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Poor health represents a major factor of exclusion from the labour market due to the influenceit exerts on early retirement. A key issue for policy makers is how to maintain the worker withresidual potentialities in active life and at the same time cope with the difficulties the workerand employer come up with continued presence in the workplace.The aim of this study is to gain an understanding of the barriers but also of the facilitatorsenhancing reintegration outcomes for chronically sick and absent workers. Without such anunderstanding, it is difficult to design and develop appropriate and transferable interventionsand approaches. Cancer is addressed as a specific long-term illness throughout the study, inorder to delimit, and, at the same time, concretise issues and proposals. The study also intendsto highlight the characteristics of national legislations concerning support for workers withlong-term illnesses to regain, where possible, social inclusion and integration in the labourmarket. The different schemes and approaches applied across the Member States are analysedto point out the level and duration of social protection of sick workers as well as how differentcountries support the workers’ wages and previous standard of living during and after sickleave. The study also intends to analyse ‘return to job’ problems, policies and forms ofreintegration of workers.

This study sets out to analyse the social and legal situation of the Roma and the policies of inclusion adopted in the European Countries with particular attention to those fostering accessto the labour market. To address these issues the study outlines the legal and socio-economic condition of the Roma Community across Europe, providing a brief overview of the maincharacteristics of a population composed of sub-communities with some common features butwith different historic and cultural backgrounds. The study focuses more on the differencesbetween the communities than on the similarities. As the aim of the study is to offersuggestions and policy options, it is worth pointing out that policies designed to take thesedifferences into account have better chances of being accepted by the communities, and soproving more effective, than ‘generic’ polices for ‘the Roma’. For example, policiesaddressing isolated and rural communities of illegal Roma have to consider specific issuesdifferent from those for urban Protestant Roma legally resident in the country and vice versa.Specific attention is paid to the legal status of the Roma, as it is highly differentiated acrossthe European Member States and within each country according to the specific group considered.

he purpose of this chapter is to provide a comparative backdrop on changing societal structures and risk profiles in the Nordic countries. The chapter is guided by two questions. Firstly, we ask to what extent labour market systems, household and ethnic demographic structures of Nordic populations have changed in the transition towards postindustrialism, with an emphasis on the most recent phase from the 1990s and onwards. Secondly, we ask to what extent it is reasonable to talk about a distinctive Nordic pattern in terms of the characteristics and distribution of new social risks in the population. These questions are addressed by offering an empirical account and discussion of changes in the socio-economic, household and ethnic composition of the population of the four major Nordic countries: Denmark, Finland, Norway and Sweden. To provide a basis for comparison we include, where possible, data from countries approximating the liberal, the employment-centred and the sub-protective welfare models — the United Kingdom, Germany and Italy, respectively (cf. Gallie & Paugam 2000).

Background: The Addiction Severity Index (ASI) assesses respondents' biopsychosocial problems in seven addiction-related domains (mental health, family and social relations, employment, alcohol use, drug use, physical health, and legal problems). This study examined the association between the seven ASI composite scores and re-employment in a sample of Swedish adults screened for risky alcohol and drug use who were without employment at assessment.

Methods: We conducted a retrospective cohort analysis of employment outcomes among 6502 unemployed adults living in Sweden who completed an ASI assessment for risky alcohol and drug use. The study linked ASI scores to annual tax register data. The primary outcome was employment, defined as having earnings above an administrative threshold. We used Cox proportional hazard models to estimate the association between time to re-employment and ASI composite scores, controlling for demographic characteristics.

Results: Approximately three in ten individuals in the sample regained employment within five years. ASI composite scores suggested widespread biopsychosocial problems. Re-employment was associated with lower ASI composite scores for mental health (estimate: 0.775, 95 % confidence interval: 0.629–0.956), employment (estimate: 0.669, confidence interval: 0.532–0.841), drug use (estimate: 0.628, confidence interval: 0.428–0.924), and health (estimate: 0.798, confidence interval: 0.699–0.912).

