Tackling-health-inequities-from-concepts-to-practice-The-experience-of-Vastra-Gotaland

on Social Determinants of Health, these conditions are, in turn, shaped bypolitical, social and economic forces (3). As a consequence, tackling healthinequalities requires joint action by multiple actors and stakeholders. It isnecessary to look at the process of policy-making, how decisions are madethat might influence the distribution of the social determinants of health andthe response in terms of implementation and effects on the distribution ofhealth in the population.Following the launch of the final report from the WHO Commission onSocial Determinants of Health in late 2008 (3), the Regional Councilin Region Västra Götaland decided to start a joint venture to tackleinequalities in health in its Region. The challenge was to identifyactions that should be efficient and concrete, and also to attract differentstakeholders with different agendas and objectives to make a joint effortto tackle health inequalities within the region and, at the same time, havepolitical commitment to the work.This report aims to summarize the process, which evolved as a result fromthe Regional Council’s decision. Section 2 presents a short background onhow the process began, and Section 3 gives an account of the theoreticalframework that served as a compass for the process. Section 4 describes theprocess and the Action Plan for Health Equity in Region Västra Götaland (4)and provides an analysis on success factors as well as pitfalls. The last sectionis a discussion in which certain important parts of the process are highlighted.This report adds to the growing number of reports on joint efforts to tacklehealth inequalities, such as the Norwegian case (5) and Malmö’s path towardsa sustainable future (6) in Sweden. These reports might inspire others tolaunch similar local and regional processes. An underlying theme in thesereports is governance – the idea that interdependence among societal actorsrequires joint action to make a difference – a core message in the WHOHealth 2020 strategy (7). This report illustrates a regional effort to establish anetwork of stakeholders, based on previous reviews on health inequities.Even if there can be no universal solution that works in all contexts, a strategyto reduce health inequalities must recognize the complexity in modernsocieties, which are increasingly interdependent in a globalized worldand thus require new approaches to governance where key goals includeSection 1. Introduction3