Swedish Municipalities Research Articles

Sub-national bureaucracies in the European administrative space

ABSTRACT An important stream of research has developed focusing on the embedding of national central government institutions into an emerging multilevel European Union (EU) administration. The role of sub-national governmental institutions within this integrated administration has however received relatively little attention. Assuming that sub-national bureaucracies are key vehicles in the ‘ground-level’ practicing of supranational law, this study examines how sub-national bureaucrats may find themselves in situations where they balance contending preferences and concerns of multiple, and competing, principals. Benefiting from original survey data gathered in Norwegian and Swedish municipalities, we assess how the notion of ‘multi-hatted’ bureaucratic agents noted in the multilevel union administration literature can be transferred to the sub-national level and provide insights into how sub-national bureaucrats relate to multiple principals and how policy conflicts are resolved in the ‘ground level’ implementation of supranational law.

Explaining Variation in Decision‐Making Authority for Care Managers in a Decentralised Welfare State

ABSTRACTLocal policy documents play a key role in the provision of social services in decentralised welfare systems. Previous Swedish research shows great municipal variation in local policies for delegation, which determines social workers' legal rights to make decisions about the welfare service given to older people. In this paper, we examine the association between local conditions and the variation of restrictiveness in local policies on delegation for elder care services, by combining data on political rule and economic, demographic, and geographic characteristics of all Swedish municipalities (n = 290), with data on delegation policy. Based on logistic regression models, the results indicate that population density, political rule and average income are correlated with the probability of restrictiveness in delegation. Our findings highlight the importance of understanding local conditions while allocating the responsibility for the provision of welfare in decentralised states with varying local prerequisites. They further highlight the need for studies investigating the consequences of varying local political policies on the outcome of the elder care services provided to older adults.

Leadership actions that enable or constrain accommodation of education for sustainable development

ABSTRACT This paper presents an empirical study on leadership actions related to education for sustainable development, i.e. education that embraces ecological and socio-economic perspectives to foster students’ awareness of the importance of long-term sustainable development. The aim is to identify leadership actions that enable or constrain permanent implementation of such educational perspectives. Empirically, the study is based on data acquired in a school improvement project on sustainability, involving five schools in a Swedish municipality during the years 2016 to 2021. Data were collected in two rounds, in 2018 and 2020, through interviews with school leaders. A theoretical framework including the coupling mechanisms concept and previously identified organizational routines is applied in analysis of the rich data acquired to explore the school leaders’ reported actions, associated routines and their outcomes. The results reveal leadership actions that enable, and others that constrain, long-term establishment of education for sustainable development. The study confirms the importance of early establishment of a holistic educational idea embracing education for sustainable development, and both communication and feedback systems for leaders on its compliance. The study also shows the value of collegial structures and transformational leadership actions that prevent the fading or failure of intended implementation.

Addressing Climate Change Through Social Innovation Initiatives

While social innovation has traditionally emphasised social sustainability, it also presents potential for the mitigation of climate change by influencing social practices. This study explores how social innovation initiatives address social practices to mitigate climate change. Our qualitative study in an affluent setting, a Swedish municipality with high emissions, led to the identification of four dimensions relevant for climate mitigation: SIIs’ social motives, inspiration of others, beneficiary participation, and use of artefacts. Social motives for climate relevant social ends focused on altering the meaning of practices while SIIs’ had social means focused on changing meaning, competences, and materials of emission-intensive practices.

Neighbourhood immigrant density and COVID-19 infection and hospitalization among healthcare workers

