Norwegian public health policy: revitalization of the social democratic welfare state?

Norway is part of the so-called social democratic welfare state model, which is characterized by its emphasis on solidarity and redistribution among social groups. The concepts of upstream and downstream policy measures may be useful to characterize different approaches to public health policies: upstream measures would be structural measures, in line with the social democratic welfare state model, while downstream measures would be more targeted at individuals or groups at some sort of risk. The aim of this article is to analyze national policies in Norway and how these may be characterized in terms of upstream and downstream factors. Health promotion and public health policies have been high on the Norwegian political agenda for two decades. However, the national policy emphasis has shifted between strategies aimed at individuals and structural strategies--that is, between downstream and upstream measures. Until 2003, policies included mainly downstream measures, but since then a policy shift has taken place and current policy includes an emphasis on upstream measures. This policy was strengthened after a left-wing coalition came into government in 2005. It may be argued that the present policy represents a revitalization of universal and structural measures, in line with the social democratic welfare state model.