Desirée Enlund

This interdisciplinary research project explores the digital vulnerabilities inherent in the algorithmic automation of welfare services across education, healthcare, social services, and media sectors, with a particular focus on Sweden. Despite promises of efficiency and improved decision-making, the reliance on algorithmic systems introduces new risks, including cyber threats and biases that undermine citizen trust.

This research seeks to comprehensively understand and address these challenges through comparative empirical analysis and theoretical development. Through a mixed methods approach combining policy analyses with the help of computational methods, citizens data journeys, a survey and in-depth interviews, the project aims to establish baselines for digital vulnerabilities across welfare domains, contribute to theoretical frameworks for understanding the digital welfare state, and provide guidelines for policymakers to mitigate risks and uphold public values.

By addressing key research questions regarding the nature, implications, and causes of digital vulnerabilities, this project aims to shed light on the broader societal impact of algorithmic governance in the welfare state and advance scholarly and public understanding in this critical area. The research environment furthermore includes an ambitious outreach programme involving the National Library and short animation films to popularize the research findings.

Funder: Swedish Research Council

Period: 2025-2029

Digital Vulnerabilities in Automated Welfare

MD GIG examines the transition to digital service provision in the public services by exploring the rise of the ‘online doctor’ that provides consultations between doctor-patient via app-based mobile phone technology. The aim is to explore the digitalisation of healthcare from a worker perspective to highlight the preconditions that give rise to gig work in the healthcare sector and explore the potential consequences at different scales.

Whereas before all patients had to go to a primary care center on appointment during office hours, today patients can have a consult with a doctor on-demand at any time and from anywhere. Medical work’s entry into the platform economy, where work is reshaped into “gigs” that workers perform where and when they want, is developing parallel to the organizational and economic restructuring of the healthcare system towards more marketisation and private-public partnerships.

The project sets out to understand the individual motivations for doctors to take up work in digital doctor platforms through in-depth interviews to produce narratives based on the MDs own experiences. It also aims to explore the approach of the trade unions and medical associations to digital doctor platforms through expert interviews with high-level union employees to document their hopes, fears and strategies regarding changing labour markets and working conditions. The project also seeks to analyse the role of digital doctor platforms in public healthcare restructuring to produce a political economy of digital healthcare in Sweden.

Funding: Swedish Research Council

Period: 2022-2026

In my doctoral thesis, I study the changes the Swedish public healthcare has gone through since the 1990s through two cases of social movements and cooperatives organizing to protest marketisation and privatization of the healthcare system, at the same time as they were working to create alternative ways of organizing healthcare through citizen cooperatives where other values than those of the market guided the operations.

One case followed a worker’s cooperative primary care center that opened in the early 1990s and later transformed into a citizen cooperative owned by the local community.

The other case concerned the cutbacks and closures of several wards at a local hospital from 2015 onwards, where protests and demonstrations turned into an occupation of the hospital entrance and later the opening of a citizen cooperative primary care center, owned by the community.

In these two cases, different strategies developed through different periods and in different places that shed light on the ongoing restructuring of the public healthcare system and its consequences of socio-spatial injustice in rural areas.

Period: 2015-2020