Abstract Background Studies have shown inequalities in COVID-19 infection among healthcare workers (HCWs), with occupational exposure failing to fully explain the inequalities. Little is known about the role of other social determinants of health, such as neighborhood immigrant density. We examined if living in immigrant-dominated neighborhoods was associated with increased risk of COVID-19 infection and hospitalization among HCWs in Sweden, and if so, whether such exposure amplified the risk of COVID-19 among immigrant HCWs. Addressing this question would contribute to a better understanding of factors driving COVID-19 disparities among HCWs. Methods Data were from HCWs aged 20 to 62 years (N = 86187) resident in one of 14 Swedish municipalities (three of which are Sweden’s largest metropolitan cities) on 1 January 2020. Residential neighborhoods were categorised into Swedish-dominated, mixed, and immigrant-dominated. The study outcomes were the first occurrence of COVID-19 infection and hospitalization registered until 30 September 2022. Multilevel mixed-effects survival regression was used for the association analyses, with control for confounders (age, sex, income, comorbidities etc). Results After adjusting for confounders, living in immigrant-dominated neighborhoods was only associated with an increased risk of COVID-19 infection in the first pandemic wave (HR 1.17, 95%CI 1.07 - 1.29), but living in these areas was associated with an elevated risk of COVID-19 hospitalization throughout the entire period. Immigrant HCWs, regardless of where they lived, had around 2-fold higher risk of being hospitalised for COVID-19 than non-immigrant HCWs living in Swedish-dominated neighborhoods. Conclusions Neighborhood immigrant density was associated with COVID-19 hospitalization among HCWs in Sweden. However, immigrant HCWs had a high risk of the outcome regardless of where they lived. More research is needed to identify the root causes of the excess risk among immigrant HCWs. Key messages • HCWs living in immigrant-dominated neighborhoods had an elevated risk of COVID-19 hospitalization. • This study sheds additional light on the drivers of COVID-19 inequalities among Swedish HCWs.

Do job demands and resources differ between permanent and temporary eldercare workers in Sweden?

Eldercare organizations face high sickness absence rates and staff turnover and rely heavily on temporary workers to fill staffing gaps. Temporary workers may experience differences in job demands and resources compared with permanent workers, but this has been largely understudied. To compare perceived job demands and resources between permanent and temporary Swedish eldercare workers. Permanent and temporary eldercare workers in a Swedish municipality were invited to answer a digital survey on work environment conditions. Differences between permanent and temporary workers in job demands and resources were analyzed using multivariate analysis of variance adjusted for age, sex, place of birth, and percent of full-time work and univariate analyses were conducted to consider differences in specific factors. A total of 1076 permanent and 675 temporary workers received the survey, and the final study sample included 451 permanent and 151 temporary workers. Multivariate analyses revealed that temporary workers reported statistically significant lower job demands compared to permanent workers, but no statistically significant differences in resources were found between the groups. Univariate analyses showed that temporary workers reported lower quantitative demands, perceived exertion, and time spent bending forward, than permanent workers. These data suggest comparable support across groups, but a higher workload among permanent workers. Our findings indicate that temporary workers experienced lower job demands than permanent workers, but that no notable difference was found in resources. Interventions aimed at distributing job demands more evenly among eldercare workers with different employment forms may be necessary.

Usability and feasibility of an online intervention for older adults to support changes to routines and the home ('Light, activity and sleep in my daily life')

BackgroundIndoor lighting, exposure to outdoor daylight, physical activity and sleep interact to influence functioning, mood and cicadian rhythm. Older adults (≥ 65 years), who often spend more time at home, are less physically active and experience more sleep problems, could benefit from strategies to support behavioural change and self-managed modifications in the home. The study’s primary objective was to assess the usability and feasibility of the ‘Light, activity and sleep in my daily life’ intervention, delivered as a web-based course.MethodsThis 9-week intervention was delivered in a municipality in Sweden (55.70° N). Participants were eight healthy women (age 71–84), community-living in one-person households. We recruited through municipal staff and posters at senior citizen meeting points. Both qualitative and quantitative data were collected before and after the intervention. The outcome measures were intervention usability (ease of use, usefulness) and study feasibility (e.g., recruitment procedure, online engagement). Measures also included changes to routines and self-managed home adjustments to determine whether the participants applied what they had learnt.ResultsAll participants completed the intervention. Time logged in varied between 25 min and 3 h (M = 1 h 50 min) per week. Seven participants’ system usability scores were between 90 and 100 (‘Excellent’) out of 100. When interviewed, participants reported overall high satisfaction with what they had learnt. Six participants were particularly satisfied with the modules targeting light. Seven participants made changes to their lighting or darkness conditions, such as replaced bulbs with either 3-step dimming or higher colour temperature LEDs (samples were included in the intervention test kit). One suggestion to improve the online delivery was to enable participants to add text comments to the weekly evaluation form.ConclusionsThe web-based intervention was feasible to deliver but time for recruitment should be extended and advertisement in the local newspaper should be considered. Participants’ computer proficiency and access to the internet at home will be critical in a future study with a larger sample. Only minor changes to the online content of the intervention are needed based on participants’ feedback. The intervention will be possible to evaluate in a future pilot study.

