The Public Health Agency of Sweden (Swedish: Folkhälsomyndigheten, abbreviated Fohm) is a Swedish government agency with national responsibility for public health. It falls under the Ministry of Health and Social Affairs and works to promote public health and to prevent illness and injuries through education. It monitors the health of the population, infectious disease control measures, and public health interventions, and assists the Government in its decision-making process by providing facts and knowledge. The agency is tasked with minimizing negative environmental impact on human health, and participates in the work of the EU and international public health organisations, such as the WHO and IANPHI.
This article explores how local patient support groups can function as sites of everyday activism within a neoliberal healthcare landscape. Based on ethnographic fieldwork with two Breathe Easy groups for individuals with chronic respiratory illness in North East England, the study examines how practices of care, peer support, and informal advocacy subtly challenge the structural marginalisation of chronically ill populations. While members do not explicitly identify as activists, their collective actions—from lobbying for local services to redistributing medical resources—demonstrate grassroots agency grounded in biosocial solidarity and relational care. Drawing on concepts such as biosociality, radical care, and everyday activism, the article shows how these groups redistribute epistemic authority not through protest, but through sustained, care-led micro-politics. Amidst austerity and healthcare reform, their efforts prefigure alternative models of community health governance and challenge dominant narratives of passive patienthood. Navigating insider–outsider roles, these groups create hybrid spaces of patient participation, community action, and informal health provision. The study offers a conceptual framework for understanding support groups as platforms for slow, collective activism operating through relational power. In doing so, it broadens understandings of activism, citizenship, and agency in the context of chronic illness and a restructuring welfare state.
OBJECTIVES:To evaluate the long term risk of invasive cervical cancer after receiving the quadrivalent human papillomavirus (HPV) vaccine, how risk varies by time since vaccination, and to assess the population level impact of HPV vaccination programmes. DESIGN:Nationwide register based cohort study with up to 18 years of follow-up. SETTING:Sweden, from 1 January 2006 to 31 December 2023. PARTICIPANTS:926 362 girls and women residing in Sweden between 2006 and 2023, born in 1985-88 (opportunistic cohort), 1989-92 (subsidised cohort), 1993-98 (catch-up cohort), or 1999-2001 (school based cohort), and with no previous HPV vaccination or diagnosis of invasive cervical cancer at the start of follow-up. MAIN OUTCOME MEASURES:Incidence rate ratios of invasive cervical cancer among vaccinated women versus unvaccinated women were estimated using Poisson regression, adjusting for age, calendar time, sociodemographic factors, and medical histories. Incidence rate ratios were further assessed by time since vaccination, stratified into three year intervals (eg, 1-3, 4-6 years), and by age at vaccination, as well as additional analyses by birth cohorts. RESULTS:During follow-up, 365 502 (39.5%) girls and women received at least one dose of the quadrivalent HPV vaccine. 930 cases of invasive cervical cancer were identified, including 97 in vaccinated and 833 cases in unvaccinated individuals. Among participants vaccinated before 17 years, the overall fully adjusted incidence rate ratios compared with the unvaccinated group was 0.21 (95% confidence interval (CI) 0.13 to 0.32), with sustained protection for 13-15 years after vaccination (incidence rate ratio 0.23, 95% CI 0.11 to 0.46). For individuals vaccinated at 17 years or older, the overall fully adjusted incidence rate ratio was 0.63 (95% CI 0.49 to 0.81) compared with the unvaccinated group, with significant incidence reductions observed during years 10-12 (incidence rate ratio 0.54, 95% CI 0.33 to 0.86), and years 13-15 (incidence rate ratio 0.23, 95% CI 0.08 to 0.60) after vaccination. Compared with the opportunistic cohort, the school based cohort had a 72% (95% CI 11% to 91%) lower risk of cervical cancer after adjustment for covariates (incidence rate ratio 0.28, 95% CI 0.09 to 0.89). CONCLUSIONS:A significantly reduced risk of invasive cervical cancer following quadrivalent HPV vaccination persisted throughout long term follow-up, with no indication of waning protection. School based cohorts showed lower incidence of cervical cancer at the population level than the opportunistic cohort.
