Chapter 1. Sami economy, livelihoods and well-being

Indigenous rights are linked to reindeer husbandry, while national minority rights relate to language and culture

In terms of national minority rights, the state has an obligation to promote the ability of Sami and other national minorities to maintain and develop their culture and language in Sweden.9 However, when it comes to the expression of Sami rights as an Indigenous people, a major distinction is made between those Sami with membership in samebyar and those without (see note on terminology, Box 1.1). Samebyar are not villages in the sense of being built-up communities; rather, they are an economic and administrative association (co-operative enterprise) created to organise the reindeer husbandry within its geographic area and its members retain certain hunting and fishing rights (but not control over fishing and hunting).10

Figure 1.1. Area of the

Source: Samer (2018[1]), Map of Samebyar, http://www.samer.se/4835 (accessed on 23 November 2018).

There are 51 samebyar in Sweden covering approximately one-third of the surface area of the country.11 These constitute areas/lands where the traditional trade of reindeer husbandry is permitted and carried out (reindeer husbandry area/renskötselområde). However, areas of state-owned land are disputed by, for example, the Sami Council (United Nations Economic and Social Council, 1997[2]).12 The Royal Decree of 1683 has often been used to verify the state’s claim that the land in the north was the property of the state of Sweden.13 These matters a source of ongoing dispute and are currently being raised by a court case brought forward by the sameby of Girjas against the Swedish state over its right to determine hunting and fishing in its territory. In January 2018 the Swedish Court of Appeal ruled that sameby of Girjas now has “better right” to determine hunting and fishing in its territory, but not the “exclusive right” to manage hunting and fishing permissions in the Girjas sameby independently of the state. This case is being appealed to the Supreme Court.

Reindeer husbandry has great cultural and economic significance for the Sami community and has been declared a matter of Swedish national interest (in the environmental code), emphasising the possibility of preserving reindeer grazing rights on private and state-owned land, according to law. According to Sweden’s Reindeer Husbandry Act (1971:437), the right to conduct reindeer husbandry and its related trades is based on prescription from time immemorial and belongs exclusively to the Sami people (as in Norway).14 However, only Sami who are members of a sameby are, according to the act, allowed to exercise this right. As such, Sweden has largely interpreted Indigenous rights as based on one aspect of traditional livelihoods. The sameby decide for themselves who can be a member.

The majority of the Sami are not members of a sameby and as such, are legally prevented to practice reindeer husbandry and do not have hunting and fishing rights on the sameby land. In other words, they are on equal footing with other Swedish citizens by law. The special treatment of reindeer herders descends from the first Reindeer Grazing Act in 1886 and has caused great opposition and division among the Sami.15 If one has not inherited a right to reindeer husbandry within a same by, it is very difficult to become a member of one due to the shortage of reindeer grazing lands and hence a hesitancy of sameby members to open up activities to more members; it is up to the sameby to accept new members. On the other hand, this can also have contributed to the fact that it still is possible to make a living of reindeer herding and there are those who work full-time as reindeer herders. The 1971 Reindeer Husbandry Act implemented “a herding fee and a voting system that favoured the larger herders; this eventually drove out the smaller herders and caused them, and subsequently their children, to lose the land and water rights associated with sameby membership” (Larsen et al., 2017[3]). In practice, membership to sameby is passed down to family members (Pontén, 2015, p. 46[4]). Further, there are state-mandated thresholds on herd size in a given area which limit the expansion of these activities. The thresholds are set with consideration to the long-term sustainability of the grazing lands. In sum, the rights to reindeer husbandry, hunting and fishing structure community identity and economic behaviour alike.

With respect to reindeer husbandry, the application of these rights fundamentally requires access to land and has led to growing land use conflicts between, for instance, reindeer herders and mining and energy developments, the forestry industry, private landowners in areas of reindeer winter grazing and between those practicing small-game hunting on crown land above the cultivation line. For example, the clearcutting of large areas of forests has been shown to reduce tree lichen for reindeer grazing (Sandström et al., 2016[5]). Research by Hahn (2000[6]) finds that Sami rights have eroded since the time of the first Reindeer Grazing Act in 1886 when the Swedish state had a clear position on conflicts (and associated rights) that was relatively favourable to the Sami. It is assessed that this legal clarity has since been lost as competing land uses in these territories have increased – particularly in the case of developments that are considered a matter of national interest, such as forestry, energy infrastructure and mining.