School Staff Strategies for Identifying, Dealing with and Preventing Cyberbullying Among Swedish Primary School Pupils

This study, using a socio-ecological model of bullying, examines how school staff, in a Swedish municipality, identify and deal with cyberbullying among primary school pupils, focusing on gender differences to better inform staff participation in the municipality’s anti-bullying strategy. Twenty-five (25) semi-structured interviews were conducted with staff members (including non-teaching staff). Results indicate that cyberbullying, predominantly occurring outside school, impacts educational activities and practices within it. Results also suggest a higher prevalence of cyberbullying among girls. Seven anti-­cyberbullying strategies employed by school staff to identify, intervene in, prevent and deal with cyberbullying among primary school pupils were indicated, providing additional insights into the unique socio-ecological context in which cyberbullying takes place, characterized by ubiquitous ‘twenty-four-seven’ availability. The implications of identifying cyberbullying and addressing initiatives related to this form of bullying in schools are also discussed.

Occupational therapists’ perspectives on welfare technologies for dementia: exploring recommendation frequencies – a pilot study

Background Occupational therapists have long been recognized for their expertise in welfare technology use, particularly in the context of dementia care. Despite this advanced training, however, there is often a gap between their knowledge of available technologies and the frequency with which they recommend these tools to individuals with dementia. Aims/objectives This study explores the perspectives of occupational therapists on the recommendations of welfare technologies for individuals with dementia. Materials and methods A survey was created with the assistance of an expert group in a Swedish municipality. The survey consisted of 26 questions (demographics, background/workload, perceptions of welfare technologies, accessibility/information and knowledge on how and when to use, and initiation of contact and recommendation frequency) and was distributed to 60 occupational therapists within the selected municipality. We received a total of 29 responses. The responses were then analyzed qualitatively for meaningful insights across various themes. Using an encoding scheme, a statistical analysis of the responses was performed to uncover potential trends in the distribution of the responses. Results Results indicate positive perceptions of welfare technologies by occupational therapists, but a low frequency of recommendations for individuals with dementia. Conclusions and significance Based on the results, we find it important to advocate for more educational opportunities for occupational therapists regarding welfare technologies and improved organizational structures that promote their understanding and ultimately benefits of recommending welfare technologies to individuals with dementia.

The IBIC – a tool for social work? Social documentation, language, and persons with psychiatric disabilities

ABSTRACT In recent years, many municipalities in Sweden are using a standardised method – the ‘Individual’s Needs in Focus’ (IBIC) for investigating needs of social support, as recommended by the National Board of Health and Welfare. The model is based on the International Classification of Functioning, Disability and Health (ICF), with a so called ‘biopsychosocial’ approach and predefined categories and classifications. The article takes a critical perspective on standardised methods in social work, specifically examining language, content, and structure in the documentation of the IBIC. We problematise how well the IBIC’s documentation fit social work in general and investigations concerning individuals with psychiatric disabilities requiring support in daily living in particular. A total of 80 investigations from four municipalities were examined in regard to language, content, and structure in relation to the context of social work. The study identified three main linguistic trends: biomedical, task-oriented, and bureaucratic language. However, none of these trends were anchored in the nomenclature of social work.

A preventive care approach for oral health in nursing homes: a qualitative study of healthcare workers’ experiences

BackgroundOral health problems are common among care-dependent older adults living in nursing homes. Developing strategies to prevent the deterioration of oral health is therefore crucial to avoid pain and tooth loss. A standardized work widely used in nursing homes in Sweden is the quality register Senior Alert (SA), which assesses age-related risks concerning e.g. pressure sores, falls, malnutrition and oral health. The oral health assessment is performed with the Revised Oral Assessment Guide-Jönköping (ROAG-J), which also includes planning and implementation of preventive oral care interventions with the goal of achieving good quality care. However, what facilitates and hinders healthcare workers in working with oral health in SA remains unexplored. The aim of this study was to describe healthcare workers’ experiences of assessing oral health with the ROAG-J, planning and performing preventive oral health care actions in accordance with SA in nursing homes.MethodsHealthcare workers (n = 28) in nursing homes in two Swedish municipalities participated and data was collected through six focus group interviews. Reflexive thematic analysis was used to identify patterns of meaning in the data.ResultsThemes generated in the analysis were:A structured process promotes communication and awareness and stresses the importance of oral health;Oral care for frail older adults is challenging and triggers ethical dilemmas;Unclear responsibilities, roles and routines in the organization put oral health at risk;Differences in experience and competence among healthcare staff call for educational efforts.ConclusionsThe structured way of working increases staff awareness and prioritization of oral health in nursing homes. The main challenges for the healthcare workers were residents’ reluctance to participate in oral care activities and oral care being more complicated since most older adults today are dentate. Organizational challenges lay in creating good routines and clarifying staff roles and responsibilities, which will require continuous staff training and increased management involvement.