Conclusions: This study suggests that several ASI domains may provide information on the complex factors (i.e., mental health, health, drug use) associated with long-term unemployment for people with risky substance use.

There is a general consensus that welfare states influence urban inequality patterns in cities experiencing increases in immigration. Whereas much of the existing research focused on the extent to which welfare states affect the well-being of immigrants after their admission, this study focuses on how immigration policy regimes affect the extent to which immigrant flows, and subsequent labour supply, match variations and fluctuations in the composition of demand in urban labour markets. In particular, the article develops a comparison between Malmo and Genoa, an Italian and a Swedish city with similar urban histories that display considerably different patterns of urban inequality. Immigration to Malmo was fuelled largely by humanitarian emergencies in the countries of origin and occurred in a period of economic decline for the city. The growth of the immigrant population was associated with a worsening of the labour market situation for immigrants and an increase in ethnic residential segregation. Immigration to Genoa was mainly driven by demand for cheap labour, particularly in the private-care sector. Therefore, the growth of the immigrant population was associated with an ethnic segmentation of the labour market, but it also resulted in a more dispersed distribution of immigrants than in Malmo. The differences in the urban inequality patterns in Malmo and Genoa can be only partly explained by policies affecting the living conditions of admitted immigrants. An important role has also been played by the immigration policy regimes of the two countries, which prescribed the integration potential of immigrant flows.

One of the dilemmas facing multi-ethnic societies is how to recognize ethnic diversity while avoiding the risk of reifying ethnic identities, i.e. conceiving ethnic groups as homogeneous and static entities. Ethnic categorization is an essential and necessary tool for developing adequate policies to address unequal opportunities and discrimination. At the same time, ethnic categorizationis an inherently problematic procedure, in official statistics but also in ethnic and migration studies. In fact, ethnic categorization may involuntarily contribute to the reinforcement of stereotypes and negative attitudes towards immigrant groups and, by and large, to the ‘racialization’ of society. The aim of this issue brief is two-fold: (1) to present and compare how the issues of ethnic categorization are dealt with by researchers of selected EU countries and (2) to highlight how cross-country differences in ethnic categorization and pan-ethnic classification practices are also related to different population-counting traditions.

Last years' reforms affected in an extremely different way the Swedish and the Italian elderly care systems, even if these reforms had been apparently inspired by the same "watchwords". In the article the comparison of the effects of these reforms assumes a "broad" definition of care: the reciprocal interrelations between market, state and family are underlined together with their transformations caused by the introduction of the recent reforms. In the 90s the Italian and the Swedish welfare state experienced a further step towards the decentralization of responsibilities on elderly care: in both countries responsibilities for the provision of home care services have been transferred to the municipalities. In the same time, both countries experienced a trend towards the marketization and the informalization of elderly care with a growing importance of private and non profit providers and of family solidarities. However, even after the introduction of these reforms, a substantial confirmation of the differences between the "family ideologies" that historically distinguished the Swedish and Italian welfare states can still be found rather than an evidence of a convergence of their elderly care systems.

In recent years, residential segregation has become a major issue in the Swedish policy debate. The prevailing view is that residential segregation is a crucial contributing factor to the development of income inequality, since individual income prospects are thought to be influenced by the population characteristics of their neighbourhoods. This study takes the opposite approach and analyses the extent to which, in the period 1991–2010, rising income inequality contributed to the development of residential segregation by income in Swedish metropolitan areas. The period was characterized by unprecedented growth in income inequality, which was associated with a decline in the redistributive power of the welfare state. Residential segregation by income mirrored locally the general trend in income inequality. Another factor was the change in income dispersion in neighbourhoods, relative to the metropolitan areas as a whole, which indicates a tendency towards increased population homogeneity in neighbourhoods with respect to income.