The Sami Parliament Act in Sweden has its own definition of who is Sami

The Sami Parliament in Sweden is both an elected political body and a government agency that carries out mandated administrative tasks. The Sami Parliament Act identifies a Sami person as one who fulfils the subjective and one of the three objective criteria for the purposes of identifying who can be registered on the electoral roll and is thus is eligible to vote in the Sami Parliament elections. By this act, Sami refers to a person who considers him/herself to be Sami (subjective) and ensures that he or she has or have had the Sami language spoken at home, or ensures that any of his or her parents or grandparents have or have had the Sami language spoken at home, or has a parent who is or has been listed on the electoral roll of the Sami Parliament. The main varieties of the Sami language are North Sami, Eastern Sami, Central (Lule) Sami and Southern Sami, encompassing nine dialects.16 An estimated 6 000 Sami in Sweden speak North Sami, 800 Sami in Sweden and Norway speak Lule Sami and 700 in Sweden and Norway speak South Sami (Sametinget, 2018[7]). All of the varieties of the Sami language are recognised by Swedish law and thus have the same level of protection despite the number of users.

Reindeer husbandry, hunting and fishing

The reindeer industry is characterised by the small-scale, ecological production of high-quality reindeer meat in accordance with natural conditions and seasonal changes. Growing consumer demand for sustainably produced and ecological food products has increased demand for reindeer meat and the average price per kilogram is presently at a historical high (Figure 1.3). A 2014 study estimates the value of the reindeer industry in Finland and Sweden (all aspects including reindeer meat, fur and other by-products like horn) as having an employment impact of 15 000 and a total turnover of about EUR 1.3 billion (Paliskuntain yhdistys, 2018[16]). Sweden accounts for about one-third of this total (Paliskuntain yhdistys, 2018[16]). According to data collected by the Sami Parliament, there are 3 900 reindeer owners, out of which 72% have registered companies; approximately 59% of these companies state reindeer husbandry as their main economic activity (Sametinget, 2018[7]).20

Figure 1.3. Price of reindeer meat per kg, SEK, Sweden

Source: Sametinget, (2018[17]), Renslakten i Kronor, https://www.sametinget.se/statistik/ekonomi (accessed on 19 March 2018).

By law, reindeer husbandry must be conducted in a way that maintains biodiversity and that ensures that the long-term grazing capacity of the natural pasturelands (i.e. by setting thresholds).21 Reindeer generally migrate from the summer’s high mountains to the winter’s forests – covering a wide expanse. Sweden’s reindeer herding area covers 150 000 km², equal to around a third of the Swedish land base.22 Severe disturbances at certain times and places may lead to over or under-utilisation of grazing resources, which in turn has consequences for other parts of the grazing cycle. The natural behaviour and needs of the reindeer determine the manner in which reindeer husbandry is conducted. The practice of reindeer husbandry inherently requires flexibility in relation to environmental and weather variations. The industry can be very busy at some times of the year, requiring time away from home in remote locations with limited accessibility (helicopters, motorcycles and snowmobiles are nowadays commonly used). As such, the practice of reindeer husbandry in conjunction with other economic activities demands flexibility and can limit the types of secondary activities that can be undertaken. The rights that are defined in the Reindeer Husbandry Act place limits on the ability to earn money in traditional land areas for Sami in the reindeer husbandry trade. Moreover, as defined by the act, sameby are prohibited from undertaking any economic activity other than reindeer husbandry which limits the ability of samebyar to act as a vehicle to scale up other business initiatives; this does not, however, preclude sameby members working in reindeer husbandry from having their own companies and there are no restrictions on such a company’s activities.23 Overall, the fact that many Sami businesses in the reindeer husbandry industry are relatively small is not just a matter of preference, but also a fact of the ecological limits and could also be a product of the rules regarding the types of economic activities that can be taken on alongside reindeer husbandry.

Reindeer husbandry is under a great deal of stress in northern Sweden. The right to herd reindeer is based on usufructuary rights and is carried out in conjunction with other land users which can lead to land use conflicts. Large infrastructure projects, mining activities, energy installations and forestry activities can negatively impact access to grazing land and the reindeer’s main food – ground and tree lichen. For example, there has been a significant decline (71%) in the area of lichen-abundant forests over the past 60 years in Sweden (Sandström et al., 2016[5]). Around 2 500 reindeer died in traffic collisions in 2017 in the four northernmost countries (Sverige Radio, 2018[18]). As will be discussed in Chapter 3, the long-term sustainability of the reindeer herding industry requires improvements in frameworks and practices to manage competing land uses. While herding strategies (i.e. use of different grazing areas and grazing resources) and husbandry strategies can be employed to manage climate change impacts, research from Sweden has indicated that competing land-uses and a lack of instruments and difficulties in exerting influence in governing interactions have more of a detrimental impact on Sami reindeer herding adaptability (Tyler et al., 2007[19]; Löf, 2014[20]).

