Background: Integration of immigrants has been high on the policy agenda for the last 20 years. Many immigrants face specific integration challenges and often continue to experience poorer outcomes than their native-born peers at several levels of life. Integration of immigrants is vital for social cohesion and inclusive growth and for the ability of migrants to become self-reliant, productive citizens. New evidence indicates that the past interventions and policies to facilitate inclusion are not sustainable because they are small-scale, informal, and complementary to the core services and lack systematic efforts to scale up with the formal integration programming.

Purpose: The aim is to propose a framework for an alternative way to empower socially vulnerable populations to meaningfully participate in their host communities and foster their social capital and -bonding through work-integrated learning (WIL) and Critical Participatory Action Research (C-PAR).

Methods: Systematic narrative synthesis of existing evidence and best practices.

Findings: When combined, C-PAR and WIL seem to be effective way to mobilize and empower localcommunity groups. This approach facilitates societal change, capacity building, and co-creation of knowledge needed for self-led integration. The study suggests novel indicators to evaluate the integration process leading to better social inclusion and quality of life.

Conclusion: For scaling up and long-term sustainability, the approach needs to combine the proven successful local bottom-up initiatives with larger top-down interventions.

Background: The five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) have long traditions of social welfare policies that have eradicated poverty as part of their goals. The purpose of this study was to increase our understanding of why child poverty is still significant in the Nordic countries despite existing strategies. Methods: A qualitative analysis of Nordic government documents and reports between 2007 and 2019 was carried out to track changes in public health priorities and political measures and to determine the similarities and differences between the five countries. Results: In all countries, most of the measures were universal, such as benefits during pregnancy, paid parental leave before and after the child was born, paid parental leave related to children’s sickness, child allowances, day care, free health care for children and support for disabled children. National policies aimed to reduce social inequalities and child poverty exist in all five countries, but unaffordable housing, unequal disposable family income distribution and unequal income distribution at local municipality levels seem to be obstacles to reaching national policy goals. Conclusions: Despite comprehensive universal measures to eradicate child poverty, inequalities are significant and increasing in some of the Nordic countries. This might be due to a lack of proportional universalism, where universal measures are in place in all Nordic countries, but with a lack of scale and intensity proportional to the children and families at risk. The significance of eliminating social inequalities needs to be emphasised at the local level.  

Roma people all over the world have often been subject to prejudice, stigma, discrimination and oppression. Many Roma have little or no education, which in combination with other factors often leads to unemployment and marginalization. Based on a case study in Sweden, this paper proposes an approach that can be used in participatory projects aiming at improving the living situation of marginalized people. In such an approach, the Roma themselves would be the leaders in all activities concerning the group. The first aim of this paper is to describe how health literacy and work-integrated learning functioned as empowering tools for a Roma-led inclusion process within a participatory action research framework. The second aim is to discuss and reflect on the use of participatory action research in community work with Roma based on the experiences of the participatory action research participants. The findings indicate that work-integrated learning may be a worthwhile approach for increasing the individual empowerment and self-led social inclusion of vulnerable people. However, the obstacles of structural discriminatory nature hindered the project to reach its full potential in its intended emancipatory goals.

The aim of this article was to explore what is known about the assumed connection between health literacy and empowerment and how this connection is portrayed in the scientific literature. If empowerment is an outcome of health literacy, what are the mechanisms behind this process? A literature search conducted in 2013 yielded 216 hits, of which five met the inclusion criteria, and thus were read in depth and analyzed through a narrative-review approach. The findings indicate that health literacy might be regarded as a tool for empowerment but does not automatically lead to empowerment. Health literacy might be increased by health education. Crucial for empowerment is to achieve the critical level of health literacy including an ability to question and reflect on the prevailing power relations and societal conditions; increased senses of power, self-esteem, and self-efficacy; and an ability to utilize these resources to engage in social and political action for change. This article suggests that for health literacy to be critical to empowerment, there must be a focus on social health determinants and individuals’ subjective perceptions of health and health needs. The article proposes functional and interactive health literacy as a form of capacity building for health and empowerment and critical health literacy as a way to describe empowerment. This scoping review indicates a research gap and a need for future research examining the relationship between health literacy and empowerment.

The basis for this article was a health promotion program based on participatory action research and work-integrated learning (WIL). Seven Roma people were employed and trained to work as local coordinators to empower the local Roma community by strengthening their participation in society and their sense of community, as well as to promote self-led integration. The study aimed to analyze the program from the Roma coordinators' perspectives, focusing on perceived individual empowerment and perceptions of contribution to the common good and to community empowerment. The findings, based on qualitative data, primarily interviews with the Roma coordinators, indicated that the WIL approach, the participatory nature of the program, and the trust and support from the Roma colleagues and non-Roma facilitators were essential for the development of empowerment. Three main themes emerged that portrayed the participants' psychological empowerment: strengthened Roma identity, a sense of power, and a sense of enculturated social inclusion.

