Swedish National Institute of Public Health, Östersund, Sweden.
Scand J Public Health. 2013 Feb;41(10 Suppl):3-56. doi: 10.1177/1403494812466989.
In 2003, the Swedish Parliament adopted a cross-sectorial national public health policy based on the social determinants of health, with an overarching aim--to create societal conditions that will ensure good health, on equal terms, for the entire population--and eleven objective domains. At that time the policy was globally unique, and serves as guidance for public health practice at the national, regional and local levels. The development of the public health policy and the determinants of health are presented regularly in various reports by the Swedish National Institute of Public Health. This supplement is a condensed version of the 174-page Public Health Policy Report 2010, the second produced since the national policy was adopted in 2003.
In order to provide a holistic approach to analysing implemented measures and providing new recommendations within the eleven objective domains of the Swedish national public health policy, we have divided these in three strategic areas. These are: Good Living Conditions, Health-Promoting Living Environments and Living Habits, and Alcohol, Illicit Drugs, Doping, Tobacco and Gambling, each described in the respective introductions for Chapters 3-5. The production of the report was supported by a common analytical model that clarified the societal prerequisites for health in the eleven objective domains. These are factors that can be influenced by political actions in order to create a change. Economic analyses have also been developed to provide a priority basis for political decisions. Analyses of the development of public health determinants were based on data from the National Public Health Survey and data delivered from about 15 various national agencies. Measures that have been implemented between 2004 and 2009 are analysed in details, as the basis for new recommendations for future measures.
The introduction describes Swedish public health policy in the new millennium and how it has developed, the role of the Swedish National Institute of Public Health and other important stakeholders. Approaches, models and methods used in carrying out the commission to produce the public health policy report are also described. In the following chapters, the trends of important determinants of public health, in relation to the overarching aim and the 11 objective domains as grouped in the three strategic areas, are analysed. The final chapter presents the proposed prioritisation for the large number of recommendations that were made, and a presentation of the annual costs of ill health in Sweden. These are compared with the costs of implementing recommended measures. The final chapter also describes how the Public Health Policy Report 2010 was received and lists the recommendations that the Swedish Government has taken action on as of September 2012.
Public health trends have generally been stable or positive, although health inequalities persist. Economic analyses demonstrate that ill-health in Sweden costs 12 billion SEK every year, yet a large amount of this ill-health can be prevented. Sixty-eight recommendations were presented in the report. The government's response to recommendations has been very positive; approximately 60% of the recommendations in the three strategic areas have been adopted less than two years after the Public Health Policy Report 2010 was published.
2003 年,瑞典议会通过了一项跨部门的国家公共卫生政策,该政策基于健康的社会决定因素,总目标是——创造社会条件,确保全体人民享有平等的良好健康——并设立了十一个目标领域。当时,该政策在全球范围内是独一无二的,为国家、地区和地方各级的公共卫生实践提供了指导。瑞典公共卫生研究所定期在各种报告中介绍公共卫生政策的发展和健康决定因素。本增刊是自 2003 年通过国家政策以来发表的第二份公共卫生政策报告 2010 年的精简版,该报告长达 174 页。
为了在瑞典国家公共卫生政策的十一个目标领域内对实施措施进行全面分析并提供新的建议,我们将这些措施分为三个战略领域。这些领域是:良好的生活条件、促进健康的生活环境和生活习惯以及酒精、非法药物、兴奋剂、烟草和赌博,这些领域在第 3-5 章的相应介绍中进行了描述。报告的编写得到了一个共同分析模型的支持,该模型阐明了十一个目标领域中健康的社会先决条件。这些是可以通过政治行动来影响的因素,以创造变革。还制定了经济分析,为政治决策提供优先基础。公共卫生决定因素发展的分析基于全国公共卫生调查的数据和来自约 15 个不同国家机构的数据。对 2004 年至 2009 年期间实施的措施进行了详细分析,作为未来措施新建议的基础。
引言部分描述了瑞典新千年的公共卫生政策及其发展情况、瑞典公共卫生研究所及其他重要利益相关者的作用。还介绍了执行公共卫生政策报告委托任务所使用的方法、模型和方法。在接下来的章节中,根据三个战略领域中分组的总体目标和十一个目标领域,分析了与总体目标和十一个目标领域相关的公共卫生重要决定因素的趋势。最后一章提出了对大量建议进行优先排序的建议,并介绍了瑞典每年因健康不佳而产生的成本。这些与实施建议措施的成本进行了比较。最后一章还介绍了《2010 年公共卫生政策报告》的接受情况,并列出了截至 2012 年 9 月瑞典政府已采取行动的建议。
公共卫生趋势总体稳定或呈积极态势,尽管健康不平等现象依然存在。经济分析表明,瑞典每年因健康不佳而损失 120 亿瑞典克朗,但大部分健康不佳是可以预防的。报告提出了 68 项建议。政府对建议的反应非常积极;在《2010 年公共卫生政策报告》发布不到两年的时间里,三个战略领域中约有 60%的建议得到了采纳。