Unlike reindeer husbandry, hunting and fishing activities are rarely a main source of livelihoods and have recreational values. Sameby members have the right to fish in certain lakes for their own use, and for the commercial market, but not for tourism purposes.24 Out of the 3 700 companies registered in the Sami Parliament business register, only two have stated hunting as their main activity while eight have stated fishing as their main activity (Sametinget, 2018[7]). Commercial fishing was the most extensive in the 1970s when about 85% of the total number of fishermen in Sweden’s five northernmost municipalities consisted of Sami fishing in the upper Lule River water system (Sametinget, 2018[7]). Household fishery for daily needs belongs in many areas to everyday life for both reindeer-herding Sami and Sami-farmers, but also for non-Sami people. This is a combination of own subsistence economy and exchange economy between family and friends.

Hunting (mainly moose hunting) is an important activity among samebyar members and represents a considerable share of members total income. Most of the moose meat on the Swedish market is produced by samebyar members. For example, in Luokta Mavas sameby, members are licensed to harvest 50 adult moose and 45 moose calves, with an estimated value of SEK 845 000.25

Tourism, duodji and food production

There is a growing market for tourism in northern Sweden and the tourism industry has ambitious goals to achieve 100% growth in the sector by 2020 (Invest in Norrbotten, 2018[21]). Visitor nights have grown strongly in Sweden over the past decade, and the growth for the northern counties is in line with the national average (Figure 1.4). Tourism-related activities are important to the labour markets of the northern counties. In 2016, accommodation, and arts, entertainment and recreation services employed 9.3% of the labour force in Jämtland-Härjedalen, 7.2% in Norrbotten and 7% in Västerbotten. Västerbotten has seen the fastest growth in this sector in recent years, with particularly strong growth in domestic tourism.26 While the tourism sector presents an opportunity, it does face some challenges in that the season tends to be short and the distances between attractions are large in northern Sweden. There are only a few areas of northern Sweden where the tourism sector has led to a substantial restructuring of the regional economy – most notably, large ski resorts (Almstedt, Lundmark and Pettersson, 2016[22]).

Figure 1.4. Number of visitor nights, Sweden and northern counties, 2008-17

Growth index (2008 = 100)

Source: Statistics Sweden (2017[23]), Statistics Sweden, Nights Spent. All hotels, Holiday Villages, Hostels, Camping Sites, Commercially-Arranged Private Cottages and Apartments by Region/County - Year 2008-2017.

There are an estimated 40 individual Sami entrepreneurs active within tourism, most of which have been in business for less than ten years (Sametinget, 2018[7]). Most of these entrepreneurs are women and around 50% run businesses combined with reindeer husbandry, or other Sami trades like duodji (Leu and Müller, 2016[24]). Organised Sami tourism is thus a relatively new Sami trade. Businesses in this area have evolved from a focus on guided tours in the mountains and hunting towards tourist activities tied with cultural learning about Sami traditions and way of life. Approximately a quarter of Sami tourist companies focus on conference events where the opportunity to hunt and fish are offered (Sametinget, 2018[7]). The vast majority of these companies are small-scale, with only a few employing more than five seasonal workers. In addition to tourist entrepreneurial activities, there is also a range of tourist experiences available at museums and retail centres for Sami duodji.

Tourism brings mixed benefits for Sami communities and there are debates about how the Sami should engage with these activities. The Sami are frequently used in tourism promotion and marketing in northern Europe and they thus represent an asset for the growing tourism industry. This could bring benefits by increasing awareness of Sami culture and traditions, but at the same time, there is a risk that the Sami are portrayed as an exotic “other”. Indeed, their representation in tourism brochures in northern Sweden has generally depicted them within the context of a reindeer husbandry nomadic lifestyle in a manner that is not always culturally sensitive or reflective of present circumstances – the modern world of the Sami is seldom represented (Müller and Pettersson, 2001[25]). Sweden’s Equality Ombudsmen notes that the definition of the Sami as nomadic reindeer herders in law has reinforced such perceptions and is founded in a conception of cultural inferiority stemming from a time when policies were formed about the Sami, not with them (Swedish Equality Ombudsman, 2008, p. 28[26]). There are also ongoing discussions, mostly in Finland and Norway, about who can wear a gákti (Sami national costume) in tourism activities. For example, whether only Sami should wear a gákti or whether others can also wear them and also whether persons in tourism activities/pictures are wearing real gáktis or whether “made-in-china” “tourist” costumes used.

