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Demokratiskolan
The Public health card from MethodKit for Society and Politics
Card 25 of 128 · MethodKit for Society & Politics
  • AreaWelfare & health
  • Centre of gravityCentral government
  • Points of influence3 on the journey
  • Decisive electionThe general election
Welfare & health

Public health

Prevent disease, prolong life & promote health

Public health is about everything that keeps us well before we get sick: vaccines, clean water, smoke-free environments, cycle paths and a sensible school lunch. The power is unusually spread out. The central government sets the goals and owns infectious-disease control, the regions vaccinate and the municipalities shape the everyday environment you live in.

Where does the power lie?1

  • Municipality · everyday environment, oversight & leisure · approx 30 %
  • Region · vaccines, screening & prevention · approx 25 %
  • State · goals, laws & disease control · approx 40 %
  • EU · outbreak preparedness & medicines · approx 5 %

The central government points out the direction and owns infectious-disease control, but your everyday environment is shaped in the municipality. The general election weighs heaviest, the municipal election shows the most.

How it works: the breakdown

The municipalityThe everyday environment
The regionCare & the vaccine
Central governmentThe goals & the laws · centre of gravity
Who decides?
The municipal council (kommunfullmäktige), the environment and health protection committee and the leisure committee.
The regional council (regionfullmäktige), the healthcare committee, the infectious-disease doctor and the health centres.
The Riksdag, the Government, the Public Health Agency (Folkhälsomyndigheten) and the National Board of Health and Welfare (Socialstyrelsen).
What do they decide?
Drinking water, air, serving permits, smoke-free environments, sports grounds, cycle paths and pupil health in school.
Vaccinations, screening, child health centres, health talks and the preventive work of healthcare.
The goals of public health policy, the communicable diseases act, alcohol and tobacco legislation and the national vaccination programmes.
Where are decisions made?
In the committees and the municipal council. Oversight decisions and minutes are public.
In the regional council and with the infectious-disease doctor, who exists in every region.
In the Riksdag and at the Public Health Agency, which follows public health and issues recommendations.
Who pays?
The municipal tax: oversight, leisure facilities and preventive work in school.
The regional tax, with central government grants for the vaccination programmes among other things.
The central government budget: the agencies, central government grants and national initiatives.
Fastest way in?
Municipal election A citizen's proposal (medborgarförslag), views to the environment office, community associations.
Regional election Email to the committee's politicians, the patients' committee, the region's consultations.
General election A referral response (remiss) on draft legislation, contact with members of the Riksdag from your county.
EUThe EU coordinates outbreak preparedness, approves medicines and vaccines and sets rules for tobacco and chemicals. Shaped in the European Parliament election.

Read the table by column to understand one level, or by row to compare the levels. The green level is the area's centre of gravity.

How it works: follow the decision

The case A vaccine reaches your arm
  1. EU

    The EU approves the vaccine

    The European Medicines Agency EMA reviews the vaccine before it is approved for the EU market. Without that approval, no vaccine reaches a Swedish health centre.

  2. State

    The Government decides on the programme

    The Public Health Agency prepares the basis and the Government decides which vaccinations should be part of the national programmes. The Riksdag steers through the communicable diseases act and the budget.

    Point of influence

    The general election steers the legislation and the money. The supporting documents are public and can be examined.

  3. Region

    The region organises the shots

    The region is responsible for delivery: child health centres and health centres call people in, and the infectious-disease doctor follows how large a share gets vaccinated.

    Point of influence

    The regional election decides healthcare's resources. Views on how it works go to the patients' committee.

  4. Municipality

    Pupil health vaccinates in school

    School vaccinations are given by pupil health, so that all children are reached regardless of how the parents prioritise. The resources of pupil health are set in the municipality's budget.

    Point of influence

    The municipal election steers the resources of pupil health. The parents' council and the principal are the nearest way in.

  5. Your everyday life

    A jab at the child health centre

    Three minutes in an examination room, a plaster and protection that lasts for decades. Behind the jab lie decisions in Brussels, Stockholm, the regional headquarters and the town hall.

The journey looks the same in reverse: what has been built came the same way, through the same decisions. Whoever knows where the decisions are made also knows where they can be changed.

Questions to discuss

  1. What in your everyday environment makes it easy or hard to live healthily where you live?

  2. How far may the public sector go to steer our habits: sugar, alcohol, tobacco, screen time?

  3. Health is unevenly distributed between groups and neighbourhoods. Whose responsibility is it to even it out?

  4. Which preventive efforts should your municipality prioritise if money is tight?

  5. Who do you trust on health questions, and what would make you trust the agencies more?

Glossary

Smittskyddsläkare
A doctor in every region with a statutory responsibility to prevent the spread of infection.
Nationella vaccinationsprogram
The vaccinations offered to everyone in a certain group, decided by the Government.
Elevhälsa
The school's combined team with a nurse, counsellor, psychologist and doctor.
Screening
Health checks offered to a whole group to find illness early.
Tillsyn
An agency's check that laws and rules are being followed.

Go further

Footnotes

1) This is an estimate of how decision-making power over the issue is split between the municipality, the region, central government and the EU, based on how responsibility is divided in legislation. A teaching guide, not an exact measurement.