A Pragmatic Approach to Evidence-Based Public Health Policy

The evidence-based approach is a means to improve the quality, safety and cost-effectiveness of the public sec-tor as a whole, not only the health service. But to be successful, the evidence-based approach needs to be restricted to the stage of the policy process where it really can make a contribution; namely in the choice of intervention. In the policy pro-cess phase that precedes the choice of intervention, i.e. the problem formulation phase, there can by definition be no "evi-dence" available, since no controlled trials can ever prove that one problem is bigger than another. Further, the policy pro-cess phase following the choice of intervention, i.e. the implementation phase, is to date still restricted to research of weaker design and the policy makers need to consider input from many different sources also here. A pragmatic approach, focusing the choice of intervention phase of the policy process, has proved successful in the dissemination of an evidence-based policy for parenting support in Sweden

Mortality by country of birth in the Nordic countries – a systematic review of the literature

Abstract Background Immigration to the Nordic countries has increased in the last decades and foreign-born inhabitants now constitute a considerable part of the region’s population. Several studies suggest poorer self-reported health among foreign-born compared to natives, while results on mortality and life expectancy are inconclusive. To date, few studies have summarized knowledge on mortality differentials by country of birth. This article aims to systematically review previous results on all-cause and cause-specific mortality by country of birth in the Nordic countries. Methods The methodology was conducted and documented systematically and transparently using a narrative approach. We identified 43 relevant studies out of 6059 potentially relevant studies in August 2016, 35 of which used Swedish data, 8 Danish and 1 Norwegian. Results Our findings from fully-adjusted models on Swedish data support claims of excess mortality risks in specific categories of foreign-born. Most notably, immigrants from other Nordic countries, especially Finland, experience increased risk of mortality from all causes, and specifically by suicide, breast and gynaecological cancers, and circulatory diseases. Increased risks in people from Central and Eastern Europe can also be found. On the contrary, decreased risks for people with Southern European and Middle Eastern origins are found for all-cause, suicide, and breast and gynaecological cancer mortality. The few Danish studies are more difficult to compare, with conflicting results arising in the analysis. Finally, results from the one Norwegian study suggest significantly decreased mortality risks among foreign-born, to be explored in further research. Conclusions With new studies being published on mortality differentials between native and foreign-born populations in the Nordic countries, specific risk patterns have begun to arise. Regardless, data from most Nordic countries remains limited, as does the information on specific causes of death. The literature should be expanded in upcoming years to capture associations between country of birth and mortality more clearly

Cross-Temporal and Cross-National Poverty and Mortality Rates among Developed Countries

A prime objective of welfare state activities is to take action to enhance population health and to decrease mortality risks. For several centuries, poverty has been seen as a key social risk factor in these respects. Consequently, the fight against poverty has historically been at the forefront of public health and social policy. The relationship between relative poverty rates and population health indicators is less self-evident, notwithstanding the obvious similarity to the debated topic of the relationship between population health and income inequality. In this study we undertake a comparative analysis of the relationship between relative poverty and mortality across 26 countries over time, with pooled cross-sectional time series analysis. We utilize data from the Luxembourg Income Study to construct age-specific poverty rates across countries and time covering the period from around 1980 to 2005, merged with data on age- and gender-specific mortality data from the Human Mortality Database. Our results suggest not only an impact of relative poverty but also clear differences by welfare regime that partly goes beyond the well-known differences in poverty rates between welfare regimes

Cross-Temporal and Cross-National Poverty and Mortality Rates among Developed Countries

A prime objective of welfare state activities is to take action to enhance population health and to decrease mortality risks. For several centuries, poverty has been seen as a key social risk factor in these respects. Consequently, the fight against poverty has historically been at the forefront of public health and social policy. The relationship between relative poverty rates and population health indicators is less self-evident, notwithstanding the obvious similarity to the debated topic of the relationship between population health and income inequality. In this study we undertake a comparative analysis of the relationship between relative poverty and mortality across 26 countries over time, with pooled cross-sectional time series analysis. We utilize data from the Luxembourg Income Study to construct age-specific poverty rates across countries and time covering the period from around 1980 to 2005, merged with data on age- and gender-specific mortality data from the Human Mortality Database. Our results suggest not only an impact of relative poverty but also clear differences by welfare regime that partly goes beyond the well-known differences in poverty rates between welfare regimes

Additional file 2: Table S1. of Mortality by country of birth in the Nordic countries – a systematic review of the literature

Summary of descriptive information for included studies (See Additional file 1: S3 for a reference list of studies included). (DOCX 50 kb

Additional file 3: Table S2. of Mortality by country of birth in the Nordic countries – a systematic review of the literature

Summary of models and results for included studies (See Additional file 1: S3 for a reference list of studies included). (DOCX 102 kb