To See and Be Seen: A Swedish Register Study on Children Who Witness Family Violence.

Authorities and civilians can make a report-of-concern to Social Services if they suspect a child is experiencing or witnessing violence. In 2021, Sweden implemented new legislation that considers children as victims of crime not only when abused but also when witnessing family violence, i.e., Barnfridsbrott. This study aimed to describe and analyze reports-of-concern regarding children witnessing family violence. Are there any changes in number of reports over the years? Who is reporting? And what interventions are most frequent? This is a register-based study of reports-of-concern in Gävle municipality in Sweden for the years 2018-2022. This unique register makes it possible to identify and follow up reported cases as long as they are active by Social Services. Results show there was already a major increase in the number of reports-of-concern in 2020. Most reports are made by Social Services and the police. Of all reports related to family violence, an increasing number lead to further investigations. In most of those cases, the children stay with their families, and Social Services offer counselling. Conclusion: there was a distinct increase in reports related to children witnessing family violence already starting in 2020 in the studied municipality, before the new legislation was implemented.

Elementary school closures in Sweden over two decades: Geographical characteristics and the role of distance

School closures have for long often been seen as a ‘rural issue’ and/or as a rural-urban dichotomy. We posit that such crude representations should be nuanced by help of intra- and inter-municipality analysis as there are differences and diversity between and within rural municipality classes. Based on this, we use official Swedish statistics to perform a spatially disaggregated analysis of the geographical characteristics of Swedish municipalities with different experiences of elementary school closures between 1997 and 2017. The results show that rural municipality classes lost considerably more elementary schools, 24,5 % compared to only 0,3 % in urban municipality classes, but also show large differences between and within rural municipality classes and municipalities, both in terms of lost elementary schools, localities who has lost elementary schools, concentration of elementary schools to municipal population centers, and decreases in mean and median distances from elementary schools to municipal population centers. In some cases rural municipality classes fared better, performed at par, or only slightly worse to their urban counterparts. In conclusion, there is a need for a more disaggregated spatial analysis to understand what is happening in different geographical contexts, since the categories of ’urban’ and ’rural’ hide more detailed but still important spatial differences.

Schooling for integration? Reception of refugees in discourse and practice in Swedish rural municipalities 2015–2022

This study explores the integration of migrants in education and the labour market from the perspectives of professionals working with young migrants in Swedish rural municipalities. It compares interview data referring to the situation during the refugee crisis in 2015 with data referring to the period 2019–2022. It addresses the organisation of teaching, how professionals talked about integration in relation to the local labour market and how integration-related practices and discourses developed from 2015 to 2022. The findings indicate a major change over time in the educational integration strategies and practices. Migrant children were mainly taught in separate preparatory classes in 2015, but by 2019–2022 there was a general aim to integrate them rapidly in regular classes. In terms of labour market integration there was also a discursive change. In 2015 the main hope was that the migrants’ reception would create short- and long-term jobs for the local population and contribute to the survival of local services and life. In contrast, in 2019–2022 the main expressed hope was that migrants would stay permanently and contribute productively to their new societies’ labour forces.

Knowledge, Influence and Accountability: A Study of Political‒Administrative Relations and Civil Servant Influence on Two Rural Swedish Citizen Dialogues

One of the current challenges of democracy is the increasing complexity of governing and, consequently, increasing civil servant influence at the expense of elected representatives. This is also affected by what politician–civil servant relations look like and by contextual aspects, although knowledge about the extent and impact of this influence is selective. Thus, this paper examines civil servants’ influence in evidently complex and resource-intensive processes by conducting a study of citizen dialogues in two rural Swedish municipalities. Expectedly, traits of this context can be recognised throughout the results. The findings point to the position of the involved civil servants as important to the level of civil servant influence in these processes. They further suggest that process complexity may contribute to amplifying already high civil servant influence. However, they also confirm expectations about civil servants’ dispositions towards political legitimate processes, which appeared to dampen the impact of the skewed influence. I conclude that, with these contextual preconditions, the studied form of process can potentially increase civil servant influence. I also argue that, given the size and form of this study, this highlights the need for further studies in local rural contexts and local politician–civil servant relations.

