Public health

Thomas Ragnarsson (M)

Mr. Speaker! Today we are debating the Social Affairs Committee's report SoU12 Public Health. I would like to begin by moving for approval of the committee's proposed decision.

We can observe that the Swedish public health is deteriorating every year and that we find ourselves in a situation that will have very large effects in the future, both for the individual and for our welfare. Public health consists of all the components that a life contains. For that reason, our choices and our lifestyle affect our continued lives.

Mr. Speaker! Society is quick to place people in a category. This also applies to us politicians. We are happy to talk about how mental ill-health among young girls and women is increasing and that Bup must have more resources. It is obvious that society should meet the demand with resources where needs exist, but we need to lift our gaze and reflect on the causal relationships.

Most people who experience poor mental well-being are obviously not mentally ill, but their perceived well-being is linked to their entire life situation. Questions that must be answered concern what the sleep hygiene is like, how one moves, diet, screen habits and so on. If I am inactive, have poor fitness and am carrying overweight, it is not strange that I experience a deteriorated mental well-being.

Mr. Speaker! I do not want to downplay people's own experiences in any way. Mental ill-health is something that we must take with the utmost seriousness. That is why the Moderate-led government has continued the work with a national strategy regarding mental ill-health and suicide prevention.

Parallel to this, we need to focus on preventive health-promoting work. My experience is that it is difficult to teach old dogs new tricks. We know that diet and exercise are two components that have a decisive role for a person's well-being, and those who are easiest to influence when it comes to creating good habits are our children. Children who are physically active in their young years have a greater tendency to continue with the activities even in adulthood, which provides great health effects in their future lives. Therefore, the upcoming leisure card is extremely important. Finances should not, after all, be a reason for not being active.

Mr. Speaker! I know that there is criticism regarding the leisure card. And unfortunately, the construction of the system will be costly, but that is because for a long time there has been a failure to act against criminals who have found ways to milk the public system for money. It is something that the Moderate-led government has taken a crack down on. We will continue that fight.

The leisure card certainly has some weaknesses, but if it is the key to getting more children and young people to become active, it is an investment that I stand behind seven days a week. That children at an early age are developing overweight and obesity, and even showing signs of type 2 diabetes, should be reason for everyone to realize how catastrophic it is for these individuals, especially in the future. There is a great risk of developing cardiovascular disease, stroke, diabetes, and joint problems – not to mention mental well-being.

We can look back in time. There have not come particularly many proposals in the last eight years, and the trend that we see now has been constant for a long time.

Mr. Speaker! Generally speaking, we are quite poor at working proactively within the health sector in Sweden. Nor can a single actor be pointed out to handle the issue; rather, it is a collective responsibility in society. The authority that, however, has a large designated responsibility is the Public Health Agency, which is to work for good and equal health in the entire population with a focus on the groups that run the greatest risk of being affected by ill health. This is a mandate that permeates their work, and they guarantee that we can actually measure the population's health status over time, which is a fundamental cornerstone for continued research in the field.

Mr. Speaker! In conclusion, I want to address personal responsibility and the parents' responsibility when it comes to these issues. It is we as parents who set boundaries and rules regarding children's screen time. It is also about how we communicate ideals and whether we take the time to eat together, while it is a meal that reflects our nutritional needs. We should not believe that a twelve-year-old is to handle this alone. Diet plays a decisive role for the whole individual's well-being when it comes to both mental and physical health and, in combination with exercise, is the best and fastest way to achieve great health gains.

I do not believe there is anyone who does not want us to achieve better public health. There are certainly many paths to take, but one thing is clear: If we do nothing, the consequences will be devastating.

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Karin Rågsjö (V)

Mr. Speaker! I believe you are making this a very large individual issue. One might wonder about that, because if one looks at it from a class perspective, it is specifically children and also adults from the working class who are affected by very poor health in different ways. Is it structural, or is it because they eat the wrong food and do not go to the gym? It is clear that one wonders a bit.

For women in the working class, life expectancy has fallen between the years 2006 and 2021, so it is something that all governments bear responsibility for. It is serious.

When it comes to children of people with pre-secondary education, one in five lives in an economic situation where the income over several years has not been sufficient for the most necessary expenses. 60 percent of these do not complete the upper secondary school examination, which of course affects public health.

