Västra Götaland, Sweden Aspirations

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© Allan Karlsson the regionallevel,12county councilsandnine with eightnationalgovernment agencies;at health andhealth-carepolicy, workinginconcert Health andSocialAffairs isresponsibleforoverall system: atthenationallevel, theMinistryof government areinvolvedinthehealth-care and municipalities.AllthreelevelsofSwedish primarily throughtaxesleviedbycountycouncils government-funded anddecentralized,financed The Swedishhealth-caresystemismainly average forSweden(22%)(2). foreign-born peopleis21%,slightlylowerthatthe equivalent tothenationalfigures.Theproportion of is 83.9yearsforwomenand80.3men, Västra Götalandis1.6million.Lifeexpectancy The populationofthegeographicalarea far asindustryandtransportationareconcerned. country, isoneoftheleadingregionsinSwedenas Västra Götaland,hometothelargestportin 564 034 in2017) and onelargecity, Gothenburg(population with smallvillages,49middle-sizedmunicipalities agricultural land,acoastlineandanarchipelago the westcoast,itencompassesforestsand populated regionsinSweden.Situatedon Västra Götalandisoneofthethreemost General overview Västra Götaland,Sweden (1). provide agood life”.In2003,theSwedish The politicalvisionofVGR iscurrently“to health promotionandhuman rights. culture, environment,public transport,public development ofseveral areas, suchasbusiness, national mandatetotaketheleadinregional Hospital andseveralsciencecentres.VGRhas a home totherenownedSahlgrenskaUniversity major responsibilitiesofVGR.Theregionis Research, innovationandeducationarealso primary-care centresand170dentalclinics. care sector, whichincludes17hospitals,200 VGR’s mainresponsibilityrelatestothehealth- held everyfouryears. political members).Electionstothesecouncilsare the RegionalExecutiveBoard(comprising15 Council (comprising149politicalmembers)and the Region.ItsgoverningbodiesareRegional billion, isresponsibleforpublicorganizationin employees andanannualturnoverofSEK60 Sweden’s largestorganizationswith55000 Region VästraGötaland(VGR)(4),oneof care oftheelderlyandpeoplewithdisabilities(3). local level,290municipalitiesareresponsiblefor delivering healthservicestocitizens;andatthe regional bodiesareresponsibleforfinancingand Västra Götaland–winter Parliament decided on a public health policy Reducing school failures – an overall priority with the overarching goal, “to create the societal The Regional development strategy of Region conditions for good health on equal terms for Västra Götaland 2014–2020 (VG2020) (6) the entire population”. The policy had a clear stipulates that skills and competencies in the focus on public health promotion and all sectors population are crucial for the future development of society were required to recognize their and growth of people, companies and responsibilities in reaching the goal. The policy institutions. The link between education and was reviewed in 2008 and minor changes made. health is strong, representing a visible social In 2017, the Swedish Commission for Equity in gradient. One of VGR’s overall priorities is, Health published the report entitled, The next step therefore, to reduce school failures and increase towards more equity in health in Sweden – how the number of school leavers eligible to study can we close a gap in a generation? (5), which at a higher level. It is obvious that finding the could lead to further amendments of the policy, right solution is the responsibility not only of the including a stronger focus on health equity. municipal school system but also of VGR, both Several VGR committees are formally responsible as a leading partner in regional development and for public health, namely, the five health and as a health authority and health-service provider. medical care committees and the Public Health To achieve long-lasting, sustainable commitment, Committee. Together with the municipalities, the VGR needs to acknowledge the importance health and medical care committees coordinate of cross-sector cooperation both within the and agree on frameworks for local public health organization and with relevant statutory and non- work, which is financed by both VGR and the statutory stakeholders. It is important that action municipalities on an equal basis. The Public taken in this area be both generic and specific. Health Committee acts as a strategic engine Cross-sectoral action has been identified in five in relation to public health promotion in the areas, namely: region, creating policy frameworks, initiating 1. promotion of sustainable cross-sector new methods of working and monitoring the cooperation; development of population health. 2. promotion of mental health and fight against Public health promotion focuses on creating the consequences of mental illness; equal access to preconditions for good health throughout the life-course. 3. stimulation of the joy of studying; 4. reduction of the negative impact of migration on school achievement; 5. reduction of the impact of social determinants and risk factors for disease.

