Policies to address the social determinants of health: a Nordic perspective

Despite a long tradition of reducing social inequalities by introducing welfare policies, social inequalities have increased in all the Nordic countries. In this chapter, the author presents findings from Nordic projects that have explored some of the mechanisms behind this development. The purpose of one project was to analyse national policies to increase health equity. The main conclusion was that reducing social inequalities in health is on the agenda in all the countries. However, regarding concrete policies and measures, individual and targeted approaches are often preferred. One explanation was that addressing the wider social determinants of health is a complex issue. Redefining the problem may make it more manageable and less politically controversial. A second explanation is the decentralization of the Nordic welfare model, where municipalities have a main responsibility for delivering many health and welfare services. Budgets are limited and the efforts to reduce social inequalities are not prioritized.