We examine the perceptions of Roma adolescents on health, well-being and quality of life (QoL) and how the Roma managed their own life situation within these areas. The data, which consists of interviews, was analysed through content analysis. The most common understanding of health and well-being was to feel good, secure and happy. A wide social network of family and friends was seen as an additional element. The respondents perceived their own health and well-being to be good. A feeling of freedom, the ability to make decisions independently and the possibilities for education and employment were the most important elements of QoL. Quality of life was perceived to have something to do with values and beliefs in the future. Social support from family and friends were the most frequently used coping strategies. The perceptions of the Roma adolescents on health, well-being and QoL turned out to be quite similar to the perceptions of the non-Roma adolescents.

OBJECTIVES: The Roma people have been known in Europe for a 1000 years, during which they have usually been the subject of discrimination and oppression leading to isolation, powerlessness and poor health. The objective of this study is to investigate the sense of coherence (SOC) in relation to self-reported health among a group of Roma people in southwest Sweden.

STUDY DESIGN: A cross-sectional, quantitative pilot study.

METHODS: A questionnaire was constructed based on the Short-Form Health Survey (SF-12) and Antonovsky's Sense of Coherence Scale (SOC-13) and was distributed among Roma people in southwest Sweden (n =102). Self-reported health was summarised in a physical score (PCS) and a mental score (MCS). Comparisons were made with a general Swedish majority population and a Sami population.

RESULTS: The health scores were significantly lower among the Roma people compared to Swedes - PCS: Roma 46.0 (Swedes 52.0) and MCS: Roma 47.5 (Swedes 52.6). The SOC score for the Roma people (54.4) was significantly lower than that of the Swedes (65.2) and Sami (65.0).

CONCLUSIONS: The low SOC with the Swedish majority society is a strong indication of the marginalisation and exclusion of the Roma people from mainstream society. Low scores in self-reported health among the Roma people also establishes the serious health risks the Roma people are experiencing through their present life situation.

Workplace health promotion may include approaches focusing on behavioral change among employees and approaches with a holistic system-oriented thinking aiming at changing the physical, social and organizational factors of a setting. This literature review aimed to identify studies on workplace health promotion in the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden), to describe when, where and how the studies were performed and to further analyze the use of settings approaches and empowerment processes. Using scientific literature databases, we found 1809 hits when searching for Nordic studies published from 1986 to 2008 with the search term health promotion. Of these, 116 studies were related to workplace health promotion and 33 included interventions. We used content analysis to analyze the abstracts of all articles and the full articles of the intervention studies. Most studies were performed in Sweden and Finland. The focus was mainly on behavioral change rather than on holistic health promotion as defined by the Ottawa Charter for Health Promotion. This was especially obvious for the intervention studies. In addition to the intervention studies using non-settings approaches with top-down driven behavioral change, we identified studies with participatory settings approaches aimed at changing the setting. We categorized relatively few studies as having a non-participatory settings approach. The studies aiming specifically at improving employees' empowerment were evenly distributed between the categories market-oriented persuasion of empowerment, therapeutic empowerment and empowerment as a liberal management strategy. More studies on workplace health promotion using empowering and participatory settings approaches are needed in the Nordic countries, and a more theory-based approach towards this research field is needed. © International Union for Health Promotion and Education 2011.

Extensive evidence proposes Antonovsky’s salutogenic theory as a pathway to health promotion. The fundamental concept of salutogenesis is Sense of Coherence (SOC). Salutogenesis is defined as the process of movement towards the health-end of the health ease/dis-ease continuum. The aim of empowerment is to reduce inequity through a learning process and mobilize the uneducated for social action. Empowerment is defined as a process enabling the people to increase control over their health determinants. Empowerment still lacks a coherent theoretical basis. It is claimed that empowerment and SOC have much common and are sometimes overlapping. However, the relationship between these concepts has not been verified by research.

Objectives: To compare the salutogenic theory with the empowerment concept and approach.

Methods: Data consists of a worldwide systematic research synthesis (1992-2003) including 471 scientific publications and an on-going follow-up to 2010. The search was performed through PubMed, Libris, ISI, PsychInfo, Cinahl, Social Services Abstracts and Sociological Abstracts. The analysis was conducted by comparing selected indicators of both theories, such as approach, theoretical focus, definitions, orientation, key concepts, measurement instruments, outcomes and applicability.

Findings: There are both similarities and differences between the concepts, which also somewhat overlap. Several unique and distinctive features for each concept were found. Salutogenesis is based on stress theories whereas empowerment has its roots in pedagogy and social psychology. Both concepts are process oriented. Empowerment can be seen as both means and an outcome whereas salutogenesis is a global life-orientation. Both concepts can be applied at the individual, group, health systems and societal levels. Both proved to be effective in promoting health. The two concepts differ when it comes to definitions and theoretical foundations.

Conclusion: Both approaches are promising methods that can lead to improved health outcomes and are seen as viable public health strategies.