The Government and SD approach public health issues from an individual perspective. We all bear responsibility for how we eat and so on, and when one looks at the public health of the middle class and their children, one sees that very many exercise, eat correctly and do the right things, because they have the prerequisites.

What are we then going to do with this group that is affected by your politics? I am thinking, for example, of the extreme unemployment that hits families hard. What are we going to say to those families, Thomas Ragnarsson? What are we going to do structurally, not at an individual level, so that public health will improve?

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Thomas Ragnarsson (M)

Mr. Speaker! Thank you, Member Rågsjö, for the question!

It is exactly as the member says: One sees differences depending on where people live and what education they have. That is completely correct.

The level of knowledge among us humans in general has actually increased, but sometimes we humans choose to take the easy way out. I am talking about all social classes. We are very quick to go to the doctor if we feel that we are not well, and we would rather have medicine instead of starting to think about what we ourselves can do. Many know this, even if one perhaps does not take the time or have the energy to do so.

It is one of the reasons behind the leisure card, which will be reinforced in areas of social exclusion and which is intended to get more young people to start moving. If one looks at young people in general, it is actually the case, according to the Swedish Sports Confederation, that young people peak at the age of eleven when it comes to physical activity. It is frightening. Here we must do something.

I am fully aware that it is financially tough for some groups, but then it also becomes even more important to really start thinking about where one spends the money one has so that it doesn't become the quick way – that one chooses junk food instead of cooking meals and so on.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Karin Rågsjö (V)

Mr. Speaker! It is not the case that the mother of three children who lives somewhere with high rent and is soon to become unemployed can afford to buy junk food. This is a matter of prioritizing: Shall we go swimming or shall we eat tomorrow? That is how raw it actually looks.

I completely agree with the member that it is incredibly important for children to move and that we get the movement started. We are in favor of the leisure card, but we also see clouds of concern regarding this. This is about the children who need the most push and help, and unfortunately, a leisure card is not enough. It is not all associations that exist, for example, in Farsta or Skarpnäck. The associations are unfortunately still very inner-city focused. If you, for example, are to go to athletics in Hammarby, it requires that you have a parent who can step up and take you there, who has time and preferably a car. It takes a very long time to get there otherwise; I am very well-informed when it comes to exactly this.

How are we going to get this started? It is very much about class and about people who suffer from, for example, obesity often getting stuck in an unfortunate circle. Therefore, large-scale efforts are required. I would wish that the Public Health Agency also worked with campaigns to get it started, which one is not allowed to do within the state today. Some action was needed, so to speak, to get people moving, so that is what I would like to see.

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Thomas Ragnarsson (M)

Mr. Speaker! I agree that it is concerning that it is still a matter of educational level. That difference can be seen in the statistics. But we have to start somewhere, because right now we are in a spiral that has a tendency to continue and continue. Every measure taken regarding the public health goal must have an improved public health as its goal.

Often there are discussions about money, and in that case, I mean at an organizational level. I have had the privilege of doing military service - a very long military service, because they probably thought it took time to teach me. I was therefore there for a very long time, and we started every day with BRAK - chest, back, shoulders and knees - for 20 minutes where we stood, in the clothes we wore.

It cost no money, but what was the health effect for Thomas Ragnarsson, who was 20 years old at that time? I went from perhaps 25-30 push-ups to being able to do 150 push-ups without any problems. It took twelve months.

One can do very much with simple means, and I am completely convinced that we all in society, and especially in health and medical care and our primary care, must start working much more proactively and health-promoting. We should not just put out fires as we do today.

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Karin Sundin (S)

Mr. Speaker! The overarching goal of Swedish public health policy is to create conditions for good and equal health in the entire population and to close the addressable health gaps within a generation.

It is a very ambitious goal. Unfortunately, we can observe that the work is not going particularly well, at least not in the part that concerns closing the preventable health gaps.

We know that public health is affected by a number of factors such as standard of living, education level, lifestyle habits, and access to health and medical care. In Sweden, in many ways, we have a good starting point and good conditions for health. But we live in a time when the gaps are increasing ever faster, not least when it comes to different aspects of standard of living.

