Public health monitoring in Sweden focusing on inequality – a developmental work

Abstract

Abstract Issue/problem The overarching goal of the Swedish public health policy is to create the right societal conditions for good and equitable health throughout the population, and to reduce avoidable health inequalities within a generation. Relevant health topics and dimensions of inequalities in health should be monitored to enable effective interventions on the local, regional and national level. To achieve this a strong national health monitoring system (HMS) is central. Description of the problem The objective was to develop a high quality HMS to monitor a broad perspective of public health and its determinants, complemented by a more focused monitoring system of inequalities in health, with relevance on the local, regional and national level. A theoretical framework was developed and empirical mapping of relevant indicators conducted. An expert group was consulted and a country assessment of how to monitor health inequalities was carried out within the Joint action Health Equity Europe project. The developmental work started in 2018 and is not yet completed. Results A web-based monitoring system has been implemented to cover the broad perspective of public health and its determinants. All indicators are reported at the national level and, when possible, degradable at the local and regional level. In addition, a report with a focus on inequalities in health on a national level is published annually, and a longitudinal indicator-based comparative study, with results from Sweden’s 21 regions and 290 municipalities was published in 2019. Lessons General public health and inequalities in health may need to be monitored in different ways. To enable effective interventions, consideration must be given to at what level - local, regional or national - policy decisions are made. Key messages High quality health monitoring enables effective interventions. To reduce inequalities in health focused monitoring is required.