such as equality and equal rights, and the significance of the welfare state. The Norwegian programme underlines the importance of empowering the individual, an ambition that could also be seen as a social liberal ambition to increase the self-determination of citizens.
There is not one Scandinavian model in public health policy but several: a Danish model mainly adhering to liberal ideals, a Norwegian one that could tentatively be labelled social liberal, and a Swedish model adhering to more social democratic ideals.
确定在斯堪的纳维亚公共卫生项目中,公共卫生问题是如何被识别、解释和解决的。
研究了丹麦、挪威和瑞典近期的公共卫生白皮书,并提出以下问题。政策和活动的依据是什么?识别出了哪些问题和原因?要采取什么措施?这些解释和建议的干预措施在多大程度上符合自由主义或社会民主政治理想?
所研究的项目处理公共卫生问题的理由相似,即希望为公民创造美好的生活并改善社会经济。识别出的健康问题几乎相同:癌症、心脏病、糖尿病、肌肉骨骼疾病和精神疾病。丹麦的项目在对问题的解释和建议解决方案方面与挪威和瑞典的项目不同。它的特点可能更倾向于自由主义。丹麦的项目强调个人行为、责任和自主权的重要性,而另外两个项目除了行为因素外,还强调社会关系、生活条件和参与。挪威和瑞典的项目强调对民众健康的政治责任。特别是瑞典的项目强调平等和平等权利等共同价值观以及福利国家的重要性。挪威的项目强调增强个人权能的重要性,这一目标也可被视为一种社会自由主义的目标,即增强公民的自决权。
在公共卫生政策方面不存在单一的斯堪的纳维亚模式,而是有几种模式:一种主要坚持自由主义理想的丹麦模式,一种可初步称为社会自由主义的挪威模式,以及一种坚持更社会民主理想的瑞典模式。