SCB noted in an analysis recently that the proportion of the population living in material and social poverty today is 6 percent. This is an increase of 2 percentage points between 2021 and 2023. This means that just over half a million Swedes live in poverty. Many of them are women.

According to SCB, today 57 percent of Sweden's single mothers have difficulty managing a major unforeseen expense. This is no surprise to anyone. Alarm reports have appeared frequently in recent years regarding the economic vulnerability of families and single individuals in Sweden, from both public actors and civil society.

We know that there is a strong correlation between economic vulnerability and ill health. This is well-documented in both Swedish and international research. There is also a strong correlation between income and life expectancy, where those with lower incomes have a shorter life expectancy than those with higher incomes.

Life expectancy in Sweden is increasing for the population as a whole. But in some groups, the development is going in the wrong direction; life expectancy is decreasing. Most of all, it is decreasing for single women born in Sweden with pre-gymnasium education. The hair-pulling fact is that it is not only so that a majority of the single mothers do not manage unforeseen expenses. They also die prematurely.

We do not solve these challenges with today's considerations. The political responsibility for people's living conditions is spread across several policy areas, across several of the Riksdag's committees, and across several of the government's departments.

It is about educational issues and the fact that every fourth student leaves primary school without passing grades and risks a tough start to adult life and professional life.

It is about labor market issues and the fact that today we have the highest unemployment in ten years, apart from during the pandemic.

It is about the social insurance system and about how more and more people are finding it increasingly difficult to manage on today's benefit levels as prices and fees skyrocket.

It is also about access to healthcare and medicines. We see that many cannot afford to pick up their medicines, and many are worried that there will be more of them now that the government is implementing a significant deterioration of the high-cost protection for medicines.

Mr. Speaker! The proposal we have on the table today concerns public health from a significantly narrower perspective. It concerns the public health policy framework, infectious disease control, vaccinations, healthy lifestyle habits, and mental health. These are, of course, also very important issues. In summary, the Social Democrats' position on these issues is that Sweden needs a new, broad strategy for mental health. The Social Democrats welcome the government's initiative in that area.

We want Sweden to have a unified, national vaccination register where Swedes and the healthcare system get a common overview of which vaccinations one has received - and has not received - throughout life. We also mean that TBE should be added to the general vaccination program for children.

We mean that more measures are needed for increased physical activity at all ages. The leisure card for children and young people that the government wants to introduce must be able to be used in public transport. Otherwise, there is a great risk that many children will not be able to utilize their leisure card because they cannot afford to get to where the activities take place.

Mr. Speaker! I move for approval of reservation 4, which concerns the addition of vaccination against TBE to the general vaccination program for children. I do so because it is a clear example of the growing inequalities in today's Sweden. Some children have parents who can afford to pay for the expensive TBE vaccinations. Other children, who do not have parents who can afford it, run a greater risk of becoming seriously ill if they stay in nature where there is tick-borne TBE. So we cannot have that. Sweden can do better than this.

(Applause)

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Dan Hovskär (KD)

Mr. Speaker! I would like to begin by expressing my approval of the proposals in the committee's report.

Today we shall debate the report regarding public health. Public health is an area that often falls into the shadows politically. Politics has many proposals to improve healthcare and people's access to it, but it is more difficult to achieve broad political initiatives to strengthen public health. This is something that the Christian Democrats want and are pushing to change.

The overarching goal of the public health policy is to create societal conditions for good and equal health for the entire population and to close the addressable health gaps within a generation. We heard that earlier as well.

According to the Public Health Agency's report on public health in Sweden 2024, health in general has become better. We live longer, and fewer die prematurely. The proportion who state that they have good health amounts to 70 percent, and that has not changed significantly. Many are therefore doing well, which is pleasing in itself.

Mr. Speaker! Not all groups have a positive development regarding public health. According to the Public Health Agency's report, the average life expectancy for women with pre-gymnasium education has fallen by approximately half a year. Nor has the occurrence of premature deaths improved. There is an inequality in average life expectancy between those with the shortest and those with the longest education, and it has increased to over six years among men and almost seven years among women.

We are therefore not reaching the overall public health policy goal of closing the health gaps. More needs to be done. Regarding the public health policy goal, it covers eight areas, where the first concerns the conditions of early life. Doing more for the good development of public health among children is very important. Therefore, the government's investment in a leisure card plays a major role. It will reach children and young people.

