| 1. |
- Dyar, Oliver J., et al.
(författare)
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Rainbows over the world's public health : determinants of health models in the past, present, and future
- 2022
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 50:7, s. 1047-1058
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Tidskriftsartikel (refereegranskat)abstract
- The need to visualise the complexity of the determinants of population health and their interactions inspired the development of the rainbow model. In this commentary we chronicle how variations of this model have emerged, including the initial models of Haglund and Svanström (1982), Dahlgren and Whitehead (1991), and the Östgöta model (2014), and we illustrate how these models have been influential in both public health and beyond. All these models have strong Nordic connections and are thus an important Nordic contribution to public health. Further, these models have underpinned and facilitated other examples of Nordic leadership in public health, including practical efforts to address health inequalities and design new health policy approaches.Apart from documenting the emergence of rainbow models and their wide range of contemporary uses, we examine a range of criticisms levelled at these models – including limitations in methodological development and in scope. We propose the time is ripe for an updated generic determinants of health model, one that elucidates and preserves the core value in older models, while recognising the developments that have occurred over the past decades in our understanding of the determinants of health. We conclude with an example of a generic model that fulfills the general purposes of a determinants of health model while maintaining the necessary scope for further adjustments to be made in the future, as well as adjustments to location or context-specific purposes, in education, research, health promotion and beyond.
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| 2. |
- Hansson, Sven Ove
(författare)
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Why and for what are clinical trials the gold standard?
- 2014
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 42:13, s. 41-48
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Tidskriftsartikel (refereegranskat)abstract
- The epistemological basis of clinical trials and evidence-based medicine is investigated. Clinical trials are directly action-guiding experiments on treatment effects. This is the reason why well-performed clinical trials take precedence over all other types of studies as far as treatment effects are concerned. The efficiency of public health interventions can be studied with directly action-guiding experiments that have the same strong epistemic justification as clinical trials. However, in order to assess the causality of diseases, information from several types of studies will have to be combined. Here, no single type of studies has priority over all the others. Therefore, evidence hierarchies are less helpful in studies of causality than they are in investigations of the effects of treatments or interventions.
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| 3. |
- Nihlén Fahlquist, Jessica, Docent, 1976-
(författare)
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The moral responsibility of governments and individuals in the context of the coronavirus pandemic
- 2021
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 49:7, s. 815-820
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Tidskriftsartikel (refereegranskat)abstract
- Aim:Not only is the coronavirus pandemic about science and facts, it also raises a number of ethical questions. Some of the most important questions in this context are related to responsibility. First, what is a government’s primary responsibility? Second, how should both the government and individuals consider personal moral responsibility in this context?Method:This paper uses conceptual and normative analysis to address responsibility in the context of the pandemic. The paper also refers to reports published by the German Ethics Council, the Malaysian Bioethics Community and the Swedish National Council on Medical Ethics.Results:The primary responsibility of governments is to create a balance between individual values and rights, one hand, and the health of the population, on the other. There are good reasons to conceive of individual responsibility as a virtue, having to do with the development of crucial character traits and habits. The responsibility of governments is connected to individual responsibility through the values of trust and solidarity.Conclusions:Governments need to communicate clearly (a) how they balance conflicts between collective health and individual rights and values and (b) what the chosen strategy entails in terms of collective and individual responsibility. Success requires attention to ethical values from all involved. Individuals will need to develop new character traits to help manage this pandemic and to prevent new ones. Governments must facilitate the development of such character traits by building trust and solidarity with and among citizens.
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