The ongoing debate on Swedish municipal housing’s universalist characteristics has focused on declining supply, stricter access criteria, and changing tenant demographics. This study addresses a research gap by examining how Swedish municipal housing queues, prioritizing apartment allocation by registration duration, influence tenant selection. Using a unique dataset from Bostaden, Umeå’s municipal housing company, linked to register data, the study investigates factors influencing housing queue accumulation and usage, with a focus on immigrant background. It further analyses how immigrant background affects the timing of exiting the housing queue to secure apartments. Furthermore, the study explores how the immigrant background of individuals obtaining queue-assigned apartments influences neighbourhood demographics. The findings highlight the substantial challenges faced by immigrants, particularly those from the Global South, in terms of housing queue accumulation, utilization, and neighbourhood attainment. These insights reveal how housing queues, as seniority-based rationing mechanisms, contribute to the perpetuation of housing and socio-spatial inequalities in Swedish cities.

Previous research has predominantly analysed the retrenchment of the Swedish welfarestate from a long-term perspective, examining restructuring processes from thefinancial crisis of the early 1990s until recent years. This study instead takes a shorttermperspective and focuses on welfare state developments in the post-consolidationphase, after the recovery from the crisis. The aim is to investigate how the fiscalpolicy reforms introduced during the recovery years forced subsequent governmentsto continue on the path of “frugality”. Specifically, the paper focuses on the effectsof austerity politics on two policy domains: income redistribution through the benefitand tax system and the municipalities’ role as social service providers and employers.The analysis indicates that the Swedish model is showing increasing signs ofdualisation due to the gradual segmentation of prior universalistic welfare programmesand to the worsening of working conditions in the social service sector.

Recent political and academic debates in Sweden have been dominated by a view of urban problems as endogenously generated by the spatial concentration of individuals with similar ethnic and socioeconomic characteristics within the same neighbourhoods. The impact of welfare state retrenchment on income inequality and residential segregation instead remained an under-investigated and somehow neglected issue in recent research. This paper aims at filling this gap by analysing income inequality dynamics in Malmö in the period 1991-2008. This city offers an interesting case of analysis, given the high rates of social problems compared to other Swedish cities. The results reveal that the increase in income inequality in Malmö has been especially due to the reduced redistributive impact of the Swedish welfare state. Furthermore, the increase in residential segregation by income can be attributed to the parallel increase in citywide income inequality rather than to an alleged increase in neighbourhood sorting.

As in other Western countries, in Sweden there is a widespread conviction that residential segregation influences the opportunities for residents social mobility and therefore is a cause of income inequality. But the opposite direction of causality, from income inequality to residential segregation, is often ignored. The paper fills this gap and analyses income inequality and economic residential segregation developments in Malmo in the years 1991-2010. During this period, changes in population composition owing to increased immigration had a negligible impact on income inequality, while the latter was primarily influenced by changes in the distribution of labour market earnings and capital incomes. At the same time, neighbourhood income inequality was predominantly driven by overall household income inequality and only to a much lower extent by the increase in residential sorting by income. Policy influencing income distribution rather than area-based strategies should thus be at the centre of current debates on residential segregation in Sweden.

This chapter presents a theoretical framework for the simultaneous analysis of the ‘scales’, ‘territories’ and ‘places’ of welfare states. The proposed theoretical framework can be applied for examining, in a comparative manner, the ways in which these three spatial dimensions intersect with one another in local welfare systems and aims at avoiding the one-dimensionalism that has been the pitfall of previous studies on the same topic. The chapter furthermore outlines a spatially sensitive periodisation of welfare state development, which focuses on the historical evolution of central–local government relationships in three subsequent stages of welfare state development.