Mr. Speaker! We Christian Democrats are proud that the government is implementing our proposal for a leisure card. It is a historic investment in active and meaningful leisure time for children and young people. The leisure card will give more children and young people the opportunity, in community with others, to access sports, culture, outdoor life, and association life. It will be an important reform to counteract physical and mental ill health and lay the foundation for more equal health. It shall be introduced during 2025, and funds will be allocated annually for the purpose.

The government has, since taking office, implemented several initiatives to strengthen public health and reduce health inequalities in society. I shall mention five examples.

Firstly: A national coordinator shall strengthen the suicide prevention work, and we have appointed an inquiry to review suicide and deficiencies in society's safety net, as well as established a new national support line.

Secondly, a proposal for a national strategy for mental health and suicide prevention was recently presented. It is the first time decisions have been made regarding a national and long-term Swedish strategy in this area.

Thirdly: The Government has commissioned an investigator to propose how the current monitoring system for public health policy can be further developed by supplementing it with health economic analyses.

For the fourth, the government has tasked the Public Health Agency with developing the work on existential health in public health policy. Research shows that good existential health leads to increased quality of life and strengthens people's ability to manage life's difficulties.

For the fifth: We also make community-promoting initiatives against involuntary loneliness. It is about preventing involuntary loneliness through increased funds to the municipalities for health talks with the elderly, by engaging the business sector in the work, and by developing a national strategy to counteract involuntary loneliness.

A lot is being done in the government or is in the works, and we are pleased with this. At the same time, there is more to be done, and we Christian Democrats will continue to prioritize public health work to strengthen public health in the entire population.

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Leonid Yurkovskiy (SD)

Mr. Speaker! I would like to begin by thanking you for good cooperation with the government even in this matter. One does not need to paint a picture of disagreement where none exists. Just as last year, it is quite clear that there is a broad consensus across party lines in the issues addressed in the report, which is a good sign for everyone out there who is passionate about public health policy.

I shall try not to repeat much of what has already been wisely said, but instead devote my speech to the subject of mental ill-health, which is perhaps the most alarming and tangible problem within the area that we need to tackle here and now.

Let me give a brief situation report. The number of suicides is not decreasing sufficiently. Every year, approximately 1,200 people in Sweden take their lives. Everyone in the chamber probably knows the statistics, but I think it is valuable to remind of the figure every time one gets the opportunity. It is important to repeat that it is about 1,200 people.

It is also more and more people who experience mental ill-health. The increase is greatest among women. When it comes to suicide, it is most men, but perceived mental ill-health affects women more often. Every year, approximately 1.2 million take antidepressants, which in itself carries a number of different consequences. One can call this mass consumption, and it is a clear sign that something is really wrong.

That is why it is welcome that the government and the Sweden Democrats have been able to present a new long-term strategy for mental health, which was mentioned earlier in the debate. Initially, 25 agencies are involved, and each agency shall specify and report back on what they are to do. In the strategy, there is an action plan that further specifies 50 measures to be implemented. As we mentioned at the press conference where the strategy was presented, this is very ambitious, but it is also realistic. Several of the measures have already been started.

It concerns everything from concrete budget allocations to, for example, shortening the queues to child and adolescent psychiatry and increasing resources for suicide prevention in civil society, to investigations and knowledge syntheses on, for example, the mental health of the elderly, involuntary loneliness, and the health effects of digital media use, which is also very topical.

We are of course very proud of the national strategy and the aforementioned action plan, but both the Sweden Democrats and the government will continue to prioritize the area and make further decisions on measures to strengthen the work with mental health.

When we are talking about mental health, I want to mention how important it is that we have now reinstated the national support line. We Sverigedemokrater have consistently pushed for this, and we are now very happy and proud that it is finally in place again. It is an important step to strengthen the support for those who struggle with mental ill-health and their relatives.

Mr. Speaker! In conclusion, I would like to mention something that is new in the Sweden Democrats' committee motion for this year, namely the proposal for a strategy for stress-related ill health.

