Preparing for the unexpected: Comparing plans for post-terror health response in Norway and France

Abstract Background How healthcare systems should respond to health and psychosocial needs in the population after terrorism is debated. Still, there has been recent interest for more coordinated health threat governance in Europe. Studies comparing approaches to health emergency contingency in different countries are thus needed. This poster will present a comparative study of how France and Norway planned for disaster follow-up prior to four major terrorist attacks, and how differences in the approaches can be understood. Methods National plans and guidelines from France and Norway, planning the response to mass casualty incidents relevant to four terrorist attacks in 2011, 2015 and 2016 were analyzed, by document analysis. Walt and Gilson's health policy model, focused on context, process, content and actors guided the analysis. Results The countries’ approaches were similar regarding identified target groups of prescribed measures and contents of some measures, however historical and systemic differences shaped approaches to post-terror needs. The countries deviated particularly on who the actors responsible for providing care were, and also the content of some measures. For instance, in France specialized mental health care were more involved in early psychosocial care than in Norway, where primary care approaches were more salient. Conclusions Contextual factors appear to affect how healthcare contingency is planned, and finding one approach applicable in all national contexts appears challenging. Still, the presentation will discuss the potential for identifying core elements for psychosocial and healthcare follow-up that can be relevant in different contexts. Key messages There is variation in how countries approach the task of protecting the population’s health and psychosocial well-being following terrorism. There is a need to continue mapping existing practices in different countries to identify core elements for psychosocial follow-up that could be used internationally.


Background:
The political context is an important determinant of health. Politicians in municipalities and regions in Sweden are responsible for many of the determinants of health, and their role is therefore important when considering health promotion. The aim of the study was to explore how politicians describe their role in health promotion.

Methods:
An electronic questionnaire focused on politicians' role, responsibility, and possibility to promote health was sent to all politicians in municipalities and regions in the north of Sweden. A total of 667 politicians answered the questionnaire, and out of them, 361 politicians answered the free text question ''as a politician I consider my role in health promotion to be ...''. The answers were analyzed using thematic analysis. The four themes discovered were used to sort politicians into groups. All politicians were sorted into the group that was most similar to their answer. Group sizes were shown in percentage of how large part of the politicians belonged to the respective groups.

Results:
Preliminary results show that the politicians could be divided into four different groups: 1) No political role, only personal aspects described (such as being a good role model) (25,3%), 2) Promote individuals to take care of their health (for example through information) (19,5%), 3) Support other parts of the organization (municipality or region) to promote health, mainly through financial support and agenda-setting (29,8%), 4) Most (if not all) political decision-making affect health (25,4%).

Conclusions:
There is a large variety in how politicians describe their role in promoting health. Only approximately half of the politicians see that their political decision-making can directly affect the health of the population. With the political context being an important determinant of health, this could be considered a missed opportunity for structural health promotion work.

Key messages:
Approximately half of the politicians did not describe political means of affecting population health. Not recognizing the political determinants of health risk making politicians miss the opportunity for structural health promotion work.

Background:
How healthcare systems should respond to health and psychosocial needs in the population after terrorism is debated. Still, there has been recent interest for more coordinated health threat governance in Europe. Studies comparing approaches to health emergency contingency in different countries are thus needed. This poster will present a comparative study of how France and Norway planned for disaster follow-up prior to four major terrorist attacks, and how differences in the approaches can be understood.

Methods:
National plans and guidelines from France and Norway, planning the response to mass casualty incidents relevant to four terrorist attacks in 2011, 2015 and 2016 were analyzed, by document analysis. Walt and Gilson's health policy model, focused on context, process, content and actors guided the analysis.

Results:
The countries' approaches were similar regarding identified target groups of prescribed measures and contents of some measures, however historical and systemic differences shaped approaches to post-terror needs. The countries deviated particularly on who the actors responsible for providing care were, and also the content of some measures. For instance, in France specialized mental health care were more involved in early psychosocial care than in Norway, where primary care approaches were more salient.

Conclusions:
Contextual factors appear to affect how healthcare contingency is planned, and finding one approach applicable in all national contexts appears challenging. Still, the presentation will discuss the potential for identifying core elements for psychosocial and healthcare follow-up that can be relevant in different contexts. Key messages: There is variation in how countries approach the task of protecting the population's health and psychosocial wellbeing following terrorism.
There is a need to continue mapping existing practices in different countries to identify core elements for psychosocial follow-up that could be used internationally. This study investigates the role of socioeconomic status (SES) and political attitudes marked by populism and libertarianism in the spread of Covid-19 infections across Austria. A spatial regression approach is adopted based on official registry data on Covid-19 cases at the municipality level, granted by the Austrian National Public Health Institute. This allows the consideration of spatial dependencies between observations in close geographic proximity. Moreover, to uncover potential temporal (in)stabilities in the effects, the associations are examined over two pandemic phases, namely the second (06/ 20 to 02/21) and third wave (02/21 to 07/21) of infections. The analysis shows that low educational attainment and income led 15th European Public Health Conference 2022