Sweden’s public health policy, adopted in 2018 by parliament, aims to create societal conditions for good and equitable health across the population and to eliminate avoidable health inequalities within a generation. This is pursued through a structured framework, ‘Towards a Good and Equitable Health’, which monitors progress across eight target areas covering conditions in early life, education, work, economic resources, housing, health behaviours, control and participation, and equitable health services.
The target areas reflect the fact that the Swedish public health system is based on the principle that health is shaped by the social, economic and environmental conditions in which people live as well as by healthcare services. This is embodied in Sweden’s Health in All Policies approach, meaning that Sweden recognises that decisions in education, employment, housing, urban planning, environmental protection and social welfare, among other areas, all significantly affect population health, rather than confining health to the healthcare sector alone.Swedish public health policy represents an integral component of the Swedish welfare state, which constitutes an economic and social system, characterised by a robust public sector, comprehensive tax-financed welfare and close cooperation between labour market parties. Central to this model are the principles of universalism and social protection, which ensure that essential services – such as health care, child care, education and pensions – are accessible to all citizens, irrespective of socio-economic status.A key principle underpinning the Swedish welfare system, and thereby our public health policy, is social compensation. This means that public policies and services provide additional support to individuals and communities facing greater social or economic disadvantages, recognising that equal treatment does not always produce equal health outcomes. This compensatory approach, in combination with universal social insurance, seeks to reduce avoidable health inequalities by distributing resources according to need across all groups. Proportionate universalism, as proposed by the Marmot Review in Fair Society, Healthy Lives and referring to universal measures and interventions that can be scaled in intensity based on need, is at the core of Swedish public health.Health across governmentPreventive action and health promotion, through structural interventions and targeted measures for vulnerable groups, are prioritised alongside medical care, with an emphasis on early intervention throughout the life course. Cross-sector collaboration, health impact assessments and evidence-based policymaking help ensure that health implications are considered in government decisions. Examples include transport policies encouraging active mobility, environmental policies reducing pollution, equitable access to high-quality early childhood education and schools promoting physical and mental well-being, and labour market policies enhancing safe and healthy working conditions. Sweden also integrates public health objectives with broader goals of sustainable development, digital innovation and climate adaptation, recognising that these factors influence both current and future population health.By combining universal access to health care with a Health in All Policies approach and a commitment to social compensation, Sweden seeks not only to treat and prevent illness but also to address the underlying social determinants of health. This integrated strategy aims to improve overall population health and reduce health inequalities to ensure that everyone has the opportunity to live a healthy and fulfilling life. Universal basic services, targeted social protection programmes and labour market policies all contribute to better health outcomes – as do green areas in cities, tobacco control measures and stable vaccination programmes. The challenge lies in ensuring that these policies are designed with health equity as an explicit goal, monitored for their health impacts and scaled to reach those most in need.Closing persistent health gapsPublic health surveillance shows health improvements at a general level, though systematic health disparities exist in nearly all health outcomes and determinants of health. Despite Sweden’s comprehensive universal welfare systems, we exhibit the same patterns as many other countries, with stubborn health gaps that appear difficult to close. This indicates a need for more effective targeted interventions, such as early and coordinated efforts for children in resource-poor areas. It also indicates a need for more nuanced understanding of inequalities, to provide a critical foundation to focus on groups with poorer conditions.Reducing health inequalities is crucial not only for those with poorer health – it also benefits society as a whole. Good and equitable health creates better conditions for economic growth and innovation and is critical for ensuring a robust and more resilient society, with the capacity to withstand crises.