Stress is often a decisive risk factor for mental ill-health and can have both direct and indirect consequences. It can contribute to depression and sleep problems and, in severe cases, also lead to exhaustion syndrome and a chronically impaired state of health. In that case, it becomes almost redundant to speak about the effect on quality of life, even though it is not something medical.

Particularly worrying is that stress levels are highest among young people. According to the Public Health Agency, 37 percent of young women reported a few years ago that they felt quite or even very stressed. Schoolchildren also report being stressed more often than others, which is a trend that none of us can or want to ignore.

The Sweden Democrats see this as a particular problem to address. Since we live in a constantly changing society, where the demands on the individual are increasing and are not always completely clear, the Sweden Democrats believe it is necessary to investigate the underlying causes of stress and present realistic measures to manage the problem. Such an investigation could include factors such as the work environment, urban planning with a focus on green areas and calm environments, the possibility of physical activity, as well as the negative impact of, for example, advertising and social media.

As you understand, the issue spills over into other policy areas. It is a bit funny with this report; it is at the same time both very broad and quite narrow. But one has to start somewhere, and we think that public health policy is a suitable place.

With full respect for the fact that the issue touches upon existential health, which as is known work is being done on, we regret that our motion on a strategy against stress-related ill health has been rejected, but we will continue to push the issue forward in various formats.

Just as with all mental health, this is about life, and we naturally see healthy and well-adjusted citizens as a win for both the individual and society.

I stand behind all our reservations, but today I only move for approval of reservation 15, which concerns a strategy against stress-related ill health.

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Karin Rågsjö (V)

Mr. Speaker! Without equality, public health easily becomes just a word. The work to break down the differences in health and life expectancy that class membership results in is the foundation for reaching that goal. Likewise, the work to eliminate the differences in health between men and women is a very important cornerstone for us.

Today, people with a low socioeconomic position are affected by ill health to a greater extent. They often state that they have unhealthy lifestyle habits and poorer conditions for health. For women in that group, life expectancy has even decreased between the years 2006 and 2021. It is serious.

At the same time, the economic standard has fallen, which can also affect health. There is nearly a seven-year difference in expected average life expectancy between people with pre-gymnasial and people with post-gymnasial education. That is something to reflect on.

Among children of people with pre-secondary education, more than one in five live in an economic situation where incomes over several years have not been sufficient for the most necessary things. More than 60 percent in the group do not complete the upper secondary school examination, and that, Mr. Speaker, becomes a public health problem. It affects future opportunities for good health. One does not only inherit billions, one also inherits one's exclusion, which is not about ethnicity but about class.

The SD-dependent government has unfortunately made it more difficult. This means that public health will be worsened. We have an extremely high unemployment rate right now, and it worries me immensely. There are very long queues for children to receive real help with mental health. There are far too few entry points, and there is far too little staff. The housing market has, during these years, been managed to be made even worse than it was. This does not improve public health.

Thanks to advances in psychiatric research, we know today that early support measures and psychosocial measures can improve the mental health of young people even later in life. Youth clinics are important actors for the early detection of substance abuse, addiction, and mental ill-health. The youth clinics have high credibility among young people, but they need to be upgraded. They are far too different and have different statuses depending on where in the country one lives. Therefore, we want the government to initiate a review of the youth clinics' mandates in order to clarify them and include addiction and mental ill-health in the mandate. I raise reservation 16, Mr. Speaker.

The national vaccination register, NVR, is a health data register for which the Public Health Agency is responsible. Reporting to the register is mandatory. According to the law, healthcare providers must report all vaccinations given within the national vaccination program, for example, covid-19 vaccine, pneumococcal vaccine for risk groups and other vaccinations that are mandatory.

We believe that even other types of vaccinations should be included in this register. It could involve vaccinations one takes before travels and vaccinations against diseases that are not covered by the national vaccination program. There are a number of actors today, you know, and sometimes it can be difficult to keep track of when one last received a TBE vaccine, for example, or what the status is regarding measles. It would facilitate things if even these vaccinations were included in the system - for the individual but also for society, to provide increased knowledge about the demand for different vaccinations. Therefore, we want the government to quickly clarify how all types of vaccinations - even vaccinations before travels and booster vaccinations - could be registered in the national vaccination register, regardless of the provider.

