Scenarios for population health inequalities in 2030 in Europe: the EURO-HEALTHY project experience

Abstract

Background Health inequalities have been consistently reported across and within European countries and continue to pose major challenges to policy-making. The development of scenarios regarding what could affect population health (PH) inequalities across Europe in the future is considered critical. Scenarios can help policy-makers prepare and better cope with fast evolving challenges. Objective This paper describes the three 2030 time-horizon scenarios developed under the EURO-HEALTHY project, depicting the key factors that may affect the evolution of PH inequalities across European regions. Methods A three-stage socio-technical approach was applied: i) identification of drivers (key factors expected to affect the evolution of PH inequalities across European regions until 2030) – this stage engaged in a Web-Delphi process a multidisciplinary panel of 51 experts and other stakeholders representing the different perspectives regarding PH inequalities; ii) generation of scenario structures – different drivers’ configurations (i.e. their hypotheses for evolution) were organized into coherent scenario structures using the Extreme-World Method; and iii) validation of scenario structures and generation of scenario narratives. Stages ii) and iii) were conducted in two workshops with a strategic group of 13 experts with a wide view about PH inequalities. The scenario narratives were elaborated with the participants’ insights from both the Web-Delphi process and the two workshops, together with the use of evidence (both current and future-oriented) on the different areas within the PH domain. Results Three scenarios were developed for the evolution of PH inequalities in Europe until 2030: ‘ Failing Europe’ (worst-case but plausible picture of the future), ‘ Sustainable Prosperity’ (best-case but plausible picture of the future), and an interim scenario ‘ Being Stuck’ depicting a ‘to the best of our knowledge’ evolution. These scenarios show the extent to which a combination of Political, Economic, Social, Technological, Legal and Environmental drivers shape future health inequalities, providing information for European policy-makers to reflect upon whether and how to design robust policy solutions to tackle PH inequalities. Conclusions The EURO-HEALTHY scenarios were designed to inform both policy design and appraisal. They broaden the scope, create awareness and generate insights regarding the evolution of PH inequalities across European regions.

Advancing tools to promote health equity across European Union regions: the EURO-HEALTHY project

“…The process was finalised by developing scenario narratives for the three plausible scenario structures [42]. The detailed description of this process is available in Alvarenga et al [43].…”

Fostering long-term care planning in practice: extending objectives and advancing stochastic treatment within location-allocation modelling

“…If these studies are followed, neither the meaning of the scenarios to be eliminated nor other considerations are accounted for when building the reduced set of scenarios. Nevertheless, when reducing scenarios, identifying plausible and relevant scenarios is recognized to be powerful information in scenario planning literature, and experts' involvement commonly play a key role in this area (Amer et al, 2013). We thus explore this research line.…”

“…A definition of scenario planning compatible with the nature of scenarios used within stochastic models is provided by Amer et al (2013), who state that scenario planning starts from the current reality to explore multiple paths to possible and plausible futures (i.e., scenarios), and these multiple futures, rather than forecasts, make explicit the future uncertainties. Three schools of techniques are recognized in scenario planning literature (also called foresight), requiring different levels of interaction with experts and a distinct information basis (Amer et al, 2013): Intuitive Logics, La Prospective and Probabilistic Modified Trends.…”

The 2021 William Feinberg Award Lecture Seeking Glocal Solutions to Cerebrovascular Health Inequities

“…5,6 Bridging health inequities requires identifying and addressing the social determinants of optimal health. 5,6 These social determinants of health are those circumstances in which people live, learn, work, and play that affect a wide range of health risks and outcomes (Table 1). 7 Often in stroke when aiming to address outcome differences, we have focused on the last row of the last column, that is, quality of care, and not as much on other areas especially the factors in the second to the last column “Community and Social Context.” Nonetheless, it remains unclear as to which of these social determinants most strongly determine cerebrovascular health and how best to craft and implement sustainable solutions to address them, thereby averting stroke.…”