The digitalization of health care is currently subject to extensive hype (both negative and positive), which obscures its potential to benefit humanity. Science and Technology Studies have described the computational translation of health information as “datafication,” often from a critical stance in which such technologies limit agency of patients and clinicians. Conversely, health care has long since been structured along highly unequal lines with high levels of inequity, in which parts of the population experience reduced healthcare access. In addition, there are high levels of health illiteracy, where some groups are not only unaware of their own health needs or how to access health care, but the healthcare system is itself lacking key information on the needs of those individuals. In that context, digital systems able to handle and communicate large datasets are often heralded as a solution for better connecting patients and the healthcare system within a holistic model. To help bring much-needed nuance to our understanding of digital health care, the article looks to the example of digital dental health—both implemented and potential—within Skåne in Southern Sweden, with a mix of an advanced welfare model healthcare system combined with a diverse population consisting of many foreign-born nationals. By interviewing dental professionals working in Skåne, we investigate the intersection between the theoretical arguments and the practical constraints and opportunities for digital health.

Background: High-quality diabetes care should offer personalized treatment and support self-management to reduce complications and maintain quality of life for affected persons. In Malmö, Sweden’s third-largest city, primary care treated twice as many individuals with type 2 diabetes (T2D) in 2018 compared to 2011. As the prevalence of T2D increases, healthcare services face increasing challenges. Objective: To explore experiences of contacts with diabetes care professionals among people living with T2D who are accessing diabetes care in the city of Malmö. Method: A qualitative inductive design was employed, involving interviews with 21 persons with T2D receiving diabetes care at four primary healthcare centers in Malmö. A semi-structured interview guide was used. Data were analyzed using qualitative content analysis. Result: The theme ‘Seeking room for one’s agency’ emerged from two categories that illustrate experiences with diabetes care in relation to meeting healthcare needs: ‘Importance of connecting with diabetes care professionals’ and ‘Concerns in navigating diabetes care.’ Eight subcategories describe what contact with diabetes care meant for the participants. Conclusion: The findings highlight opportunities for improving diabetes care to better meet patients’ needs. Contacts with diabetes care professionals were perceived as supportive when there was a clear intention to adapt to individual needs and when expectations and communication were transparent. Continuity with general practitioners and educational aspects were identified as unmet healthcare needs. Based on the findings of this study, efforts to a systematic and broad implementation of group-based T2D-education in Malmö are recommended.

INTRODUCTION: Migration is an increasing phenomenon and associated with a physical and psychosocial burden on individuals. Little is known about migration and skin health. The objective of this study was to describe the characteristics of patients regarding migration background and dermatological morbidity among adults seen in a dermatological out-patient clinic in Malmö, Sweden.

METHODS: An observational cross-sectional study was performed in 2017. Dermatological out-patients completed questionnaires and were examined by a dermatologist. Sociodemographic variables including ethnicity and migration status were assessed by self-report. Ethnicity was assessed with country of birth. General and physical health and details about skin disease were self-reported. Stress was assessed by the Perceived Stress Scale (PSS) and with items assessing stressful life events and economic difficulties. Depression and anxiety were assessed with the Patient Health Questionnaire-2 (PHQ-2) and the General Anxiety Disorder Assessment-2 (GAD-2).

RESULTS: 250 patients were included. 24% were foreign-born (FB) reporting 41 different countries of birth. Mean duration of living in Sweden was 24.4 years. Compared to non-foreign-born (NFB) patients, FB patients were more stressed (PSS mean 17.5 vs. 15.3, p = 0.044), had more economic difficulties (31.0% vs. 14.6%, p = 0.005) and more anxiety (39.7% vs. 24.9%, p = 0.03). There were significantly fewer patients with psoriasis in FB and more with connective tissue disease. FB rated skin disease severity significantly higher than NFB patients.

CONCLUSION: This study reports the multi-ethnic population in an out-patient dermatological clinic in Malmö, Sweden and the difference in distribution of dermatological conditions among FB patients and NFB patients as well as the burden of disease, with higher levels of stress and anxiety in FB patients. These issues will be investigated further by our group in a larger multicentre study.

Introduction: Type 2 diabetes is increasing worldwide, and the trend is also observed in Sweden. In Malmö, the third largest city in Sweden, the prevalence has doubled. Populations with lower socioeconomic status have a higher prevalence and poorer outcomes, making preventive interventions targeting these groups increasingly important.

Objective: To investigate the types of interventions that have been tested and reported regarding the prevention of type 2 diabetes targeting low socioeconomic populations and are applicable in a high-income country.

