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CNN  — 

Voters in Sweden will cast their ballots Sunday in a potentially game-changing election that could see the Sweden Democrats – a once obscure far-right party with neo-Nazi roots – become the second-biggest party in the perennially left-leaning country.

The political landscape in Sweden has changed dramatically since the last election in 2014. Sweden’s open-arms approach to refugees in 2015 catapulted the populist, anti-immigrant SD party to political prominence, forcing many of the country’s liberal and moderate parties to adopt more conservative policies around immigration.

While the immigration debate has dominated the headlines, there are a host of other critical issues on voters’ minds, including healthcare, education and the environment.

Here’s a look at how Sweden compares on these issues with the rest of Europe – and what the country’s largest political parties are pledging to do to tackle them.

These include the ruling Social Democrats, a historically working-class and center-left party; the Moderates, a traditionally center-right party; and the Sweden Democrats, the hard-right party that also claims to want to uphold the country’s generous social benefits.

Healthcare

Healthcare is the top issue for 38% of Swedish voters, according to recent polls, and has been one of the central focuses of the campaign.

Swedish healthcare performs well compared to other European Union countries – Swedish life expectancy is among the highest in the EU – and is the linchpin of one of the world’s most successful welfare states.

Few Swedes question the quality of the care they receive. But many others lament the long waits they sometimes endure to access that care.

“Ordinary people think the accessibility to healthcare is really bad,” said Henrik Oscarsson, professor of political science and electoral studies at the University of Gothenburg in Sweden. “Of course, once you get help it’s world-class, but it takes time for people [to] get into the system.”

The poor working conditions of nurses and other staff working in elderly care has been another long-standing issue. Since 2005, the number of patients per staff member has continued to increase, Expressen reported, putting extreme pressure on already taxed workers.

As staff have become more dissatisfied, the quality of care offered has also fallen. Around 50% of staff are considering quitting their jobs, Expressen reported.

All the major parties, including the Social Democrats, the Sweden Democrats, and the Moderates – projected in a recent poll to win 25%, 17.2% and 17% of the vote, respectively – have included measures to cut waiting times as part of their campaign initiatives.

The Social Democrats also intend to train and hire 14,000 new healthcare workers to address the current gap in personnel that is currently delaying access to treatment.

The Sweden Democrats, on the other hand, have taken a hard line on access to the country’s generous healthcare system, promising to stop providing free care to undocumented immigrants and create new rules around what kind of care non-residents can get.

Immigration

In 2015, Sweden took in 162,450 asylum seekers, the second-largest number of migrants per capita of any EU nation, and a huge number for a country with a population under 10 million people. (Only Hungary took in more migrants per capita).

The number of asylum seekers has dropped since then to 26,325 in 2017.

Nonetheless, the large initial wave of refugees that came to Sweden in 2014-15 – combined with what Oscarsson described as the “cultural distance” between migrants and native-born Swedes – has led to tensions.

The Sweden Democrats have capitalized on those tensions and risen in the polls, from 2.9% in the 2006 election to around 17% in recent polling.

Recent reporting on gangs and gang violence has helped to keep the immigration issue in the spotlight, though homicide data has remained relatively stable over time.

The Social Democrats are urging more integration programs in marginalized communities to be established as well as increasing financial support for municipalities to encourage better educational attainment for people living in those areas. The Social Democrats also say that they will give the police more resources for social work in marginalized areas.

The Moderates have pledged to give more funds to the police, and are pushing for Swedish migration policy to fall in line with laws in other EU countries, such as Norway, Denmark and Germany. This would mean that migrants won’t be able to stay unless they can prove that they can support themselves, enabling them to get a permanent residence permit. They are also looking at ways of more quickly incorporating migrants into the workforce, such as promoting “simple jobs,” a reference to work that can be obtained with only an elementary education.

The Sweden Democrats plan on providing police with more tools to seek out undocumented immigrants, as well as changing the law so that residence permits for foreigners can be revoked under certain circumstances.

“If you are ready to adapt, you are welcome to live here in Sweden,” said Jimmie Åkesson, leader of the Sweden Democrats. “But if you do not want to adjust, you can live elsewhere.”

Education

More than 47% of Swedes between 25 and 34 had some form of tertiary education in 2016 – the year with the latest available data – ranking the country among Europe’s top performers.

Some of the country’s Program for International Student Assessment (PISA) scores – an OECD measure of countries’ educational systems – have fallen over the past decade, worrying many Swedes, according to Bo Rothstein of the Quality of Government Institute at the University of Gothenburg.

Despite investing substantially in education – Sweden spent 6.6% of its GDP on education in 2016, the second most in the EU, behind only Denmark – the country’s performance has fallen below many voters’ expectations. Among EU countries, Sweden ranked 14th in science, 11th in math, and 8th in reading in the latest PISA assessment.

The Social Democrats are proposing to hire more teachers, while the Moderates want to extend the school day and further emphasize mathematics in the curriculum.

The Sweden Democrats have vowed to increase teacher wages and encourage more vocational training for students.

Environment

Sweden is a European leader on environmental sustainability, with the highest share of renewable energy sources in the EU at 53.9%.

The spate of fires that rocked Sweden over the summer, spreading all the way up to the Arctic, re-emphasized the environment for many voters.

Concern over the environment has been growing in recent weeks in the lead-up to the election, and many voters are looking for politicians that offer strong environmental policies, CNN affiliate Expressen reported Wednesday.

The Social Democrats have emphasized the importance of increasing access to public transport, while at the same time investing in more green technology and better recycling.

The Moderates have proposed various business incentives for companies to encourage them to reduce their emissions, while the Sweden Democrats want to increase investment in innovative environmental technology as well as concentrate more funding efforts on nuclear energy.

Economy

On a nation-by-nation level, unemployment ranks as a top issue for voters across the EU, according to the Eurobarometer.

While the jobless rate is typically a top issue for Swedes, it is lower down the list of priorities in the current election.

Sweden’s 6.7% jobless rate is the lowest since the financial crisis in 2008 and below the EU average of 7.6%.

And although the economy looks set to slow slightly in 2019, Sweden’s GDP is still estimated to grow by 2.2%.

“Everyone predicted that when we took in this massive influx of migrants, the economy would collapse,” Oscarsson said. “It didn’t.”