Sweden and Coronavirus: Unexceptional Exceptionalism

Associations between neighbourhood characteristics and participation in a population-based organised prostate cancer testing (OPT) programme: A register-based study of 50-year-old men

OBJECTIVES

Regional, population-based organised prostate cancer testing (OPT) began in Sweden in 2020. We investigated associations between participation and neighbourhood characteristics.

SETTING

Region Västra Götaland's OPT programme.

METHODS

Data were retrieved from the regional OPT database, for all 50-year-old men invited in 2020-2021. Addresses were linked to demographic statistical areas defined and socioeconomically described by Statistics Sweden. Logistic regression models were used to analyse participation based on neighbourhood deprivation, income, education, proportion of non-western immigrants, and degree of urbanisation, categorised in quintiles. Results are reported as unadjusted and adjusted odds ratios (ORs) with confidence intervals (CIs).

RESULTS

Unadjusted participation was significantly lower in the quintiles of neighbourhoods with the highest deprivation index (OR 0.61, 95% CI 0.56-0.67), lowest income (OR 0.64, 95% CI 0.59-0.71), lowest education (OR 0.81, 95% CI 0.74-0.89), and highest proportion of non-Western immigrants (OR 0.70, 95% CI 0.64-0.77), compared with the opposite quintile. After adjustment for the other variables, significant gradients remained for deprivation (OR 0.65, 95% CI 0.57-0.74), proportion of non-Western immigrants (OR 0.78, 95% CI 0.69-0.88), and degree of urbanization (OR 0.78, 95% CI 0.71-0.87 for rural versus urban areas). No adjusted analysis was done for income owing to its strong correlation with deprivation.

CONCLUSION

Socioeconomic factors and degree of urbanisation influence participation in organised screening for prostate cancer. Actively inviting men for screening, does not in itself avoid socioeconomic disparity in early detection of prostate cancer.

Health, human rights and freedom at stake? A critical discourse analysis of the Swedish media debate on the national COVID-19 pandemic strategy

PURPOSE

The aim of this study is to, in the Swedish media debate, explore the discursive constructions of challenges in human rights and freedoms following the national spatial strategy for health and survival during the COVID-19 pandemic.

METHODS

The study, inspired by a critical discourse analytic approach, focused particularly on the issues addressed, subject positions, relations and rhetoric. Seventeen opinion articles published in Swedish national newspapers December 2019 - February 2022 were analysed.

RESULTS

The main contents were threats to democracy, threats to the freedom and rights of specific groups, and threats to the debate itself. Contents were expressed through three discourse dichotomies: contribution vs interjection, documented vs alarmistic, and active on the stage vs commenting from the balcony.

CONCLUSIONS

Striking about the results is the absence of dialogue, the one-way communication, and the absent politicians. It seems that the analysed debate on the challenges of the Swedish COVID-19 pandemic strategy, based on its impact on overall freedoms and rights, has not been the focus of decision-makers during the pandemic. They have neither addressed the threats highlighted in the articles, nor contributed to the discourse. This is worrying for the long-term maintenance and development of a healthy democracy.

Space and place for health and care - Nationalist discourses in Swedish daily press during the first year of COVID-19

Sweden's strategy during COVID-19 with restrictions but no firm closure of the society surprised the rest of the world and was questioned, not least by neighbouring countries. This article analyses public discourses on space and place for health and care in the Swedish daily press during the first year of the pandemic, 2020. Critical discourse analysis was conducted on daily press newspaper articles to approach issues of space, place, health and care during the COVID-10 pandemic. The findings suggest three main discourses. First, a powerful discourse on unity against the threat is articulated, urging citizens in Sweden to be loyal in the national space. Secondly, an affirming national reconstructing discourse is manifested, related to constructions of borders of national space but also in relation to places of family life and social contacts to 'flatten the curve' and stay healthy. Thirdly, later in the period the overarching discourse of the nation and its loyal citizens was torn apart and increasing tensions were articulated due to, as it appeared, the uncertain actions from the government. This study adds to the literature on a theoretical and practical level. Raising awareness on nationalist discourses in relation to place, space, health, and care could prove important in combating inequalities in the local society as well as when cooperating on an international level.

National health governance, science and the media: drivers of COVID-19 responses in Germany, Sweden and the UK in 2020

The COVID-19 pandemic is an unprecedented global crisis in which governments had to act in a situation of rapid change and substantial uncertainty. The governments of Germany, Sweden and the UK have taken different paths allowing learning for future pandemic preparedness. To help inform discussions on preparedness, inspired by resilience frameworks, this paper reviews governance structures, and the role of science and the media in the COVID-19 response of Germany, Sweden and the UK in 2020. We mapped legitimacy, interdependence, knowledge generation and the capacity to deal with uncertainty.Our analysis revealed stark differences which were linked to pre-existing governing structures, the traditional role of academia, experience of crisis management and the communication of uncertainty-all of which impacted on how much people trusted their government. Germany leveraged diversity and inclusiveness, a 'patchwork quilt', for which it was heavily criticised during the second wave. The Swedish approach avoided plurality and largely excluded academia, while in the UK's academia played an important role in knowledge generation and in forcing the government to review its strategies. However, the vivant debate left the public with confusing and rapidly changing public health messages. Uncertainty and the lack of evidence on how best to manage the COVID-19 pandemic-the main feature during the first wave-was only communicated explicitly in Germany. All country governments lost trust of their populations during the epidemic due to a mix of communication and transparency failures, and increased questioning of government legitimacy and technical capacity by the public.

COVID-19 Is Examining the EU and the Member States: The Role of Attitudes and Sociodemographic Factors on Citizens’ Support towards National Policies

During March and April 2020, the European Union (EU) was the center of the COVID-19 pandemic. Many national governments imposed severe lockdown policies to mitigate the health crisis, but the citizens’ support to these policies was unknown. The aim of this paper was to analyze empirically how citizens in the EU have reacted towards the measures taken by the national governments. To this end, a microeconometric model (ordered probit) that explains the citizens’ satisfaction by a number of attitudes and sociodemographic factors was estimated using a wide database formed by 21,804 European citizens in 21 EU countries who responded a survey between 23 April and 1 May 2020. Our results revealed that Spaniards were the least satisfied citizens in comparison with Danes, Irelanders, Greeks, and Croats, who were the most satisfied nationals. The years of education and the social class also played a determinant role. We also found that the most important determinant was the political support to the government, and that those who were more worried by the economy and the protection of individual rights were usually more critical of the measures than those who were more worried by the health consequences.