The biggest public health problem, not only in Sweden but in the entire Western world, is overweight and obesity. In addition to real health risks, such as cancer, type 2 diabetes, and cardiovascular diseases, obesity and overweight are also associated with social stigmatization, which can lead to mental ill-health. For children and adolescents with overweight and obesity, the risk is very great that the problems will follow into adulthood.

In Sweden, approximately 16 percent of the population suffers from obesity and just over 50 percent suffer from either overweight or obesity. These are quite massive figures. Statistics show that the group with post-secondary education is more physically active compared to those who have secondary or only pre-secondary education. One does not need to be a Nobel Prize winner to understand what this is about.

Children and young people's opportunity to participate actively in association life is in many cases limited by the parents' ability to pay for equipment and term fees. When it comes to the leisure card, which is now being distributed, it is very good that one, as a previous speaker has said, can link it to, for example, ski passes, if one should need it; most perhaps cannot afford a car.

We want to see an investigation to produce proposals for the measures required to counteract unhealthy overweight and help those who suffer from it. Much more needs to be done.

TBE is a very unpleasant disease, which one can protect oneself against. I believe that the government should investigate the conditions for introducing a vaccine against TBE as part of the general vaccination program. Children and adults who are in specific areas that are particularly affected by TBE need to have access to the vaccine at a lower cost than today. The Public Health Agency is investigating the issue of TBE vaccination, and my hope is that this work is expedited to increase the vaccination rate against TBE. While waiting for a specific vaccination program to be established, I believe that a high-cost protection should be introduced so that adults pay at most 200 kronor per dose. For children, the vaccination should be completely free of charge. TBE vaccine is today a class issue, and something can be done about it.

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Christofer Bergenblock (C)

Mr. Speaker! Tonight we are debating public health. It may sound like a limited area, but it actually extends across many different things. It is about how we live our lives, what we do in our free time, what we eat, and what kind of relationship we have with alcohol, drugs, and tobacco – because those are the things that affect both our mental and physical well-being. What kind of lifestyle habits and living conditions we have affects, in a very high degree, the risk of developing specific diseases and also the risk of poor mental well-being and suicide.

To a large extent, it is the habits we build up already as children and young people that influence us throughout life. Therefore, it is of course alarming when the Public Health Agency reports that every fourth child aged six to nine years suffers from overweight or obesity today. If one suffers from obesity as a child, the risk is unfortunately high that this continues even when one becomes an adult, and thus the risk also increases for a number of follow-up diseases, such as type 2 diabetes, cardiovascular diseases, and several different types of cancer. But it also increases the risk for poor mental well-being.

For that reason, we need to work more actively to prevent obesity. From the Center Party's side, we see that it is about encouraging physical activity among children and young people. We do not, however, believe in the Tidö parties' idea of establishing a leisure card, where hundreds of millions go to administration, instead of actually providing support to the voluntary sector, which we have a strong confidence in. We also believe that physical activity needs to be encouraged to a greater extent during school time. And we see a need for knowledge support regarding healthy foods so that parents and, for the most part, children themselves can make active and conscious choices in the grocery store or at the restaurant.

At the same time, we believe that a stimulus to the food industry may also be needed. In the United Kingdom, it has been shown that the introduction of a producer levy on sweetened drinks has had a positive effect and contributed to reducing the amount of sugar in soda and other sweetened drinks, which we know is a direct cause of obesity – this because the economic incentive has landed with the producer instead of with the consumer. Therefore, Centerpartiet advocates for a similar system also in Sweden.

Recently, Mr. Speaker, the government's plan for mental health and suicide prevention was presented, and it is something that the Center Party welcomes. Suicide is an all too common cause of death in Sweden today, and there is much we can do to more actively prevent and stop suicides and suicide attempts. The suicide strategy will, of course, be debated in its own right, but I can already state that there is much to be done when it comes to development within the area. Not least, it is about investing in the mental health of children and young people.

There is no doubt that there are many young people in need of help and support, when 52,000 children and young people were prescribed antidepressants during 2023, which corresponded to a doubling over the last ten years, and 24,000 children and young people are in a queue for child and adolescent psychiatry. The mental well-being of children and young people is an area where the entire society needs to join forces.

