Hinder i folkhälsoarbetet - Statens folkhälsoinstitut

Summary
Obstacles in public health work and ways around them
knowledge base for the public Health policy report 2010
tHiS report iS one of 21 sub-reports related to the Public Health Policy Report
2010 and considers obstacles in public health work. In this report, the Swedish
National Institute of Public Health has identified obstacles to health-promotion and
illness prevention work that can lead to no intervention being applied (or being neglected).
In this report, the Institute will present these obstacles through four concrete
examples. In the analysis of the examples, the following obstacles emerge:
• The budget systems in the public sector are often short term and limited to small
organisational units, making it impossible for decision-makers to see what actionable
alternatives are best for health and for the economy. This can result in priorities
being set so that they lead to illness and large, unnecessary costs to society.
• When municipalities invest in early prevention measures, other actors in society,
such as authorities, often cut their costs. The municipalities are important in
terms of these measures, but the economic driving forces are often missing.
• Today’s organisational structures do not promote cooperation between various
actors in society.
There are ways around the obstacles and new methods have been tested in some places
in Sweden. These methods should be supported and evaluated. In order to reach
the overriding objective of public health (of creating the social conditions for good
health on equal terms for the entire population), the experiences of overcoming
obstacles needs to be distributed. The Swedish National Institute of Public Health
proposes a Government investigation in order to carry out and evaluate a number
of pilot projects that promote health and the economy. There are a few conceivable
emphases:
• The actors concerned, such as municipalities and authorities, may apply for stimulus
funding and try new models for budget systems and cooperation that
promote early intervention and prevention work.
• The Government establishes funds in order to promote health and prevent illness
from which, for instance, county councils, regions and municipalities can borrow
money for measures that create the conditions for long-term good health
and promote the economy.
H I N D E R I F O L K H Ä L S O A R B E T E T O C H VÄ G A R F Ö R B I 7