IntroductionCarbapenem-resistant (CR)-Enterobacterales are a serious threat to public health worldwide. However, there are limited surveillance data on the molecular epidemiology of CR-Escherichia coli. To address this need, the European Centre for Disease Prevention and Control (ECDC) investigated the molecular epidemiology of CR-E. coli in the carbapenem- and/or colistin-resistant Enterobacterales (CCRE) survey launched in 2019, involving 37 European countries, including Italy.MethodsIn 2019, 46 acute-care hospitals in Italy were enrolled to collect the first 10 non-duplicated consecutive isolates of carbapenem non-susceptible Klebsiella pneumoniae specie complex or E. coli isolates and 10 carbapenem-susceptible comparator isolates of the same species. Each isolate was subjected to antibiotic susceptibility testing. WGS analysis was performed using Illumina technology to determine the ST and to detect resistance genes, virulence factors, and plasmid content.ResultsA total of 61 E. coli isolates were collected from 17 hospitals: 17 CR-E. coli isolates (from urine, 41.2%, and blood, 23.5%) and 44 carbapenem-susceptible (CS)-isolates (from blood, 43.2%, and urine, 38.6%). All the CR-E. coli isolates were resistant to amoxicillin/clavulanic acid, cefepime, ceftazidime and piperacillin/tazobactam; three were resistant to ceftazidime/avibactam and all were susceptible to amikacin and tigecycline. MLST analysis showed the presence of unrelated lineages: CR-E. coli isolates belonged to 8 different STs, with ST131 predominant (58.8%). All the CR-E. coli isolates carried one carbapenemase: KPC-3 (10 isolates), KPC-2 (three), NDM-5 (two), VIM-1 and OXA-181 (one each). Among CS-E. coli isolates, the highest resistance rates were observed for amoxicillin/clavulanic acid (36.4%) followed by ciprofloxacin, and trimethoprim/sulfamethoxazole, and ST131, carrying CTX-M-15, was the predominant clone.DiscussionCR-E. coli clones from infection showed a heterogeneous genetic background, ST131 being the most frequent. KPC was the most common carbapenemase but the presence of E. coli isolates carrying NDM-5 is worrisome, as it results in resistance to several novel beta-lactam-beta-lactamase combinations. Our study underlines the importance of genomic surveillance to monitor and prevent the spread of high-risk clones causing difficult-to-treat infections.
Background Mental ill-health is increasingly recognised as one of today’s major public health challenges. Many possible causes exist, distributed across all socio-political arenas. It is generally agreed that promotive, and preventive policies should be multisectoral, yet there is a lack of empirical studies concerning such endeavours. In a collaborative effort of 26 national governmental agencies, a proposal for a new national mental health and suicide prevention strategy was developed in Sweden. Objectives To explore key stakeholders’ perceptions of the process for developing a new national strategy proposal. Methods This is a qualitative study based on interviews with 25 representatives from 20 national governmental agencies and two external organisations. We used Directed Content Analysis and applied the Health Policy Triangle as analytical framework. Results We found that the multisectoral collaboration led to agencies’ realisation of their limited knowledge about each other’s way of operating. The development process has been perceived as uncharacteristically long and loosely directed. Exploring contextual factors shed light on a need for better care, prevention, and promotion. For a successful implementation of the strategy, respondents demanded clear tasks from the government. Ultimately, respondents highlighted the collaborative implementation of the strategy over its content. Conclusions The multisectoral developmental process was perceived as successful in convening various stakeholders to establish a basis for more collaborative work, particularly regarding the strategy’s implementation. The process did not only serve the purpose to develop a new strategy, but also allowed national agencies to learn about each other and how to collaborate going forward.
AIM:To analyse the association between specific socioeconomic measures and the risk of incomplete vaccination for diphtheria-tetanus-pertussis (DTP) and measles-containing vaccine (MCV) in Swedish two-year-olds. METHODS:This nationwide, population-based cohort study included 227 457 children born in Sweden during 2014-2015. Data were obtained from the National Vaccination Register (NVR) and linked to socioeconomic data from Statistics Sweden. Multivariable logistic regression was used to estimate the associations between family characteristics-including income, education, employment, and family structure-and incomplete DTP and MCV vaccination at 24 months of age. RESULTS:Incomplete vaccination was found in 13.1% of children for DTP3 (three doses) and 8.7% for MCV1 (one dose). Low family income, single parenthood, parental unemployment, frequent residential mobility, and parental immigration were risk factors for incomplete vaccination. A previously unreported risk factor was having a sibling with a disability or chronic disease, which increased the risk of incomplete DTP3 (aOR 1.15, 95% CI 1.05-1.27) and MCV1 (aOR 1.27, 95% CI 1.14-1.41). CONCLUSION:Despite a tax-funded national immunisation programme, socioeconomic disparities in vaccination coverage exist in Sweden. Children in socially vulnerable families, and those with siblings requiring disability support, need targeted interventions to ensure full immunisation.