In Sweden, ethnic residential segregation has been a problem associated traditionally with the largest metropolitan areas of the country. In recent years, however, growing attention has been paid to the areas of immigrant concentration located outside the largest metropolitan areas. Landskrona is one of the most renowned Swedish municipalities, among those located outside the largest metropolitan areas, in which the recent growth of the immigrant population has led to high levels of ethnic residential segregation and, therefore, to the appearance of what Swedish policymakers define as “areas of outsiderness.” Whereas Swedish debates on ethnic residential segregation are dominated by attention to the social and ethnic composition of segregated neighbourhoods, this article focuses on how immigrant settlement patterns in Landskrona have been influenced primarily by immigration policy developments over time as well as by the downscaling of this city within the Swedish urban hierarchy. In recent decades, Landskrona has in fact gone from being an economically buoyant and socially balanced industrial city into a declining and polarized city which is struggling to find a new post-industrial identity. The growth of the immigrant population in Landskrona also has been encouraged by the general unravelling of the Swedish welfare state, which has been associated with an increase in regional imbalances in economic development as well as in housing availability and affordability.

Following Neil Brenner's 3-fold periodization, the article analyses the historical development of the Swedish and the Finnish social assistance systems, from the early phase of Spatial-Keynesianism, through the phase of Endogenous Development Policies, to the present phase of Locational Policies. The Swedish and the Finnish cases have been often clustered in the same welfare regime typology but little investigation has been done on the ways in which the territorial organization of their welfare systems has differently affected their trajectories of development. The article explains how the interrelationship between national and local welfare policies has been firstly established and subsequently evolved in a different manner in the two countries.

The thesis examines the relationship between income inequality and residential segregation in Swedish cities. In recent years, in Sweden, much attention has been given to the direction of causality from residential segregation to income inequality. Residential segregation is considered to lead to a differentiation of opportunities between neighbourhoods and, therefore, to be a contributing factor to or even a major cause of income inequality in cities. The thesis focuses on the opposite direction of causality, from income inequality to residential segregation. In fact, residential segregation can also be seen as the spatial manifestation of existing disparities in income distribution, since residential location choices are always (although not exclusively) made within a predetermined framework of economic constraints.

Specifically, two research questions are addressed in this thesis. What institutional factors, in the Swedish context, favour the transformation of the social divide between specific population subgroups into a spatial divide between those groups? To what extent and in what ways does income inequality contribute to the development of residential segregation in Swedish cities?

The first part of the thesis explains why Swedish cities are characterized by higher levels of residential segregation than cities of other countries characterized by higher levels of income inequality. The historical and comparative analyses developed in the first two studies indicate that it is not so much the magnitude of immigration that accounts for this difference between Swedish cities and their more unequal counterparts in other countries but, rather, the institutional factors influencing the modes of incorporation of immigrants into cities.

The second part of the thesis analyses how, in recent decades, the increase in income inequality has influenced residential segregation patterns in Malmö and in the three major Swedish metropolitan areas. The third and the fourth study show that, during the studied period, the widening of income disparities between neighbourhoods mirrored the general upward trend in income inequality in the population. The growth of the immigrant population contributed only slightly to this trend and income inequality was primarily driven by changes in the distribution of market incomes. During the late study period, however, income sorting processes have played a steadily more important role in contributing to economic residential segregation. Therefore, neighbourhood-based urban policies have not succeeded to reverse, or even just impede, the trend towards an increased spatial clustering of poverty and wealth in Swedish cities.

Until recently, comparative social policy research remained strongly influenced by methodological nationalism (i.e. an approach equating social boundaries with state boundaries) and has rarely considered immigration-driven changes in welfare states. Yet, over the past decades, immigrant populations have grown in size and become increasingly diversified, both in terms of origin countries and in terms of integration patterns, in all Western countries. Immigrants are a more visible but also contested presence in Western societies, which affects also the development of national labour market and welfare systems. The chapter focuses on the link between immigration-driven ethnic diversity and welfare state development by considering four interrelated issues: (1) how the patterns of immigrants' labour market incorporation in host societies affect the social rights they are entitled to; (2) how increasing international migration contributed to the reconfiguration of care arrangements; (3) the implications of immigration-driven multiculturalism for welfare state sustainability; and (4) the connection between immigration and public support for the welfare state. Then, we narrow down our analysis by providing a more detailed account of recent development of migration policies in some European countries. Based on the analysis of the country cases, we put forth the argument that recent institutional developments point to an 'Americanization' of European migration policy and, therefore, to an increasing 'racialization' of European welfare states.

