The Public Health Status and Foresight report 2014: Four normative perspectives on a healthier Netherlands in 2040

• Published in: Health policy (Amsterdam) Vol. 123; no. 3; pp. 252 - 259
• Main Authors: Schoemaker, Casper G., van Loon, Jeanne, Achterberg, Peter W., van den Berg, Matthijs, Harbers, Maartje M., den Hertog, Frank R.J., Hilderink, Henk, Kommer, Geertjan, Melse, Johan, van Oers, Hans, Plasmans, Marjanne H.D., Vonk, Robert A.A., Hoeymans, Nancy
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.03.2019; Elsevier Science Ltd
• Subjects: Autonomy; Challenges; Clinical outcomes; Cure; Decision makers; Experts; Foresight; Freedoms; Health administration; Health care policy; Health services; Health status; Illnesses; Interest groups; Normative scenarios; Population health; Public health; Public involvement; Social participation; Stakeholders; The Netherlands; Values; Vulnerability; Netherlands; The Netherlands; Normative scenarios; Public involvement; Public health; Population health; Foresight
• ISSN: 0168-8510; 1872-6054
• DOI: 10.1016/j.healthpol.2018.10.014

•In public health and healthcare foresights, deliberative scenario methods are clearly needed.•A new approach was developed to incorporate different societal norms and values.•A deliberative dialogue with stakeholders identified four societal challenges for health.•These societal challenges were expanded into four corresponding normative scenarios.•Synergies and trade-offs between the four scenarios were identified to inform policy-making. Policy-oriented foresight reports aim to inform and advise decision-makers. In value-laden areas such as public health and healthcare, deliberative scenario methods are clearly needed. For the sixth Dutch Public Health Status and Forecasts-report (PHSF-2014), a new approach of co-creation was developed aiming to incorporate different societal norms and values in the description of possible future developments. The major future trends in the Netherlands were used as a starting point for a deliberative dialogue with stakeholders to identify the most important societal challenges for public health and healthcare. Four societal challenges were identified: 1) To keep people healthy as long as possible and cure illness promptly, 2) To support vulnerable people and enable social participation, 3) To promote individual autonomy and freedom of choice, and 4) To keep health care affordable. Working with stakeholders, we expanded these societal challenges into four corresponding normative scenarios. In a survey the normative scenarios were found to be recognizable and sufficiently distinctive. We organized meetings with experts to explore how engagement and policy strategies in each scenario would affect the other three societal challenges. Possible synergies and trade-offs between the four scenarios were identified. Public health foresight based on a business-as-usual scenario and normative scenarios is clearly practicable. The process and the outcomes support and elucidate a wide range of strategic discussions in public health.