A well structured, efficient health service is an important component of the welfare state, in Sweden for example. But its significance for the state of the nation's health is limited and will be affected, inter alia, by life styles and the environment. A progressive health policy must be based on cooperation between various sectors of society, and here the health service plays a central part. Therefore social policy must be well documented and subjected to continuous review. This is an important prerequisite for planning and correction at different levels. The analysis must take account of society as a whole, organization, and the individual! In so doing, greater significance should be attributed to the effectiveness and quality of the health service than to structures, capacity and statistics. With reference to the health of children in the Nordic countries, it is encouraging to see that this conception of evaluation has also gained greater acceptance in preventive care, firstly in the field of paediatric health care and more recently in the school health service as well.
Health implies broad and positive aspects of life, well beyond disease and medical care. It is clearly expressed in the constitution of the WHO, and has been clarified in the Health for All strategy, emphasizing health promotion as a basic means to enable people to increase control over their health. The study of the broad and complex issues of population health is called public health; it naturally also includes children and their special needs. The ideology of Health for All, the science of public health and the imperatives of children's health are integrated in Social Pediatrics. Its task is to place the health of children in a full social, economic and political context, using inter-disciplinary, interprofessional and inter-sector cooperation with the children and their parents as the basis for all activities. After relating a few successes of socio-pediatric actions on a national level, the focus is directed towards health promotion issues that are especially significant for children and young persons, i.e. fundamental, academic and practical issues. The way ahead for children's health promotion and for Social Pediatrics lies in the readiness to anticipate change and to adapt to new societal needs.
A socio-pediatric study of children's health and well-being has been carried out, based on questionnaires from 2000 children with long-term illnesses and disabilities and from a representative sample of 10,000 children from the five Nordic countries. The overall results confirm that Nordic children enjoy a high standard of living, and that they are healthy, both physically, mentally and socially. They frequently use the health services but mainly for minor complaints and their hospital stays are short. Disabled children and their families have the same material standard of living and a similar social network as the others. Their leisure time activities, however, are reduced and the children's peer acceptance and self-esteem are lower and they have more psychosomatic symptoms. It is mainly the mothers who have to interrupt their career to take care of the disabled children. Most families, both disabled and others, are quite satisfied with the children's medical care, especially where continuity and specialist services are provided.