A growing nature-based tourism sector with activities such as hunting, fishing, skiing, snowmobiling and dog‐sledding, has the potential to create new sources of income and future employment opportunities for the Sami. Despite this, very few Swedish Sami choose to make a living within tourism and, for those who do, it is often alongside reindeer husbandry – though the combination of these two livelihoods is not without difficulty due to the cyclical nature of herding which requires time away from home. Some of the main constraints preventing Sami from getting more involved in tourism development include cultural norms and legal obstacles for tourism development; a large geographical area and dispersed attractions; a lack of business traditions within the Sami communities themselves and; expensive and exclusive touristic offerings, which limit the size of the market (Müller and Pettersson, 2001[25]; Müller and Huuva, 2009[27]). Moreover, nature-based tourism can disrupt reindeer herding and this has led to conflicts between both non-Sami and Sami tourist operators and reindeer herding Sami (Müller and Pettersson, 2001[25]). There is no general permit or licence for tourist operators in protected areas, but there are laws and regulations within the Swedish environmental code that must be followed within the purview of such activities (Swedish Environmental Protection Agency, 2018[28]).

The growth of the tourism industry in Northern Sweden is opening up the potential of duodji and food production which have long been an important part of Sami culture. There is a growing demand for high quality and ecological food products worldwide for which Sami food products are well suited. High-end restaurants in northern Sweden such as Fäviken in Jämtland, have raised the profile of northern cuisine based on local ingredients including traditional Sami fare such as salted meats and fish. Groups such as Slow Food Sapmi – an organisation that includes the Sami regions of Sweden, Finland, Norway and Russia – and Slow Food Sweden, represent Sami food entrepreneurs and Sami people interested in cuisine and the sustainable use of natural resources. There is potential to grow this sector further, which is quite limited at the moment. For example, out of the 3 700 companies registered in the Sami Parliament business register, less than 2% (65 companies) have stated food production as their main activity. There are very few Sami owned meat processing firms – therefore, the Sami engaged in reindeer husbandry are rarely capturing the value added from the processing of meat. The presence of large established meat processing businesses in northern Sweden present barriers to the expansion of the Sami meat processing market. The Sami meat processing market is also heavily dependent on national interpretation of EU legislation – large established meat processing “factories” are “obligatory” to sell the meat. This change from “killing at place” to the transport of living animals to meat processing plants due to changes in EU regulations related to food health and safety has been one of largest changes in reindeer herding during the last decades.

Duodji have a strong symbolic value for the Sami identity and are important for cultural reproduction. The commodification of duodji is an issue of longstanding debate; it is often thought of as a form of cultural expression as opposed to a developable trade. The vast majority of local arts and crafts, including duodji, are sold to tourists (Dlaske, 2014[29]). The lack of available statistics on turnover, business structure, market analyses, etc. makes it difficult to demonstrate the needs and competitiveness of duodji. Out of the 3 700 companies registered in the Sami Parliament business register, just 2% (78 companies) have stated duodji as their main activity (Sametinget, 2018[7]).

One of the greatest barriers to the expansion of this industry is the proliferation of products that culturally appropriate duodji in style and substance, but that are in fact mass produced, largely for the tourist market. These products undercut the value of authentic duodji. This is an issue that is common to many Indigenous peoples and there is growing recognition of the need to protect the cultural and intellectual property of Indigenous design and techniques. Doing so can help Indigenous peoples to build their craft into a viable market based on sustainable principles and traditional knowledge. To protect genuine Sami duodji and guarantee original Sami design, a special seal has been introduced for which only licensed Sami artists are permitted to mark their products and distinguish them from imitations. While this helps direct consumers to authentic products, it does not address the appropriation of Sami designs more generally. Litigation against the appropriation of Sami designs has been pursued in some cases; the time and expense associated with such litigation lead to its infrequent use.

Cultural trades

Sami culture and traditions are a unique asset to northern Sweden and Sapmi more generally which extends to the cultural industries. This sector includes photo, film, performing arts, literature, music/joik, multimedia, fine art and museum activities. Relatively few Sami businesses note this as a main activity. Out of the 3 700 companies registered in the Sami Parliament business register, 2.7% (100 companies) have culture as their main activity. Therefore, this does not appear to be a large sector at the moment; though, the limitation of this data needs to be considered.

