Ivan Harsløf

Changing social risks and social policy responses in the Nordic welfare states

The Nordic welfare states have found themselves in the firing line of post-industrial developments, resulting in fundamental changes in societal institutions at all levels. In particular, changes in the labour market and family, reinforced by processes of migration and international market integration, have presented the welfare states with new social needs to attend to. This book critically explores responses to changing social risks across areas such as structural unemployment, entrepreneurship, immigration, single parenthood, education and health. It explores critical changes in the structure of the Nordic welfare states and the social policy strategies for alleviating social risks. While the Nordic countries are shining in most international comparisons, such changes and their wider implications have often been overlooked in the literature. The book raises the question whether certain risks are even being evoked actively through new social policies instating incentive structures concomitant with policy goals in order to encourage certain behaviour among citizens.

‘Integrative’ or ‘Defensive’ Youth Activation in Nine European Welfare States

Young unemployed persons are a prioritised group in active labour market programmes. Such programmes can be regarded as ‘integrative’, facilitating integration into the labour market for young people in accordance with their own preferences. However, such programmes can also be regarded as ‘defensive’, discouraging young unemployed persons from claiming transfer incomes and urging them to lower their sights when looking for jobs. The article examines the conceptions of the young participants themselves, analysing whether activation programmes are experienced in ways endorsing the integrative or the defensive perspective across different European welfare states. Survey data from these countries indicate that activation programmes for youth are at the integrative end of the spectrum. This is especially the case in the universal welfare regime countries, which are also the group of countries in which youth activation schemes are most widespread. Participants scheme evaluations are least favourable in Scotland, in line with expectations of a liberal welfare regime approach. Most conservative welfare regime countries fall in between.

Facing diversity under institutional constraints: challenging situations for community nurses when providing care to ethnic minority patients

AIMS To explore the challenges faced by community nurses when providing home health care to ethnic minority patients. BACKGROUND Norway has a growing number of immigrants, including older immigrant patients. Community nurses who provide home care encounter considerable challenges when delivering services to an increasingly diverse patient population. DESIGN A qualitative study based on a hermeneutics approach. METHODS A qualitative study was conducted involving 19 nurses in Norwegian home health care districts, which had high proportions of minority patients. Data were collected in 2008. FINDINGS We identified three critical aspects of the encounters between community nurses and minority patients. The first was intimate care. Nurses perceived the fear of mistakes and crossing boundaries related to the cultural and religious practices of minority patients as particularly stressful. The second was rehabilitation after stroke. The beliefs of nurses in the benefits of rapid rehabilitation conflicted with those of the minority patients and their relatives who favoured extended rest during recovery. Third, the commitment of community nurses to transparency in the care of dying patients was tested severely when they met relatives who believed in religious explanations for the destinies of patients and who wanted to conceal the true diagnosis from terminally ill patients. CONCLUSION Community nurses encountered various challenges due to a lack of experience with highly diverse patient populations. This situation will continue to create difficulties for nurses and minority patients if management support and appropriate training measures are not provided.

Changing Youth Labour Markets, Welfare Institutions and Young People's Control over Working Time

The objective of this article is to examine the ways in which young peoples control over working time is related to phenomena originating in recent trends in European youth labour markets such as the rise in temporary employment and the increasing importance of active labour market policies. The heuristic concept of social chronotopy is introduced to capture the interrelatedness of social time and social space, considering how the value of young peoples working time is dependent upon their own contractual status, and the market and welfare institutional context in which they find themselves. In comparative multilevel analyses of survey data, self-reported control over working time is found to be adversely affected by being temporarily employed and finding oneself in a national context of low income replacement for unemployed youth and being confronted with a troublesome youth labour market characterized by the lack of jobs, the lack of permanent jobs, and the lack of spending on active labour market policies.

Health Capital: New Health Risks and Personal Investments in the Body in the Context of Changing Nordic Welfare States

Throughout the Western world, patterns of diseases and disabilities have changed as new forms have emerged (OECD 2010). While many old social risks affecting people’s health, such as inadequate nutrition and hard, physical labour, were related to scarcity, today we are witnessing health risks such as obesity, type II-diabetes, hypertension, cardiovascular disease, certain forms of cancer and so on that in intricate ways may be associated with abundance. Similarly, old social health risks, including dangerous work environments and poor housing conditions, were related to outward physical threats and are as such still present as risk factors, while new health risks appear to be more intangible and seemingly lifestyle related, sometimes even self-inflicted, like eating disorders (e.g. bulimia, anorexia) and deliberate self-harm. And in contrast to the old health risks, often manifested in conspicuous handicaps, the new health risks are less visible, and hence often labelled as ‘diffuse’ — for example, fibromyalgia, chronic fatigue syndrome, clinical depression and anxiety (cf. Overbye 2005).

Introduction: Changing Social Risks and Social Policy Responses in the Nordic Welfare States

Insuring its citizens against the misfortunes that may threaten their livelihood is the defining feature of the welfare state. The first social insurance schemes that emerged in the late 19th and early 20th centuries were instituted to protect people in cases of work accidents, sickness, unemployment, widowhood and old age (if it occurred). By instituting such schemes, the state acknowledged that individuals were exposed to social risks conditioned by societal structures that were beyond their control (Rothstein 1994).

Discussion : The take on, new social risks in the Nordic welfare states

Amidst the deep and interrelated global crises in finance and employment, the Nordic countries might look like heaven on earth. They could be regarded as such not only by individuals who are partic ...

Danish and Norwegian hospital social workers’ cross-institutional work amidst inter-sectoral restructuring of health and social welfare

ABSTRACT Starting in the 2000s, Denmark and Norway have undergone extensive restructuring of their health-related social benefit programmes, including how they are governed. Several reforms have sought to enhance inter-sectoral collaboration. Aiming at ensuring patients’ faster return to work, policy-makers have instituted economic incentives to both individuals and the health and welfare organisations who handle them. Through an institutional logics approach, this paper explores how hospital social workers in these countries are experiencing these changes. The ‘social’ part of post-treatment care and rehabilitation receives more attention in the Norwegian institutional set-up than in the Danish, and whilst challenges are experienced in both countries, in group interviews Danish social workers in particular express concerns about the implications of the accelerated return-to-work focus. In both countries, they report increasing difficulties in ‘making their way through’ the state-municipal bureaucracy. However, by drawing on the formal health knowledge derived from medical settings and the symbolic capital it bestows on them, they often manage to negotiate the work-and-welfare services, thereby transforming the social context for the patients.