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

International Journal for Equity in Health

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[1] 0000 0000 9511 4342, grid.8051.c, Center for Health Studies and Research (CEISUC), University of Coimbra, Coimbra, Portugal;0000 0000 9511 4342, grid.8051.c, Centre of Studies in Geography and Spatial Planning (CEGOT), University of Coimbra, Coimbra, Portugal;0000 0001 2164 7602, grid.415373.7, Agència de Salut Pública de Barcelona, Barcelona, Spain;CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain;0000 0001 2181 4263, grid.9983.b, CEG-IST, Centre for Management Studies of Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001, Lisbon, Portugal;ALVA Research and Consulting, Lisbon, Portugal;ALVA Research and Consulting, Lisbon, Portugal;0000 0001 2181 4263, grid.9983.b, CEG-IST, Centre for Management Studies of Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001, Lisbon, Portugal;0000000121511713, grid.10772.33, IHC, Institute of Contemporary History, Universidade NOVA de Lisboa, Lisbon, Portugal;0000000121511713, grid.10772.33, Nova School of Business and Economics, Universidade NOVA de Lisboa, Campus de Carcavelos, Rua da Holanda 1, 2775-405, Carcavelos, Portugal;0000 0001 2181 4263, grid.9983.b, ISEG, Lisbon School of Economics & Management, Universidade de Lisboa, Lisbon, Portugal;

关键词: Health inequalities;    Population Health;    Participatory approach;    Delphi method;    Foresight;    Policies;    Socio-technical approach;    Scenarios;    Stakeholders;   

DOI  :  10.1186/s12939-019-1000-8

来源: publisher

【 摘 要 】

BackgroundHealth 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.ObjectiveThis 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.MethodsA 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.ResultsThree 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.ConclusionsThe 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.

【 授权许可】

CC BY