| 1. |
- Tinghög, Gustav, 1979-, et al.
(författare)
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Horizontal Inequality in Rationing by Waiting Lists
- 2014
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Ingår i: International Journal of Health Services. - : Baywood Publishing Company, Inc.. - 0020-7314 .- 1541-4469. ; 44:1, s. 169-184
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this article was to investigate the existence of horizontal inequality in access to care for six categories of elective surgery in a publicly funded system, when care is rationed through waiting lists. Administrative waiting time data on all elective surgeries (n = 4,634) performed in Östergötland, Sweden, in 2007 were linked to national registers containing variables on socioeconomic indicators. Using multiple regression, we tested five hypotheses reflecting that more resourceful groups receive priority when rationing by waiting lists. Low disposable household income predicted longer waiting times for orthopedic surgery (27%, p < 0.01) and general surgery (34%,p < 0.05). However, no significant differences on the basis of ethnicity and gender were detected. A particularly noteworthy finding was that disposable household income appeared to be an increasingly influential factor when the waiting times were longer. Our findings reveal horizontal inequalities in access to elective surgeries, but only to a limited extent. Whether this is good or bad depends on one's moral inclination. From a policymaker's perspective, it is nevertheless important to recognize that horizontal inequalities arise even though care is not rationed through ability to pay.
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| 2. |
- Burstrom, B
(författare)
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What Is Happening in Sweden?
- 2019
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Ingår i: International journal of health services : planning, administration, evaluation. - : SAGE Publications. - 1541-4469 .- 0020-7314. ; 49:2, s. 204-211
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Tidskriftsartikel (refereegranskat)abstract
- Election to the parliament was held in Sweden on 9 September 2018. None of the traditional political blocks obtained a majority of the vote. The nationalist Sweden Democrats party increased their share of the vote from 13% in 2014 elections to 17% of the vote in 2018. As no traditional political block wants to collaborate with the Sweden Democrats, no new government has yet been formed, more than 2 months after the election. Health care was a prominent issue in the elections. Health care in Sweden is universal and tax-funded, with a strong emphasis on equity. However, recent reforms have emphasized market-orientation and privatization in order to increase access to care, and may not contribute to equity. In spite of a majority of the population being opposed to profits being made on publicly funded services, privatization of health and social care has increased in the last decades. The background to this is described. Health is improving in Sweden, but inequalities remain and increase. The Swedish Public Health Policy from 2003 has been revised in 2018, on the basis of a national review of inequalities in health. The revised policy further emphasizes reducing inequalities in health.
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| 3. |
- Burström, Bo, et al.
(författare)
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The dialectics of childhood diarrhea mortality
- 2006
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Ingår i: International Journal of Health Services. - 0020-7314 .- 1541-4469. ; 36:3, s. 481-501
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Tidskriftsartikel (refereegranskat)abstract
- As in European countries a century ago, diarrhea is a major cause of child mortality in poor countries today. In Stockholm at the turn of the 19th century, political commitment, infrastructural investments in water and sanitation, and enforcement of sanitary improvements by a strong implementing organization helped eliminate diarrhea as a principal cause of death among children. These interventions also had an equitable impact on social class differences in diarrhea mortality, but not on overall mortality; overall mortality declined, but class differences remained. General infrastructural improvement and health education coupled with targeted interventions to vulnerable children may be successful in improving child health and reducing social differentials in mortality. Specific health care interventions may need to be complemented by infrastructural investments to improve water and sanitation if diarrhea mortality is to be further reduced in poor countries today.
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| 4. |
- Farrants, K, et al.
(författare)
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Recommodification, Unemployment, and Health Inequalities: Trends in England and Sweden 1991-2011
- 2016
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Ingår i: International journal of health services : planning, administration, evaluation. - : SAGE Publications. - 0020-7314 .- 1541-4469. ; 46:2, s. 300-324
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Tidskriftsartikel (refereegranskat)abstract
- Recommodification, the withdrawal of social welfare, has been going on for some decades in both Sweden and England. Recommodification disproportionately affects the unemployed because of their weak market position. We investigated the impact recommodification has had on health inequalities between the employed and unemployed in Sweden and England. Using national surveys, odds ratios for the likelihood of reporting less than good health between the employed and unemployed were computed annually between 1991 and 2011. The correlation between these odds ratios and net replacement rates was then examined. Health inequalities between the employed and unemployed were greater in 2011 than in 1991 in both countries. Sweden began with smaller health inequalities, but by 2011, they were in line with those in England. Sweden experienced more recommodification than England during this period, although it started from a much less commodified position. Correspondingly, correlation between unemployment benefit generosity and health inequalities was stronger in Sweden than in England. Recommodification is linked to ill health among the unemployed and to the health gap between the employed and unemployed. We propose that further recommodification will be associated with increased health inequalities between the employed and unemployed.
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| 5. |
- Ferrarini, Tommy, 1966-, et al.
(författare)
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Earner-Carer Model at the Cross-Roads : Reforms and Outcomes of Sweden’s Family Policy in Comparative Perspective
- 2010
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Ingår i: International Journal of Health Services. - 0020-7314 .- 1541-4469. ; 40:3, s. 373-398
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Tidskriftsartikel (refereegranskat)abstract
- Following the 2006 election, the Swedish earner-carer model of family policy seems to have come to an important crossroads, and questions have been raised about the future course of policies. Will the prototypical earner-carer model in Sweden persist? The separate reforms in cash transfers, services, and tax systems in several respects seem to point in contradictory directions, simultaneously introducing new principles of social care. In this article, past and present reforms and potential outcomes of policies are discussed from an institutional and comparative perspective. Reviewing research on outcomes of earner-carer policies for gendered patterns of productive and reproductive work, class-based stratification, child well-being, fertility, and work-family conflict, the article also contributes to the discussion about future challenges for family policy institutions in Sweden and other advanced welfare states.
