Denmark is a constitutional monarchy in the north of Europe with a population counting a little over 5,5 million. Although not in the Eurozone, the country has been part of the EU since 1973. Denmark constitutes a large welfare state and has the highest level of income equality in the world. At age 65, Danish women can expect to live almost another 20.7 years, and men another 18.0 years.
Denmark has a national health service, which is funded by national-level tax together with government and municipal funds. After a large structural reform in 2007, the country was structured into five new regions and 98 municipalities. The reform remodeled the tasks and obligations of Danish regions and municipalities in a range of areas. They also covered healthcare, health promotion, and disease prevention. Consequently the current model aims to distinguish between healthcare Treatments, mainly being a task for the 5 Danish regions, and Prevention, mainly being a task for the 98 Danish municipalities. Both regions and municipalities cover healthcare costs via taxes, the regions via an economic service model paid by the state taxes, the municipalities via municipal taxes.
Health inequalities have long been recognized on the political agenda with the first official document regarding this topic issued in 1989. However, political focus on health inequalities in Denmark has not been constant. Before 2001 the response to health inequalities was relatively high. Succeeding governments have addressed this issue, confining responses to health inequalities mainly to programmes aimed at vulnerable groups, and not by considering the gradient. Recent estimates indicate that in the last 20 years inequalities in Denmark have doubled, despite the greatly developed healthcare system and a high average income.
The National Board of Health governs both the regions and the municipalities and approves and suggests strategies, goals, and priorities on behalf of the Ministry for Health. Every four years the regions are each obligated to establish “Health Agreements” between their specific region and the municipalities (as general templates at regional level) to set political goals and ambitions. As well as to ensure the more specific ambition and separation of the needed tasks in terms of specific economical, health, or service levels between the hospitals, the GPs, and the health promotion and disease prevention efforts of the municipality. These Health Agreements are then approved the National Board of Health.
An overview of policy responses addressing health inequalities in can be found in our Policy Database.
An overview of projects and initiatives that are currently taking place or that have successfully been finalized, and that are addressing health inequality issues, can be found in our Project Database.
Please find below an overview of key actors in Denmark working on health inequality issues:
Are you aware of any other key actors that should be added to this list?
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Please find below an overview of relevant documents addressing health inequality issues in Denmark. Further publications can be found in our Publications Database.
- Inequality in health – causes and interventions -2010-2012 While it has long been clear that the reason for the weak development in mean life expectancy is that Denmark has not to the same degree as other countries implemented structural preventive measures in the fields of tobacco smoking and alcohol, there has been more uncertainty about how to break the progression of health inequality in Denmark and the rest of Europe. Therefore, in later years, England, Sweden and Norway have all taken steps to assess the causes of and possible countermeasures against health inequality. Most recent and relevant to the work in hand is the review carried out by WHO’s Commission on Social Determinants of Health. With the current report, an analysis has now been conducted in a Danish context to point to the existing knowledge about the causes of health inequality, and the countermeasures that may be expected to impact on it.
- Increasing social inequality in lifespan (Stigende social ulighed i levetiden) This report (2011), by the National Institute of Public Health and the Labour Unions Economic Committee, concludes that social inequalities in health have risen over the last 20 years from 5,5 to 10 years between the top 25 and the lowest 25 % of SES.
- The National Public Health Profile 2010 (Den Nationale Sundhedsprofil 2010) The report is produced by the National Board of Health, with free access to a corresponding interactive data base including a national sample of more than 180,000 citizens (response proportion about 60%). Tables may be produced from any computer with internet connection, including a range of health indicators by a few important background variables, including also social information, e.g. education and marital status. This material is intended to interact with the development of national, regional and municipal strategies and campaigns, e.g. campaigns on safe sex; alcohol abuse; anti tobacco intervention; physical activity. Material about how to plan, implement and follow-up campaigns has been produced for regional and municipal managers.
- Danmark 2020: Knowledge, growth, wealth, welfare (Viden, vækst, velstand, velfærd) This working program (2010) has been presented by the Danish Government as a national multi- sectoral population strategy, which has the reduction of HI as an indirect consequence of its application.
- Advisory paper on the area of cancer prevention and treatment (Styrket indsats på kræftområdet: et sundhedsfagligt oplæg) The paper (2010), realized by the Danish Board of Health, refers to the reduction of HI is as a specific aim of the strategy. The area of implementation is regional,: it is health sector driven and disease-group specific, addressing the gap between low and high SES.
- The Danish Board of Health’s initiatives concerning health inequalities The report has market significant resources to local and regional projects tackling social inequalities in health special emphasis of projects improving the conditions for the most vulnerable groups.
- We can live longer and healthier (Vi kan leve længere og sundere) Recommendation from the Prevention Commission for an improved prevention effort. Reducing health inequalities is one of the main aims, as outlined in section 3.5 of the report. Published in 2009.
- National Report on strategies for social protection and social inclusion – 2008-2010 Document from the Ministry of Social Welfare and Health and Prevention. Overview of the current situation + national action plan for social inclusion + national strategy for pensions + national strategy for health care and long term care. Reduction of HI and SI as specific aims of strategy.
- Social differences: public health report (Sociale forskelle: Folkesundhedsrapporten) Report by the National Institute of Health. Published in 2007.
- What do we know about the health of socially vulnerable? (Hvad ved vi om socialt udsattes sundhed?) Publication by the National Institute of Public Health in collaboration with the Council for the Socially Vulnerable (2007). It offers a literature review and analysis of existing data regarding the health behavior, health and disease patterns among the socially vulnerable.
Are you aware of any other key resources that should be added to this list?