Methods: Based on a systematic search strategy developed using the People, Concept, and Context model, the databases CINAHL, PubMed, and Web of Science were searched in January 2024 and updated in December 2024, and EMBASE was searched in May 2025. A flowchart of the screening process has been created. From the selected studies, data were extracted, charted, and the findings were compiled in a narrative form.

Results: Seventeen studies were included, 12 were conducted in the United States and five in Europe. Most used culturally adapted diabetes prevention programs, and a higher proportion of participants were women. Key features included flexibility in attendance and format, development through a community-based participatory approach, gender-specific groups, and the involvement of significant others. Increases of physical activity proved challenging within broader lifestyle interventions. Screening interventions were conducted in community and healthcare facility settings, as well as through a school-and community-based program. Challenges with enrollment and retention were commonly reported.

Conclusion: There is a need for more interventions in the European context and for interventions to engage more men with strategies such as male peer coaches and community screening in locations frequented by men. Longer time frames and sustained engagement strategies are necessary to reach and retain groups with low socioeconomic status in preventive type 2 diabetes interventions.

Aim: To identify existing public knowledge regarding diabetes and diabetes-related services offered to persons living with diabetes in the City of Malmö.

Methods: A literature review of City of Malmö’s website, public statistics, School health documentation, job databases, education programs, local newspaper, Swedish National Diabetes Register, and PubMed was performed in 2020.

Results: We identified political decisions about diabetes nurses in home care, financing a project about diabetes complications, and funding support in schools for designated children. Schools had no registrations of diagnoses. Diabetes was common among pregnant women. The local newspaper discussed children and older people with diabetes asking for increased support. Job listings did not require diabetes-relevant competencies. Curricula for nursing assistants did not mention diabetes. National Diabetes Register reported 16,658 persons in Malmö. Three articles were identified in PubMed.

Conclusion: Public documents in Malmö did not mention diabetes despite being responsible for caring for persons with diabetes.

This paper draws upon the theoretical literature on migration policy and health, and empirical data on three European states with differing welfare models - Sweden (social democrat), France (conservative), and the United Kingdom (liberal) - during Covid-19, to highlight the often hidden and contradictory politics through which refugees, asylum seekers, and undocumented migrants were forced to navigate during the most uncertain period of the pandemic. Although migrants' treatment during Covid-19 was generally better in Sweden with a social democrat welfare tradition, we see migration management priorities greatly undermining the extent to which welfare systems function overall for the benefit of population health. Furthermore, Sweden's recent political shift to the right exacerbates those negative tendencies. As the paper shows, there was considerable effort by civil society and local government to fill the gap where national governments failed to protect this group, stepping in to provide health information, and support.

Introduction: The prevalence of type 2 diabetes has increased worldwide, where the highest prevalence has been found in the Eastern Mediterranean region. Effective measures must be taken to prevent or delay the occurrence of type 2 diabetes and its complications. The present study aimed to investigate the correlation between factors linked to risk for diabetes, individually and cumulatively, and established diabetes in recently arrived migrants from Iraq and Syria in Scania and compare it to the rest of the population.

Method: A cross-sectional survey was used to compare data between a sample of recently arrived migrants and a sample from the rest of the population in Scania, Sweden.

Results: The prevalence of self-reported diabetes was significantly higher among recently arrived migrants (6.9%) compared to the rest of the population (4.9%). High blood-pressure, unhealthy weight, physical inactivity, and older age increased the risk for self-reported diabetes solely but also cumulatively.

Conclusion: It is important to identify individuals with a high risk of diabetes and put preventive efforts into combating risk factors for diabetes. Targeting specific risk factors significantly reduces the risk of developing this disease.

Aim: A limited number of studies discuss the changes in patients' self-care skills and needs for assisted self-care after discharge from in-patient treatment due to diabetes foot ulcer-related complications. The aim of this study was to examine the ability to perform self-care and needs for assisted nursing interventions at hospital discharge, compared to pre-admission, for people with diabetes admitted and treated for foot ulcer-related complications.

Design: Retrospective patient record study.

Methods: A retrospective assessment was done on the medical records of a total of 134 patients with diabetes consecutively admitted to a specialist in-patient unit due to foot ulcer complications, between 1 November 2017 and 30 August 2018. Data on daily self-care needs and home situations at admission and discharge were recorded.

