This degree project will include a document and discourse analysis on diversity and integration strategic work in the Falun municipality. Three steering documents will be evaluated regarding diversity in Falun municipality in relation to appropriate guidelines, as well as collected information from executive directors of administration regarding implementation of steering documents and of diversity and integration work, as well as evaluation material on the public health policy and other written material connected to the policies. The aim is to understand and evaluate the diversity and integration strategic work within Falun and Falu Municipality (both as geographical area/city and as the employer), understand if you can reach social change through the policies related to diversity and integration strategic work, and what role the citizen plays in that process. I aim to analyse and highlight the major findings and concluding with ideas for further research or development areas. The research question is; How are diversity and integration strategic work defined and communicated in Falun municipality through their policies and can a participatory approach to policy and policy-making lead to social change?The result show that steering documents – policies - somewhat works as the platform for strategic diversity and integration work in theory, but not in practice. National and international guidelines regarding the subject has proven to be used very well in the case of Local Public Health Program, but not as well in the Integration Policy Program or in the Plan for equal rights and possibilities 2012-2014. Collected information from executive directors of administration regarding implementation of the Integration Policy Program and implementation of diversity work, as well as evaluation material on the public health policy showed very little implementation, and very little participation from the executive directors, employees and the citizens, which raises questions regarding availability of the programs. In order for policy making to be successful executive directors, employees and citizens need to be participating in the policy-making process, as well as the implementation and evaluation. If not; policymaking is only by politicians, for politicians and therefor it will not reflect on the developing society as a whole.

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Congestive heart failure (CHF) is associated with a significant economic burden that includes frequent emergency department visits, hospitalizations, and readmissions. The purpose of this study was to examine the differences, if any, between hospital readmission rates and insurance reimbursement rates for non-Hispanic Black and White CHF patients in California. The theoretical framework was Bandura's social cognitive theory. Secondary data for this quantitative study were obtained from the Office of Statewide Health Planning and Development and State Inpatient Databases from Healthcare Cost and Utilization for calendar year 2014-2016. A t-test and Levene's test for equality of variance were conducted on a sample of 11,905 patient records from 675 hospitals in California; the readmission discharge data and insurance reimbursement rates were analyzed by ethnicity and payer type. The results indicated that there was not a statistically significant difference between non-Hispanic Blacks as compared to non-Hispanic Whites in relation to readmission rates (M = 49.6, SD = 38.28) or insurance reimbursement rates (M = 50.88, SD = 36.52). Non-Hispanic Blacks had a higher readmission rate (36%) as compared to Whites (29%), and although these results are not significant, they support the need for healthcare professionals to develop programs that meet the needs of the community. The results of this study contribute to positive social change by providing information that healthcare professionals may be able to use to decrease CHF readmissions and improve access to care for non-Hispanic Blacks and other vulnerable patient groups.

Det finns en ojämlikhet i hälsan hos utsatta grupper i samhället, där nyanlända flyktingar är en växande patientgrupp. Syftet är att beskriva distriktssköterskans upplevelse av arbetet med nyanlända flyktingar inom primärvården med fokus på jämlik hälsa. Det är en kvalitativ intervjustudie med induktiv ansats där nio intervjuer genomförts på vårdcentraler i Västra Götaland och Halland. Kvalitativ innehållsanalys har gjorts enligt Elo och Kyngäs. Resultatet presenteras i kategorierna Det viktiga mötet, Den helhetstänkande distriktssköterskan och Den komplicerade organisationen. Det framkommer att distriktssköterskan har en viktig roll i att möta den nyanlända flyktingen och det är viktigt att se helheten kring patienten, att i mötet uppmärksamma hela situationen patienten befinner sig. Där är psykisk ohälsa och den sociala situationen värdefull att uppmärksamma. Lyhördhet, en god kommunikation med hög kvalité på tolk är nödvändigt, vilket även är viktiga delar för en jämlik vård. Det behövs även organisatoriska förutsättningar som tillräckligt med tid avsatt och att samverkan med andra kring patienten fungerar, där finns det ett behov av förbättringsarbete. Det finns hinder för nyanlända flyktingar med att komma i kontakt med hälso-och sjukvården och distriktssköterskan fyller en viktig funktion att informera, vägleda och lotsa rätt. Distriktssköterskorna upplever att det finns ett stort behov av hälsofrämjande åtgärder.