The Swedish intersectoral national public health policy: effects on child and adolescent health

BACKGROUND: To improve health, intersectoral cooperation is often advocated. However, only few studies have reported health effects of this approach. Sweden has adopted a national public health policy (NPHP), which focuses on intersectoral primary prevention of disorders and injuries. AIM: To investigate the effects of the NPHP, on child and adolescent health in Sweden during the period 2000–19. METHODS: In the first step, the most important improvements in disorders and injuries, assessed as DALYs and incidences, were identified using the GBD Compare database. In the second step, primary prevention methods for these disorders and injuries were identified. In the third step, the relative importance of various government agents for these preventive measures was assessed using Google searches. RESULTS: Out of 24 groups of causes of disease or injury, only two groups demonstrated an incidence decrease: neoplasms and transport injuries. Leukaemia neoplasms might be prevented by reducing parental smoking, reducing outdoor air pollution and having the mother take folate supplements before getting pregnant. Transport injuries might be prevented by speed restrictions, and physically separating pedestrians from vehicle transport. Most of the primary prevention work was done by government agencies, like the Swedish Transport Agency, which worked independently of the National Institute of Public Health. CONCLUSION: Governmental agencies outside the health carried out most of the effective primary preventive efforts, almost independently of the NPHP.