COVID-19 and the Nordic Paradox: a call to measure the inequality reducing benefits of welfare systems in the wake of the pandemic. (November 2021)

• Record Type: Journal Article
• Authors: Friedman, Joseph; Calderon-Villarreal, Alhelí; Heggebø, Kristian; Balaj, Mirza; Bambra, Clare; Eikemo, Terje Andreas
• Is Part Of: Social science & medicine. Volume 289(2021)
• Publication Date: 2021-11
• Subjects: Nordic paradox -- COVID-19 pandemic -- Welfare systems -- Health inequalities -- Social inequality; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2021.114455
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: The Nordic Paradox of inequality describes how the Nordic countries have puzzlingly high levels of relative health inequalities compared to other nations, despite extensive universal welfare systems and progressive tax regimes that redistribute income. However, the veracity and origins of this paradox have been contested across decades of literature, as many scholars argue it relates to measurement issues or historical coincidences. Disentangling between potential explanations is crucial to determine if widespread adoption of the Nordic model could represent a sufficient panacea for lowering health inequalities, or if new approaches must be pioneered. As newfound challenges to welfare systems continue to emerge, evidence describing the benefits of welfare systems is becoming ever more important. Preliminary evidence indicates that the COVID-19 pandemic is drastically exacerbating social inequalities in health across the world, via direct and indirect effects. We argue that the COVID-19 pandemic therefore represents a unique opportunity to measure the value of welfare systems in insulating their populations from rising social inequalities in health. However, COVID-19 has also created new measurement challenges and interrupted data collection mechanisms. Robust academic studies will therefore be needed—drawing on novel data collection methods—to measure increasing social inequalities in health in a timely fashion. In order to assure that policies implemented to reduce inequalities can be guided by accurate and updated information, policymakers, academics, and the international community must work together to ensure streamlined data collection, reporting, analysis, and evidence-based decision-making. In this way, the pandemic may offer the opportunity to finally clarify some of the mechanisms underpinning the Nordic Paradox, and potentially more firmly establish the merits of the Nordic model as a global example for reducing social inequalities in health. Highlights: Nordic countries have high health inequalities despite robust welfare systems. The veracity and origins of this paradox are contested in decades of literature. Pandemic-related inequality increases offer a clarifying natural experiment. New, rapid, and socially stratified data collection and reporting mechanisms are needed. In the wake of the pandemic research agendas must prioritize social inequalities.