Swedish wind power expansion: Conflicting responsibilities between state and municipalities

Sweden has experienced two decades of wind power expansion and enters a broad diffusion phase. In this study the aim is to deepen the knowledge of the municipal role in this phase in relation to national wind power policy. Local public officials and politicians was interviewed in fourteen Swedish municipalities. The results show that municipal representatives experience great uncertainty about the responsibilities and incentives they have in the energy transition – responsibilities that are difficult to interpret but also difficult to realize in practice. In conclusion, unclear State policy, increased social resistance, lacking municipal capabilities, and a market-driven planning regime adds a burden of incongruous responsibility on municipalities, which risks enforcing uncertainties in the transition of the national energy system. The study brings socio-technical insight to the global expansion of renewable energy within decentralized political systems.

What is the role of architects and urban planners in crime prevention?

In this article, we discuss the role of urban planning professionals in situational crime prevention. We begin by examining their role as city “shapers” and the reasons behind their frequent neglect of crime-related factors in their decision-making process. We also explore why criminology tends to underestimate the influence of urban planning professionals on the urban environment, a factor crucial for effective crime prevention. To highlight the disconnection between urban planning and crime prevention, we present findings from a survey conducted with urban planners and safety experts in 290 Swedish municipalities. The article concludes with future research and practice recommendations, stressing the urgent need for improved communication and collaboration between urban shapers and environmental criminologists and a more comprehensive understanding from all parties involved.

Why do politicians perceive the same financial conditions differently?

AbstractBehavioral public administration research has provided empirical evidence of several perception biases when individuals process information. Building on these findings, we seek to advance the literature by analyzing politicians' financial perceptions of their own government. Drawing on the theory of motivated reasoning, we examine the context of Swedish municipalities and find financial perception gaps associated with politicians' party affiliation (establishment or anti‐establishment), parliamentary position (opposition or governing party), and formal hierarchical rank. Specifically, politicians representing anti‐establishment and opposition parties, as well as those occupying lower positions in the political hierarchy—and thus having less influence over and less responsibility for municipal affairs—tend to perceive the financial situation more negatively. These findings suggest the presence of a motivationally driven bias in politicians' perceptions of financial conditions; moreover, they illustrate that these perceptions are influenced by factors beyond the traditional financial, socioeconomic, and demographic ones examined in previous research.

Conditions for higher education study: the perspectives of prospective students from rural areas

ABSTRACT Background Access to higher education in rural areas has been a recurring theme of debates and government inquiries in many countries in recent decades. Previous research is relatively unequivocal regarding the importance of higher education for regional or national development, identifying the local presence of highly educated individuals in a municipality as crucial for its prosperity and development. Purpose This study aims to contribute to the development of scientific knowledge regarding linguistic discursive representations by rurally located prospective university students in Sweden, of the conditions for further study at university level. Method A total of 23 qualitative interviews and/or discussion groups were held with 34 prospective university students in three rural municipalities in Sweden. Data were collected and analysed to answer the research question: How do prospective university students in rural areas describe the conditions for further study at the university level? Findings Prospective university students created and reproduced a series of linguistic representations in two discursive categories: (1) proximity/distance to study; and (2) education offerings. In the first category, narratives related to the physical distance to study; commuting by public transport or private car; and moving to the home city of a higher education institution. In the second category, narratives focused around the importance of location; remote learning; and doubts about pursuing higher education and/or making the right choice. Conclusion Linguistic representations in both categories were tense, balancing depictions of conflict and consensus. This balancing act represents a linguistic means of creating and re-creating cohesion, involvement, integration, participation, unity, and normality in the discourse and can be interpreted as a form of social pedagogical recognition that is important for the individual’s success in the context that the narratives reflect.

Gendered cooperation in a post-NPM era: a comparative study of the perceptions of municipal technostructure experts and middle-line managers

ABSTRACT By exploring the perceptions of cooperation between technostructure experts and middle line managers of different departments in three Swedish municipalities in a qualitative study, this paper contributes to an understanding of how gendered norms inscribed in type of work influence expectations on cooperation. Theories of principal-agent, stewardship, and partnership, and a gender perspective are used. The comparative analysis shows that despite changes in work roles under the influence of NPM, traditional norms about gender appear to be reproduced in the expectations of cooperation. The results illustrate how cooperation is shaped in contexts associated with feminine respective masculine work.