Public Health Policy to Tackle Social Health Inequalities: A Balancing Act Between Competing Institutional Logics

Abstract

Kvåle and colleagues examine the logics of Norwegian government initiatives to respond to social inequalities in health. Whereas the individualist logic favors bounded and specialized measures and organization, the collectivist logic favors broad approaches and organizational coordination. A content analysis of Norwegian health policy documents between 2003 and 2017 shows how such specialized and integrative measures and structures are alternately introduced and hence create a pattern of priorities to tackle public health challenges alternating between a collectivist and an individualist logic. They argue that reform of service coordination to tackle social inequalities in health requires a clear awareness across political and organizational levels and sectors, of how public health should be a public responsibility, and not primarily the responsibility of the individual citizen.