Different welfare states--different policies? An analysis of the substance of national health promotion policies in three European countries.

This study examines healthy public policy development in three European countries representing different welfare regimes: England representing the liberal model; Norway, the social democratic model; and the Netherlands, the corporatist model. National policy documents were used for the analysis. In England and Norway, health promotion has a prominent place and there is a political focus on the broader determinants of health. However, while the Norwegian policies have an explicit focus on the social gradient, the English policies have a much clearer focus on disadvantaged groups and geographic areas. In the Netherlands, the main focus is on disease prevention and risk behaviors. In the Netherlands and England there is a strong focus on the free will of the population in changing unhealthy lifestyles. By analyzing the different policies in the light of Esping-Andersen's typology of welfare state regimes, it is possible to better understand the differences among the countries. While all types of regimes seem willing to develop targeted measures, the social democratic regime seems the most willing to also develop structural measures addressing the wider social determinants of health.