Swedish politicians’ reflection of health effects for newly arrived migrants in decision-making

Abstract

Abstract Background The political context of health promotion is important, however politicians' role has been sparsely researched. The aim was to explore whether politicians reflect on health effects of newly arrived migrants during political decision-making. Methods In total 667 politicians from municipalities and regional councils in the north of Sweden answered a web-based survey in 2019. The variable self-reported reflection of health effects during decision making in the last three months, focused on newly arrived migrants and the general population in the area, was used for analysis. Differences between political groups were analysed through Chi-squared test and differences in focus between the general population and newly arrived migrants were analysed by Wilcoxon Signed Rank Test. Results Preliminary results indicate that out of the participants 29,0% reported reflection on health effects for newly arrived migrants in large parts of their decisions, 50,5% having done so a few times, while 20,5% did not reflect. The politicians from the regions reported to a higher degree, compared to the municipality politicians, to have reflected on health effects (p = 0,003, Cramer's V = 0,136). Politicians more often considered the health effects of the general population in their decisions than for newly arrived migrants (z=-0,006, p < 0,001, r = 0,249). This difference remained when testing the municipality politicians (z=-7,417, p < 0,001, r = 0,228) and regional politicians (z=-5,138, p < 0,001, r = 0,346) separately. Conclusions Not all politicians reflect on the health effect of their decisions, especially not for newly arrived migrants' health. Politicians in the municipalities, responsible for many of the social determinants of health, did so to a lesser degree than the politicians in the regions, responsible for the healthcare system. The potential for politicians to promote health is thus not realized and political decisions can unintentionally affect health. Key messages Only a relatively small part of politicians considers health effects for newly arrived migrants in large parts of their decision-making. Municipality politicians, whose political decisions affect many determinants of health, consider health effects in a lesser degree than regional politicians do.