We also see that the risk of suicide exists throughout life and that it increases in certain situations and in certain groups. Therefore, it is particularly important to identify and prevent the risks that exist. The suicide prevention work needs to be strengthened, not least linked to people with poor mental well-being, mental illnesses, and comorbidity. But it is also about vulnerable groups, such as hbtqi persons, persons with disabilities, and elderly people living in solitude. Centerpartiet believes that active preventive work and improved cooperation between society's various actors are needed.

Another aspect that I want to highlight within the area of public health, Mr. Speaker, is the preventive work through vaccinations. Sweden has for a very long time had a national vaccination program for children and young people, which has been extremely successful in terms of countering and even eradicating dangerous diseases.

One of the recent additions to the program is the vaccination of girls against HPV, which was added in 2010 to prevent cervical cancer. A few years later, it was determined that this is also a major issue among boys, who can develop other forms of cancer. Vaccination of boys against HPV was included in the general vaccination program in 2020. It is somewhat strange, partly that it took so long to include boys in the program, and partly that catch-up vaccinations are still not carried out in an equal manner. This needs to be addressed so that boys and girls born in the same year also receive the same protection against HPV.

Centerpartiet also works to ensure that the general vaccination program applies to the entire population and not just children and young people. Above all, we have for several years highlighted the need for a vaccination program for the elderly, who we know are particularly vulnerable to several diseases that can actually be prevented with the help of vaccines. This could, for example, involve vaccines against shingles or seasonal influenza. We want to start there, but we want to see, in the long run, that the general vaccination program applies at all ages.

Overall, Mr. Speaker, the public health area is to a very large extent about prevention. We must work significantly more with the preventive work linked to lifestyle habits and living conditions and also linked to screening programs and vaccination programs. With the right measures, both physical and mental ill health can be prevented and both diseases and suicide can be avoided.

With this, I move for approval of reservation 7, under point 5 in the report, regarding HPV.

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Ulrika Westerlund (MP)

Mr. Speaker! Public health issues are something that engages many. Being able to live one's life with the best achievable health is a human right, and it is also something that most people desire and actively strive for. Despite this, we do not always receive the support we need to be able to make the best choices. This, the Green Party believes, must be improved, and we have therefore this year introduced a motion concerning the promotion of health.

Dietary habits are one of the biggest risk factors for ill health and premature death in, for example, diabetes, cancer, and cardiovascular disease. According to Cancerfonden, in Sweden 46 percent of all cases of coronary artery disease and 15 percent of all cases of stroke are linked to unhealthy dietary habits. Of the cancer cases, 5 percent are estimated to be linked to unhealthy dietary habits and high BMI, and the figure is expected to increase in the coming years. According to WHO, overweight and obesity risk overtaking smoking as the most important modifiable risk factor for cancer.

In addition to human suffering, illness is also something that entails great costs for society, and it is therefore naturally good if the preventable ill-health can be reduced. At the present time, for example, 35 percent of the costs for cardiovascular disease are caused by our lifestyle habits.

Mr. Speaker! In Sweden, we have the keyhole symbol as a labeling on food products. It has existed since the end of the 80s and has an interesting history, which I intended to tell about.

The labeling was initiated as an initiative from Norsjö municipality in Västerbotten. I was not aware of this previously. The reason was that epidemiological studies during the 1970s showed very large differences in Sweden regarding mortality in cardiovascular diseases. In Västerbotten, the mortality in these diseases was 40 percent higher among persons younger than 75 years than in Halland, which had the lowest mortality in the country. The highest mortality was in Norsjö municipality, and therefore a project was initiated which a few years later became the national Keyhole labeling.

The keyhole has been developed, and now there are requirements for fat content, fat quality, fiber content, and how much sugar and salt a food item may contain. The food items that are a better alternative receive the labeling.

Many countries have similar labeling with slightly different types of design. In the United Kingdom, for example, there is a labeling designed like a traffic light, where different aspects of a food item's content have been clarified. It is easier to see if an item, for example, contains too much salt, sugar, or fat. The Keyhole is something that many are familiar with, but perhaps there is room for improvement here.

Great Britain has also taken the lead in another interesting area, namely a producer levy on sugar-sweetened beverages, which was introduced in 2018. This led to a decrease in the proportion of beverages with very high sugar content.