Aim: This study used 17 year of Swedish registry data (2003–2019) for 25,125 adults assessed for their severity of substance use to identify the baseline factors predicting the risk of being court-ordered into compulsory care and examine the association between admission to compulsory care and mortality risks due to alcohol- or drug-related causes.

Methods and materials: Addiction Severity Index (ASI) assessment data were linked to register data on demographic characteristics, compulsory care, and alcohol- and drug-related mortality. Cox regression models were used to identify baseline factors predictive of post-assessment admission to compulsory care in the 5 years post-substance use assessment. Discrete-time random-effect logistic regression models were used to examine the association between compulsory care duration and alcohol or drug-related mortality risks. Propensity score matching was used for validation.

Results: The first models identified that younger age, female gender, and ASI composite scores for drug use, mental health and employment were significantly associated with the risk of placement in compulsory care for drugs other than alcohol. Female gender and ASI composite scores for alcohol, drug use and employment were significantly associated with compulsory care treatment for alcohol use. The second models showed that older individuals and men were more likely to die due to alcohol-related causes, while younger individuals and men were more likely to die due to drug-related causes. Length of stay in compulsory care institutions significantly increased the likelihood of dying due to substance use-related causes. Propensity scores analyses confirmed the results.

Conclusion: In Sweden, a significant concern is the higher likelihood of women and young individuals to be court-ordered to compulsory care. Although compulsory care is often advocated as a life-saving intervention, our findings do not provide strong support for this claim. On the contrary, our findings show that admission to compulsory care is associated with a higher risk of substance use-related mortality. Factors such as compulsory care often not including any medical or psychological therapy, together with relapse and overdose after discharge, may be possible contributing factors to these findings.

This quantitative study assesses knowledge improvement among partici-pants of the EPI university course. The majority were social workers in sub-stance abuse. The course led to significant enhancements in participants’ knowledge, particularly concerning intervention and care continuity and the use of motivational interview techniques. Knowledge about older individuals with substance dependencies and benefits of ASI follow-up interviews for social workers and clients also improved.

Background: In Sweden, as in other countries, individuals with immigrant backgrounds are disproportionately represented within the incarcerated population. This study examined the association between immigrant background and future incarceration for individuals assessed for illicit substance use severity, while considering their prior incarceration history.

Methods: Using data from Swedish Addiction Severity Index (ASI) assessments linked to register data from Statistics Sweden, we employed Zero-Inflated Negative Binomial (ZINB) regression models to analyse differences in incarceration histories within five years before and after ASI assessments based on immigrant backgrounds. Additionally, Cox proportional-hazard models were used to assess the likelihood of post-assessment incarceration among these groups.

Results: Immigrant background was positively associated with pre- and post-assessment incarceration. First- and second-generation immigrants from the Global South had longer periods of incarceration in the five years before assessments compared to native Swedes. Post-assessment, first-generation immigrants showed longer periods of incarceration. Survival analyses supported these findings, indicating a higher risk of prolonged post-assessment incarceration among all immigrant groups, particularly first-generation immigrants from the Global South.

Conclusion: Among individuals assessed for illicit drug use within Swedish municipalities, those with immigrant backgrounds faced higher incarceration risks, even after controlling for substance use severity and prior incarceration. Tailored interventions and support systems are vital to prevent re-entry into the criminal justice system. Timely actions can break re-offending cycles, redirecting paths away from reoffending and towards legal reintegration, thereby reducing incarceration and recidivism rates.

