Decentralised welfare services for families with disabled children: a register-based study of local variation and social inequalities

Abstract The tension between universalism and local autonomy is particularly pronounced in the Nordic welfare states. Decentralisation enables tailoring services to local needs and preferences but can also give rise to local disparities. Using Norway as a case, this study examines local variation and social inequalities in the allocation of decentralised care services to families of disabled children. The study is based on administrative register data on children with disabilities born between 2008 and 2019, identified by selected diagnoses or receipt of the attendance benefit ( n = 21,163). The results show that a non-trivial share of the total variation in service allocation lies between municipalities. Part of this variation was due to differences in care needs, but local conditions such as municipality size also matter, suggesting inequalities in access to services by place of residence. While the municipal variation did not reflect differences in the distribution of families’ socioeconomic status and immigration background, these characteristics were associated with allocation at the individual level.