Results: The median age was 72 years (38-94), 103 (76.9%) were men and 101 (73.7%) had diabetes type 2. The median length of admission was 10 days (2-39). Infection was the most common cause of admission (51%), with severe ischaemia in 6%, and a combination of both in 20% of patients. Surgical treatment was performed in 22% and vascular intervention in 19% of patients. The percentage of patients discharged to their home without assistance was 48.1% compared to 57.5% before admission, discharge to home with assistance was 27.4% versus 22.4% before admission and 9.2% were discharged to short-term nursing accommodation versus 6% before admission. Three patients died during their stay in hospital. The need for help with medications increased from 14.9% of patients at admission to 26.7% at discharge and for mobility assistance from 23.1% to 35.9%. Social services at home were increased in 21.4% of patients at discharge.

BACKGROUND: Effective prehospital care for acute chest pain critically relies on ambulance nurses' adherence to clinical guidelines. However, current adherence is inadequate, with no instruments available to improve the situation. Therefore, this study aimed to develop and psychometrically evaluate an instrument measuring ambulance nurses' adherence to and attitudes towards acute chest pain guidelines, and to adapt and test the Attitudes Regarding Practice Guidelines instrument for measuring general attitudes towards guidelines.

METHODS: An instrument development design was used. A 49-item Adherence Instrument was initially developed for measuring adherence to and attitudes towards acute chest pain guidelines and the 18-item Attitudes Regarding Practice Guidelines instrument was translated into Swedish. Both instruments were validated through cognitive interviews and expert reviews. To ascertain its reliability, a test‒retest was conducted. The construct validity of the Adherence Instrument was assessed via principal component analysis on the basis of a polychoric correlation matrix.

RESULTS: The developed Adherence Instrument was refined to 18 items and showed strong validity and reliability. Similarly, the Attitudes Regarding Practice Guidelines instrument, refined to 12 items, demonstrated strong validity and reliability. Principal component analysis of the Adherence Instrument identified five components: professional evidence-based practice, assessment of symptoms, confidence in skills, clinical autonomy, and guideline clarity and education. These components accounted for 64.5% of the total variance and demonstrated strong reliability, with an ordinal alpha of 0.84 for the entire scale.

CONCLUSION: The psychometric properties of the Adherence Instrument were satisfactory and will be useful in prehospital emergency care to measure attitudes and adherence towards acute chest pain guidelines.

Aim: Type 2 diabetes is becoming more prevalent in many parts of the world. Malmö's population has increased in recent years mainly because of migration from other parts of Sweden and the world in addition to increased birth rates. We aimed to explore diabetes prevalence in Malmö in 2011-2018 as well as the achieved treatment targets for selected diabetes-related outcomes.

Method: The current study is a part of the Cities Changing Diabetes Malmö project. Prevalence data were retrieved from the region's primary care and hospital diagnosis register, and data on treatment targets were collected from the National Diabetes Register. The inclusion criteria were either being a resident of Malmö or using a primary healthcare centre located in Malmö.

Results: The prevalence of type 2 diabetes in 2018 doubled from 2011 in the entire Malmö population. During the same period, the prevalence of type 1 diabetes remained stable at 0.49 %. In 2011, the type 2 diabetes prevalence was 2.46 % (2.76 % for males and 2.28 % for females), and in 2018, it was 4.26 % (4.84 % for males and 3.82 % for females). The increase was 139 % for residents aged 0-29 years, 119.6 % for residents aged 30-39 years, 96.2 % for residents aged 40-49 years, 102 % for residents aged 50-59 years, 98.2 % for residents aged 60-69 years, and 115.5 % for those aged 70-79 years. Finally, the increase was 60.9 % for those aged 80-84 years and 90.7 % for residents 90 years of age and older. The National Diabetes Register reported that during 2019, 58 % of all patients with diabetes using primary care in Malmö reached HbA_1c <52 mmol/mol, 20 % had albuminuria, 36 % had retinopathy, and 21 % had not had their feet inspected by a healthcare professional during the last year. The median HbA_1c was 52.6 mmol/mol, and 17 % were registered as active smokers.

Conclusion: Diabetes prevalence in Malmö has increased markedly in recent years, exacerbated by a rise in type 2 diabetes mainly in the younger population. Targets regarding p-glucose lowering treatments were not met by 42 %. One patient out of three had microvascular complications in the eye, one out of five had impaired kidney function, one out of five had not had their feet inspected, and one out of five was an active smoker. Active diabetes treatments need to be improved to reduce the number of younger patients developing microvascular complications. Preventive activities need to target younger populations to counteract even more residents developing type 2 diabetes.