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

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Section 4. Addressing health inequities in Västra GötalandThis section accounts for the Commission’s work including organizationalstructure, work phases and the scope of the Action Plan that Region VästraGötaland used in its process to address health inequities. Then, the expectedresults and the outcome are summarized and discussed. The objective of theCommission was to identify the concrete actions that were the most likely,given current knowledge, to reduce health inequalities in the region.But first, what motivated the assignment?MotivationA number of different aspects when taken together could explain themotivation for this process. In Sweden, there is a national public health goalto create the social conditions needed to ensure good health on equal termsfor the entire population. This goal was formulated in 2003 and is defined byeleven subgoals that include societal as well as lifestyle-related characteristics.These goals can be viewed as a first step towards a more welfare-orientedpublic health work (16).The final report from the WHO Commission on Social Determinants ofHealth in 2008 started a discussion in Västra Götaland as it did in many otherareas across Europe on health equity and fairness in the distribution of thesocial determinants (3).Complementary reports were published that explained the societal costs forhealth inequities and the media/public became aware of the unexpectedlygreat differences in life expectancies between city areas for example (2). Theincreased professional knowledge and interest in gathering and presentingstatistics and a better understanding of the causes, together with the politicalwill and public awareness, all acted as inspiration for the Commission.In parallel to the development within the field of health equity, the conceptof social sustainability appeared on the agenda of public authorities as wellas in research and media. As inequalities in society became tangible and theeffects of people’s dissatisfaction spread from one neighbourhood to another,16 Tackling health inequities: from concepts to practice.
the social aspects of sustainability became more pressing for stakeholders inall domains and spheres – for public authorities as well as nongovernmentalorganizations.The regional organization with public health as a field between (1) healthand medical care and (2) regional development was a vital arena for includingstakeholders in the work that followed. Bridging both pillars of the regionalresponsibilities is crucial, since the question of social sustainability and healthequity relies on both of these arenas.Organizational structureThe organizational structure of the Commission had two objectives: (1) toanchor its work in the internal organization at the political level as well as atthe administrative level and (2) to include a broad spectrum of stakeholders byusing a bottom-up approach. The Regional Council decision in 2010 was theprecondition for the first objective, where internal stakeholders were named.The Commission was thus led by a Political Steering Group representedby politicians from the HMCCs, the Regional Development Committee,the Cultural Affairs Committee and the Human Rights Committee. TheCommission was chaired by the Chair of the Public Health Committee. TheSteering Group met on a regular basis and gave feedback on the work thatwas carried out by the other arenas working with the Action Plan, mainly theproject group and working group. This was an important part of the internalanchoring to get everyone on board.For anchoring at administrative level as well as enabling the professional levelto be an active part in the organizational structure, a workgroup or task forcewas also formed. The workgroup comprised officials from the aforementionedadministrations and representatives for some of the municipalities in VästraGötaland, the Coordination Association, the Swedish Public EmploymentService, the Social Insurance Office, the County Administrative Board of VästraGötaland, trade union organizations and the non-profit sector. Parties outsidethe Region’s organization participated on a voluntary basis and according totheir own assignments. These representatives were also supposed to report backand anchor in their own organizations as well as provide input on the work.Section 4. Addressing health inequities in Västra Götaland17
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Tackling-health-inequities-from-concepts-to-practice-The-experience-of-Vastra-Gotaland

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