Miljöpartiet believes that Sweden should use the experiences from this and investigate how a producer fee on sweetened drinks could be introduced in Sweden.

Even when it comes to salt intake, more should be done. The government should set goals for salt reduction and give a mandate to Livsmedelsverket to continue its work in this area.

There are also many good proposals from civil society in Sweden that Miljöpartiet thinks are worth pursuing. The initiative Folkhälsa för alla, which brings together many different organizations and was started by Cancerfonden and Hjärt-Lungfonden, proposes, among other things, that a national action plan for increased physical activity and better eating habits should be developed and that the VAT on vegetables and fruit should be removed. Miljöpartiet thinks this is something that could be investigated.

I also want to advocate for a report from the Public Health Agency and the Swedish Food Agency from February last year: A sustainable and healthy food consumption. It is a report back to the government on a mandate the agency received in April 2021 to develop proposals for national goals, indicators, and relevant areas of intervention for a sustainable and healthy food consumption. There are many proposals here that the government should move forward with.

Mr. Speaker! In conclusion, I would like to change the subject and speak about another very important public health issue, namely the HPV vaccine. In December last year, the Public Health Agency issued updated recommendations regarding vaccination against HPV. Now, the agency recommends that all persons, regardless of gender, up to and including 26 years of age who have not previously been vaccinated against HPV should get vaccinated. The purpose is, of course, to reduce the incidence of HPV-caused cancer. Many associate HPV with cervical cancer, but the virus can also cause other forms of cancer that can affect everyone. The risk of HPV-caused cancer is higher within certain groups, for example, men who have sex with men, transgender people, and people living with HIV. These groups are extra important to reach, but the recommendation is that everyone up to 26 should take the vaccine.

Despite the recommendation, the government and SKR have now reached an agreement in the cancer area, where they have doubled the money going to the eradication of cervical cancer, with a focus on the vaccination of young women. This is naturally important, but boys and young men have been excluded, and the catch-up vaccination is not included. This is very regrettable, and Miljöpartiet hopes that the parties will reconsider.

I support all of the Miljöpartiet's reservations but move for approval only of reservation 10.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Jakob Olofsgård (L)

Mr. Speaker! School lays the foundation for our lives. It is the place where we as children and young people spend a majority of our waking time. How the school is designed has a decisive effect on our health, in particular our mental health. Preschool and school must provide children with the right socio-emotional development, which means safety, stability, and stimulation. Today, it is not always so.

Upbringing conditions, home environment and socioeconomic circumstances have a strong impact on our mental health. But today there is a factor that affects our mental health that did not exist when I grew up, namely social media and mobile phones.

Today, a mobile phone for children and young people is as self-evident as a house key. But we have realized the negative effects of this development far too late. We are ten years behind the ball. Children's and young people's screen time has been allowed to grow unhindered and without being problematized for a long time. It is time for us to wake up.

Public health

Screens are a distraction in the classroom. Nearly 30 percent of young people are distracted by mobile phones or other digital devices in school, and Sweden is above the average according to OECD measurements of this.

Screen use contributes to poorer language development, hindered learning, and difficulties with concentration. Who pays for this? Yes, it is the kids.

We have girls who suffer from sleep deprivation due to scrolling at night. We have girls who are dissatisfied with their bodies due to distorted beauty ideals and comparisons with unrealistic and retouched images.

We have boys who have to endure mean comments and bullying in gaming chats and become addicted to computer games.

The children who suffer most from the escalating level of screen time are also those who are most vulnerable: children and young people with NPF diagnoses, girls with low self-esteem, and children with lacking parental support.

Mr. Speaker! How are we then to get Sweden's young people to feel better by sleeping more, exercising more, and using the mobile phone less? It may seem obvious that our most basic needs such as sleep, exercise, and good nutrition are what play the biggest role for our mental health, but it bears repeating over and over again. The screens are our time's greatest public health challenge, especially for the young.

That is why we in the Liberals have been clear that powerful measures are needed to tackle this. Schools need to become screen- and mobile-free. By removing mobile phones from the classrooms, we make school a safer and more secure place. We need to do that, because every child deserves a happy life.

The deliberation was hereby concluded.

(A decision was to be taken on 13 February.)

The speech at riksdagen.se, in Swedish (opens in a new tab)