Divergent Outcomes of Centralisation Versus Decentralisation: A Comparative Analysis of Poland’s and Sweden’s COVID-19 Governance Models and Their Implications for the Health Security of the European Union

The COVID-19 pandemic posed unprecedented challenges to global health systems, revealing significant disparities in public health management across countries. This study investigates the divergent health outcomes observed in Poland and Sweden, focusing on the implications of their differing healthcare governance models – centralisation in Poland versus decentralisation in Sweden. The primary objective is to explore how these governance structures and the respective data collection strategies influenced COVID-19 outcomes, including infection rates, mortality and vaccination availability. A comparative analysis of national and regional epidemiological data from 2020 to 2023 was conducted, employing statistical validation techniques to ensure robustness. The findings indicate that Poland’s centralised approach, characterised by strict enforcement of health policies, resulted in higher morbidity and mortality rates, with over 6.55 million reported cases and an excess mortality rate of +18%. In contrast, Sweden’s decentralised model, which integrated socio-economic factors into health responses, reported 2.73 million cases and +6% excess mortality rate. The study highlights the impact of socio-economic determinants on health outcomes, revealing that immigrant populations in Sweden faced a mortality rate three times higher than that of native Swedes. The analysis underscores the need for coherent health policies within the European Union, advocating for regulatory reforms that enhance the capacity of the European Centre for Disease Prevention and Control (ECDC) and promote equitable health standards across member states. Ultimately, this research contributes to a deeper understanding of the consequences of divergent healthcare governance models and offers insights for developing more effective public health policies in the EU, emphasising the importance of resilience and equity in future health crises.