Within the EU, the so-called “refugee crisis” has been predominantly dealt with as an ill-timed and untenable financial burden. Since the 2007–08 financial crisis, the overarching objective of policy initiatives by EU-governments has been to keep public expenditure firmly under control. Thus, Sweden’s decision to grant permanent residence to all Syrians seeking asylum in 2013 seemed to represent a paradigmatic exception, pointing to the possibility of combining a humanitarian approach in the “long summer of migration” with generous welfare provisions. At the end of 2015, however, Sweden reversed its asylum policy, reducing its intake of refugees to the EU-mandated minimum. The main political parties embraced the mainstream view that an open-door refugee policy is not only detrimental to the welfare state, but could possibly trigger a “system breakdown”. In this article, we challenge this widely accepted narrative by arguing that the sustainability of the Swedish welfare state has not been undermined by refugee migration but rather by the Swedish government’s unbending adherence to austerity politics. Austerity politics have weakened the Swedish welfare state’s socially integrative functions and prevented the implementation of a more ambitious growth agenda, harvesting a potentially dynamic interplay of expansionary economic policies and a humanitarian asylum policy.

The aim of this chapter is to challenge an axiomatic assumption made in current public debates – namely, that the sustainability of the welfare state in an age of globalisation requires the imposition of limits on immigration. With a particular focus on Sweden and recent changes in Swedish welfare policy, the chapter shows how the current crisis of the Swedish welfare model has, in fact, haunted this model for decades. The argument presented is that the socially integrative capacities of the Swedish model had been compromised well beforethe start of the post-2015 refugee crisis in Europe but that it is not the scale of immigration that made the Swedish welfare state unsustainable. Rather, it is the austerity-driven retrenchment of the Swedish welfare state which, in the past quarter of a century, has steadily undermined the capacity of the welfare model to offer emancipatory and non-discriminatory pathways of incorporation to immigrants. With the neoliberal reforms implemented since the early 1990s, the current reality in Sweden is that of deepening, and increasingly ethnically tinged, class divisions and the long-term social exclusion of sizeable population groups from substantial citizenship rights.

This chapter analyses the shift from an expansive Swedish welfare state with full employment as its paramount priority to an austerity-driven neoliberal model subordinating social and employment policies to the goals of inflation control and debt reduction. The authors discuss implications of this for rising inequality and social exclusion, with a focus on the Swedish welfare state in general and immigration and integration policies in particular.

Den svenska samhällsekonomiska modellensupplösning under 2000-talet har följts av en djup politisk kris. Det är enkris som har tagits till intäkt för den upprepade berättelsen om liberalt präglad invandrings- och mångfaldspolitik som misslyckat experiment. Författarna ifrågasätter denna berättelse genom attvända på argumentet om det negativa förhållandet mellan migrationoch välfärdsstatlig solidaritet. De hävdar således att det främst är deneuropeiska och svenska åtstramningspolitiken som sedan tidigt 90-talhar undergrävt samhällets socialpolitiska integrationspotential, skapat fördjupade etniskt präglade klasskillnader, permanentat social exkluderingav stora befolkningsgrupper från sociala och medborgerliga rättigheter,samt i sin konsekvens medfört bristande solidaritet kring välfärdsstatens institutioner.

The winds of xenophobia hovering over Europe have swept the moral political foundations of an inclusive Swedish migration policy into the dustbin of history and twisted an enlightened left-right consensus on an open and humanitarian asylum policy into its mirror opposite. Lured by advances of the extreme right the main political parties have, since 2015, come to indiscriminately embrace the view that immigration, etno-cultural diversity and an open-door refugee policy is detrimental to welfare and, in consequence, curbing migration has become the all dominant political strategem in vying for votes. The authors challenge this widely accepted narrative by arguing that the sustainability of the Swedish welfare state has not been undermined by migration but by consecutive Swedish governments' unbending adherence to austerity politics since the beginning of the 1990s. Austerity politics have, step by step, weakened the Swedish Model's socially integrative functions and prevented the implementation of an ambitious agenda, harvesting a potentially dynamic interplay of expansionary economic and social policies and a humanitarian asylum policy.