Support for the cultural industries has shown to have wide-ranging benefits on such factors as schooling, health, economic participation and leadership and is increasingly recognised as an essential element of well-being.27 Culture has, for example, been recognised as a social determinant of health in countries such as Canada and has been included within the framework of the United Nations’ Sustainable Development Goals. The prospects for the commercialisation for this sector differ and may require either seed capital or grants in order to thrive. Government policies hence play an important role in supporting and encouraging the growth of this sector. Moreover, regional and municipal governments and instrumental in developing and supporting the cultural infrastructure – e.g. workshop space, museums, theatres, performance spaces and community spaces – that helps this industry thrive (Lindqvist, 2015[30]).

Other rural activities

Within the rural economy, Sami participate in a range of sectors and commercial activities outside the traditional trades and culture as both business owners and employees in such industries as mining and forestry. Unfortunately, it is very difficult to gauge the scope and scale of these activities due to a lack of statistical data. In terms of Sami-owned enterprises, these activities involve small-scale industry, construction, transport, retail and private service companies and can generally be characterised as small businesses with few employees, low competition, limited markets and low profitability (Sametinget, 2018[7]). For example, small-scale farming is practised by around 9% of companies registered in the Sami Parliament business register (318 out of 3 700). In the three northernmost counties, there are a large number of so-called small-scale farms that have a very varied background both in terms of origin and development. Farming often involves a combination of small-scale farms with animal husbandry, hunting, fishing and small-scale tourism. In general, the share of agriculture in northern Sweden has declined in recent decades and this is not a growing sector.

Forestry is a large industry in northern Sweden and is conducted in accordance with forestry legislation that applies to Sami and non-Sami alike. Reindeer herding Sami have no tradition of commercial forestry but have used forest resources and remain dependant on them for building and handicraft materials, firewood, and to provide shelter and protection for reindeer against wind and rapid temperature changes.28

Sami businesses/livelihoods and connections to the regional economy

Sami businesses in northern Sweden have unique characteristics and face a number of challenges in terms of their connections to the regional economy. First, many Sami businesses are small. There could be opportunities for growth in this sector by improving access to markets and adopting value-added activities. However, there are also limiting factors to Sami business growth. This is perhaps most evident for reindeer herders who need to coexist with predators, climate change, declines in lichen, conflicts with other land uses and whose herds sizes are capped with maximum thresholds set by the national government. Second, Sami businesses and cultural practices are not always well understood or well aligned with that of some of the growing industries in the regions. While there are ongoing efforts to make forestry practices more compatible with reindeer husbandry, conflicts still occur. The dominance of the energy and mining sectors within the northern economies can detract from herding activities, as can nature-based tourism. This raises the importance of effective policies and good governance to help mediate and overcome some of these challenges in order to ensure that regional development works for all – issues that are discussed in Chapters 2 and 3. Finally, it is important to note a bias in understanding Sami businesses stemming from the fact that the data privileges traditional activities simply because these are easier to identify as Sami under current data collection practices. The range and diversity of Sami livelihoods are thus poorly captured and this, in turn, has implications for how Sami contributions are recognised and linked with regional policies in northern Sweden.

There is a limited picture of Sami well-being in Sweden

Sweden does not collect official statistics based on ethnicity or Indigenous status and as a result data limitations make it difficult to provide an assessment of Sami well-being in Sweden. There is data related to the occupation of reindeer husbandry which enables statistical analysis related to this activity (size, gender, and prices for example) but this is only an estimated 15% of the total Sami population in Sweden. The geography of the Sami can also be delimited by the 19 municipalities that belong to the administrative area of the Sami language, and the 51 sameby areas, but many Sami live outside of these areas, including in the largest cities (Beach et al., 2015[35]).

