The social determinants of health among vocational school students in Finland:
50 recommendations to reduce health inequalities (2010)
Published in January 2010. 
“Terve amis!” report explores factors contributing to the health of Finnish vocational school students and was commissioned by “Savuton Sohva Sakille” campaign (2009–2011). The campaign is funded by RAY (Finnish Slot Machine Association), and jointly coordinated by the Association for Healthy Lifestyles and the Vocational Trainees – SAKKI ry.
The report consists of two parts. The first section outlines the present health situation of Finnish vocational trainees and maps the theoretical background of community-based health promotion (Chapters 1 and 2). The second part compiles the interviews of six health and welfare experts on promoting health among vocational trainees (Chapter 3). The report describes the social determinants of health that can be addressed through vocational schools.
The experts interviewed include Professor Matti Rimpelä (National Institute for Health and Welfare), Director Tapani Melkas (Ministry of Social Affairs and Health), Secretary-General Tuomas Kurttila (Advisory Council for Youth Affairs), Senior Researcher Marita Sihto (National Institute for Health and Welfare), Researcher Timo Hujanen (National Institute for Health and Welfare) and Lecturer Päivi Vatanen (Vantaa Vocational College Varia).
The main focus of the report is on building health-promoting structures and communities in the school context. The quality and accessibility of health services were deliberately left outside the scope of analysis. Ameliorating the structures and committing to the management of the educational institutions to promote health is the most efficient means of enhancing the health of vocational trainees. In addition to health-promoting environments, youth empowerment and possibilities for community participation have been shown to improve the well-being of students.
Health problems are most common among the least educated, manual workers, and low-income families. Vocational school students are thus a key group if the health gap is to be diminished. For the past 25 years, Finnish health policy has been aimed at reducing health disparities with little progress. No detailed policies or programmes seeking to bridge the health divide and to improve the situation of the vocational students have been presented in recent years.
Drawing on expert interviews and professional literature, this report presents 50 concrete actions and policy recommendations to reduce health inequalities and enhance the health situation of vocational trainees (Chapter 4). The recommendations are focused on social determinants of health, such as building health-promoting structures and environments in vocational schools, strengthening student board activities, and improving health education. In addition, the report calls for better recognition of students' interests, strengthening parental roles, and increasing the accountability of vocational school management, politicians and other decision-makers over the well-being of the students.
Many of the proposed recommendations do not require additional resources for their implementation. However, an implementation requires an innovative attitude and the willingness to change practices so that they would better advance health and well-being. In the next phase of the “Savuton Sohva Sakille” campaign, the findings and recommendations will be commented on by vocational students themselves.
Keywords: vocational trainees, educational institutions, students, social determinants of health, health promotion, health inequalities, policy recommendations, Finland