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| 6. |
- Fritzell, Sara C., et al.
(författare)
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Family Structure, Child Living Arrangement and Mothers’ Self-rated Health in Sweden — A Cross-Sectional Study
- 2017
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Ingår i: International Journal of Health Services. - : SAGE Publications. - 0020-7314 .- 1541-4469. ; 47:2, s. 298-311
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Tidskriftsartikel (refereegranskat)abstract
- Alternate living, i.e. children living 50-50 with their parents following separation is emerging as a new family form. This study is the first to differentiate separated mothers with sole/main custody from mothers with alternately living children, analysing health outcomes and using a sample representative of the population. The association between the self-rated health (SRH) of mothers and different family structures are examined. Parental cooperation is included in the analyses as a potential mediator. Data on 755 mothers from the 2010 Swedish Level of Living Survey were analyzed by multivariate logistic regression. Single mothers with sole/main custody reported poorer SRH than couple mothers in intact families while the difference was not significant for single mothers with children living alternately and mothers in stepfamilies. Controlling for potential confounders, probabilities for poor SRH for single mothers were reduced. The excess risk among mothers with sole/main custody may be due to poorer socioeconomic conditions. Employment was significantly more common among mothers with alternate living and an important explanatory factor for their better health compared to single mothers with sole/main custody. Adjusting for parental cooperation lowered the increased probability for poor SRH among single mothers with sole/main custody compared to single mothers with alternate living.
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| 7. |
- Gådin, Katja G., et al.
(författare)
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School-related health - A cross-sectional study among young boys and girls
- 2000
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Ingår i: International Journal of Health Services. - 0020-7314 .- 1541-4469. ; 30:4, s. 797-820
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Tidskriftsartikel (refereegranskat)abstract
- The authors analyze the association between psychosocial factors in the school environment and pupils' health and self-worth in a sample of 538 pupils (264 girls and 274 boys) in the third and the sixth grades. High control in combination with low demand at school was associated with the best health status in relation to somatic problems, stress, tiredness, and feelings of self-worth. In a multiple regression analysis, problems in relations with classmates were the most recurrent psychosocial factor associated with ill-health. Some gender differences were found in school-related health. Lack of control at school affected self-worth among girls only. In the third grade and among boys in the sixth grade, high demands were an explanatory factor for the health outcome. Foreign background, divorced parents, high achievement, and low relational orientation, as well as disorderly and rowdy classes, were also of importance for somatic ill-health and stress among girls. Older girls became more relationally oriented, while boys became more achievement-oriented. The authors conclude that the pupils' somatic health and self-worth were affected by psychosocial factors at school, even when adjustment was made for social background.
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| 8. |
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| 9. |
- Johansson, Gun, 1957-, et al.
(författare)
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Components of the illness flexibility model as explanations of socioeconomic differences in sickness absence
- 2009
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Ingår i: International Journal of Health Services. - 0020-7314 .- 1541-4469. ; 39:1, s. 123-138
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Tidskriftsartikel (refereegranskat)abstract
- The authors studied the social gradient in sickness absence in relation to components of the illness flexibility model, which highlights conditions affecting whether people attend work when they are ill. The conditions studied were: adjustment latitude, attendance requirements at work, stimulating work, and health. The population sample was part of a panel originating in 1994 when 15,154 inhabitants of Stockholm County were randomly selected to receive a questionnaire covering, among other things, health and psychosocial conditions. New questionnaires were sent to the respondents in 1998 and 2002. This article analyzes the 2002 data, for 1,634 women and 1,063 men. These respondents had reported being employed or on leave of absence. In this sample, a social difference was found in sickness absence of 31 days or more per year. For manual workers, women had an odds ratio (OR) of 2.8 and men an OR of 3.4 for such absence compared with nonmanual workers of both sexes in high socioeconomic positions. All single potential confounders decreased these ORs. Adding all characteristics decreased the OR by 78 percent for women and 67 percent for men. The results indicate that the social gradient in sickness absence is due to differences in health and in working conditions when one is ill.
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| 10. |
- Jones, Chris, et al.
(författare)
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Studying Social Policy and Resilience to Adversity in Different Welfare States: Britain and Sweden
- 2006
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Ingår i: International Journal of Health Services. - : Sage. - 0020-7314 .- 1541-4469. ; 36:3, s. 425-442
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Tidskriftsartikel (refereegranskat)abstract
- Is poverty more damaging to health in Britain than in Sweden, and if so, why? Following previous research by the authors that suggested such an effect, a new comparative study is examining whether there are aspects of the social and policy context in Britain that add to and reinforce the health-damaging experience of being poor. Conversely, are there other aspects of living in Sweden that are supportive for people in poverty, which make the experience of poverty less stressful and health-damaging? Stemming from this ongoing study, the aim of this article is to present a framework for understanding the context in which social welfare policies are formed and operate in Britain and Sweden. It then uses the framework to consider the “upstream” influences of ideology, culture, and values on policy development in the two countries and what these developments might mean for the health and well-being of people facing financial adversity in the two societies.
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