There are few comprehensive statistical studies of the Sami, and in particular, a lack of studies that examine multiple dimensions of well-being. The Swedish Agency for Economic and Regional Growth has developed municipal level well-being data, but it is not possible to distinguish Sami well-being within (Tillväxtverket, 2018[36]). There are, however, smaller studies – qualitative case studies, sample surveys, etc. – which have examined socio-economic indicators for Sami and non-Sami populations which can offer a partial picture of Sami well-being. For example, a 2015 study on the living conditions and quality of life of Indigenous peoples included assessment of the Sami in Sweden (Beach et al., 2015[35]). The sample for the study was drawn from the voter registration list of the Sami Parliament of Sweden, and although limited, does provide some important insights about the well-being of Sami peoples. Overall, the well-being of the Sami is characterised by high life satisfaction, impacts of out-migration from rural areas, the balancing of formal market participation with non-market values and subsistence, and managing pressures associated with climate change and resource extraction (Beach et al., 2015[35]). There are similar patterns apparent to the non-Indigenous population in terms of youth out-migration (for education and work) with lower levels of mobility for men, which is impacting the overall demographic profile of the Sami in rural areas over time. Identity issues are also important in Sami society, particularly the differences in recognition and rights between Sameby and non-sameby members. Gender issues are also important because voting rights in samebyar are predominantly given to men (Beach et al., 2015[35]).

The majority of studies about Sami well-being have focused on health outcomes. While poorer health outcomes among Indigenous populations versus non-Indigenous are common in many countries, research from Sweden indicates that the Sami have a life expectancy and mortality patterns similar to the general population with the exception that slightly greater incidences of cancer and cardiovascular diseases have been reported (Sjölander, 2011[37]). However, there are greater incidences of unnatural death among reindeer-herding men which is related to working conditions and the use of off-road vehicles. Between 1961-2000 there are no reported differences in suicide rate between Swedish Sami and other Swedes (Sjölander, 2011[37]). It is also noted that the suicide risk among reindeer herders has been slightly higher than among other mountain peoples and reindeer-herding Sami men and women as well as Sami living in the three north most counties may be at particular risk for suicidal expressions (Kaiser, Niclas; Salander Renberg, 2012[38]; Sjölander, 2011[37]; Omma, Sandlund and Jacobsson, 2013[39]). Studies of suicide have reinforced the importance of linking these issues to power relations and identity within a threatened Sami cultural context – this, in turn, raises the importance of culturally-relevant services and curriculum in schools for suicide prevention (Stoor et al., 2015[40]). In terms of youth, a study of Sami youth aged 18–28, the majority expressed pride in their heritage and a desire to preserve their culture (Omma and Jacobsson, 2011[41]). Nearly half had perceived discrimination or ill-treatment because of their ethnicity, with reindeer herders reporting a higher degree of ill-treatment (70%) (Omma and Jacobsson, 2011[41]). In terms of educational outcomes, there are no studies that compare educational achievement between Sami and non-Sami. However, research by Omma (2013[42]) indicates that Sami school children have lower health-related quality of life (HRQL) than other Swedish children and that education is one of the areas where they scored lower than other Swedes.

Some recent government-funded studies help to fill in the gaps in healthcare knowledge and promote culturally appropriate healthcare practices

There are several recent government-funded studies that help to fill in some of the knowledge gaps on Sami well-being. For example, in 2015, the government commissioned the Sami Parliament to compile knowledge about psychosocial ill health among the Sami people in Sweden. This knowledge overview was conducted in order to provide support to the Public Health Agency of Sweden and the relevant County Councils in work to design culturally-appropriate psychological interventions. A 2016 report by the Sami Parliament found that mental health among the Sami population, especially the reindeer herding Sami, is worse than other groups in society (Stoor, 2016[43]). This is shown both among young Sami, women and especially among reindeer-herding Sami. Rates of suicide during 1961-2000 were 50% higher among reindeer-herding Sami men than what would be expected among Swedish men. Reindeer herding Sami also have lower confidence in the healthcare system (primary healthcare and psychiatry) than other inhabitants in the northern part of Sweden and healthcare providers may lack knowledge about Sami population health.

In 2018, the Swedish government committed to funding a population-based study called HALDI – health and living conditions in Sapmi, Sweden – which will identify participants on the basis of ethnic self-identification (Axelsson, 2018[44]). The study was submitted by the Centre of Sami Research at the University of Umeå and will be structured in a manner that is similar to that of an earlier Norwegian health study led by the Sami Centre for Health Research at the Arctic University of Norway (UIT) – thus facilitating comparability between the two countries.

Most recently, in March 2017, the Government granted Västerbotten County Council, together with Jämtland County Council, Norrbotten County Council, the Sami Parliament and Swedish Sami organisations, SEK 3 000 000 to develop a knowledge-based network about Sami health outcomes. The three-year project will be used to develop a centre for Sami health which will work to increase the availability of culturally relevant healthcare that is accessible in the Sami language. The results of this initiative will be presented in 2020. This project, together with the above-mentioned studies address the need for improved understanding of Sami healthcare needs and enhanced capacity to deliver culturally-adapted health services.