How Sweden can close the health gap – seminar with WHO
On 21 October, policymakers, researchers, and other experts met at Karolinska Institutet to explore how health equity can be advanced in Sweden and globally, guided by the WHO 2025 World Report on Social Determinants of Health Equity.
Panel discussion moderated by Tanja Tomson with Line Gordon, Mårten Palme, Olivia Wigzell, Stefan Swartling Peterson and Margareta Kristensson.
The half-day seminar was organised by Stockholm Trio for Sustainable Actions (STSA), an initiative within the University Alliance Stockholm Trio. It featured keynote talks, a panel and group discussions. A central topic was how to reverse widening health inequities in Sweden. Sudhvir Singh, Global Lead for Equity and Health at WHO highlighted in his keynote how economic systems, discrimination and “megatrends” like climate change and digitalization determine population health, underlining that health equity must sit at the heart of policy across sectors.
“Health equity is key not only for health systems but for governance as a whole. In times of interconnected crises—climate change, conflict, and rising living costs—investing in health equity is an investment in our shared future. By investing in health, societies can become more resilient and cohesive,” said Sudhvir Singh.
“Sweden has many strengths to build on—for example, progressive taxation and financing for public services and robust protections for sick and parental leave. As in all countries, the priority now is to strengthen and sustain these systems and give everyone the best opportunity to make healthy choices.”
Sudhvir Singh, Global Lead for Equity and Health, WHO, participated remotely.
How do living conditions affect health in Sweden?
The theme of investing in health carried into a panel on addressing health inequities in Sweden, moderated by Tanja Tomson, Associate Professor at Karolinska Institutet. The panelists were: Olivia Wigzell, Director-General, Public Health Agency of Sweden; Stefan Swartling Peterson, Professor of Global Transformation for Health, Karolinska Institutet; Line Gordon, Professor and Director, Stockholm Resilience Centre; Margareta Kristensson, Professor, Linköping University; and Mårten Palme, Professor, Stockholm University.
Mårten Palme presented research showing that gaps in life expectancy between income groups have tripled in Sweden since the 1960s. For men, the gap has increased from about 3.5 years to nearly 11. For women, it has grown from 4 to closer to 9 years. Palme noted however that economic equality does not automatically translate into health equity.
“Even during the period when the income distribution became more equal in Sweden in the 1990s, inequality in life expectancy grew much more pronounced,” said Palme adding that other drivers for health inequity such as food, smoking and physical activity must be addressed.
Stefan Swartling Peterson stressed that the healthy choice must be the easy choice.
“The Swedish government’s current proposal of a flat, low VAT on food will also make unhealthy options cheaper. It is the lost opportunity of the century to not use the opportunity to design a tax system that promotes healthy food.”
Line Gordon also argued that shifting taxes to make healthy food more affordable—combined with regulating marketing would be powerful levers for equitable health.
“Around 80 percent of food marketing towards children in Sweden promotes unhealthy foods. We need better food environments based on science-based dietary guidelines. We can get this by making healthy food affordable and supporting farmers to invest in sustainable practices.”
Widening health gaps require cross-sector action
Olivia Wigzell outlined recommendations that the agency has sent to the Swedish government to support children’s health that take a broad perspective on health: developing spaces that encourage physical activity, establishing safe walking and cycling routes to schools, guaranteeing healthy school meals, and banning the marketing of unhealthy foods to children. Wigzell emphasized the importance of creating forums where researchers, business, civil society, and the public sector co-create solutions for health equity.
“To achive our goals for health equity in Sweden, we need to work across sectors at local, regional, and national levels,” said Olivia Wigzell.
Margareta Kristensson pointed to "Östgötamodellen for equitable health" as a good example of how the public sector, civil society and academia can come together to work for health equity, but noted that implementation of recommendations remains insufficient.
“We need even closer cross-sector collaboration with a focus on implementation.”
Photo: Ulf Sirborn