Strengths

Västra Götaland’s strengths include: 99 strong development potential (the business sector is 99 a high standard of health and steadily increasing life highly influenced by research and development); expectancy; 99 fast-growing tourism, cultural and creative industries; 99 health indicators with positive trends (fewer people smoking, fewer people drinking alcohol and no increase in obesity).

Västra Götaland, Sweden Aspirations

VGR is aiming to: 99 fight exclusion and segregation, and strengthen the 99 strengthen primary-care services in addressing link between education and working life; mental health. 99 strengthen the possibilities for children and teenagers to take part in cultural activities;

Challenges

These are: 99 the persistent problem of matching the demand for a 99 the need for continued strong and forceful innovation skilled, experienced and highly educated workforce to maintain sustainable development in the region; while many seeking work today have low levels of 99 increasing inequity throughout the region, particularly education and no experience of being in the Swedish that resulting in failure to graduate from school to labour market; institutions of further education.

Potential areas of collaboration

VGR is interested in collaborating with other RHN regions in the following areas: 99 health and education (with a view to implementing 99 health equity (in particular, the importance of the region’s strategy and action plan, “Joint action for addressing gaps in knowledge, trust and language reducing school failures”); that affect people’s access to health-care services 99 the Sustainable Development Goals (SDG’s) (7) and and treatment). regional development (particularly in connection with the process of establishing a new regional development strategy for Västra Götaland);

Working groups

VGR is interested in participating in working groups on: 99 the Sustainable Development Goals (SDGs) (7)/ equity; 99 the all-of-government approach/intersectoral action; 99 education and health.

Västra Götaland, Sweden People active in the Regions for Health Network (RHN)

Political focal point Others Gunnel Adler Elisabeth Rahmberg Chair, Public Health Committee Director of Public Health Region Västra Götaland Region Västra Götaland Mariestad Mariestad Email: [email protected] Email: [email protected]

Technical focal point Håkan Linnarsson Elisabeth Bengtsson Regional Commissioner Senior Public Health Adviser Public Health Committee Region Västra Götaland Region Västra Götaland Mariestad Mariestad Email: [email protected] Email: [email protected]

References

1. Statistik och analys [Statistics and analyses). In: Göteborgs Stad [Gothenburg City] [website]. Gotherburg: 2018 (http://statistik.goteborg.se/, accessed 16 April 2018). 2. Populär statistic [Popular statistics]. In: SCB [website]. Stockholm: Statistiska centralbyrån; 2018 (www.scb.se, accessed 15 April 2018). 3. Gelnngård AH. The Swedish health care system. In: International Health Care System Profiles [website]. New ork,Y NY: The Commonwealth Fund; 2018 (http://international.commonwealthfund.org/countries/sweden/, accessed 15 April 2018). 4. Västra Götalandsregionen [Västra Götalands region] [website]. Vänersborg: Västra Götalandsregionen; 2018 (www. vgregion.se, accessed 15 April 2018). 5. Lundberg O. The next step towards more equity in health in Sweden – how can we close a gap in a generation? Stockholm: Kommissionen för Jämlik Hälsa [Commission for Equal Health]; 2017 (http://kommissionjamlikhalsa.se/ publikationer/next-step-towards-equity-health-sweden, accessed 15 April 2018). 6. Regional development strategy of Region Västra Götaland 2014–2020 (VG2020). In: Growth – internal market, industry, entrepreneurship, and SMEs [website]. Brussels: European Commission; 2018 (https://ec.europa.eu/growth/ tools-databases/regional-innovation-monitor/policy-document/strategy-growth-and-development-v%C3%A4stra- g%C3%B6taland-vg2020, accessed 15 April 2018). 7. Sustainable Development Goals. In: Sustainable Development Knowledge Platform [website]. New York: United Nations; 2018 (https://sustainabledevelopment.un.org/sdgs, accessed 15 April 2018).

Västra Götaland, Sweden