Challenges to promoting health in the modern welfare state: The case of the Nordic nations

Abstract

Finland, Norway, and Sweden are leaders in promoting health through public policy action. Much of this has to do with the close correspondence between key health promotion concepts and elements of the Nordic welfare state that promote equity through universalist strategies and programs that provide citizens with economic and social security. The purpose of this article is to identify the threats to the Nordic welfare states related to immigration, economic globalization, and welfare state fatigue. Through a critical analysis of relevant literature and data this article provides evidence of the state of the Nordic welfare state and some of these challenges to the Nordic welfare state and its health promotion efforts. There is evidence of declining support for the unconditional Nordic welfare state, increases in income inequality and poverty, and a weakening of the programs and supports that have associated with the excellent health profile of the Nordic nations. This is especially the case for Sweden. It is argued that the Nordic welfare states' accomplishments must be celebrated and used as a basis for maintaining the public policies shown to be successful in promoting the health of its citizens.