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The future of public health in Europe – EuroHealthNet Foresight report

25 March, 2024

The European health landscape is undergoing significant changes. The digital transition as well as demographic and climate change influence social and health inequalities, and are bound to shape the future of public health in the region. Health promotion and disease prevention must be at the core of these changes, to ensure the most efficient and equitable use of limited health resources, including financial and human resources.

EuroHealthNet – in collaboration with the Copenhagen Institute for Futures Studies – has conducted a Foresight study to collect insights and identify risks and opportunities. The study investigates the role of public health by 2035 in achieving health equity through health promotion and prevention, in the context of the digital and green transition.

Read our Foresight summary report (.pdf)

The six themes of this Foresight study

Public health policy and governance
Public health financing and spending
Sustainability and the green transition

Health promotion and disease prevention
Equity and society
Digitalisation in public health

Three overarching recommendations

Generate political will for health and wellbeing for all through a robust evidence base, new narratives, and participatory governance, as well as supporting community-based approaches, thereby shifting societal values, and reducing demand for health and social care services.

Advocate for Wellbeing Economies, which will facilitate new economic and financial models for health promotion and prevention within and beyond health systems, align incentives, and foster multi-stakeholder cooperation, including with the private sector, while tackling the commercial determinants of health.

Leverage digital, AI and other technological, biomedical as well as social innovations, while applying equity impact assessments and exploring new health promotion and disease prevention approaches. This new approach should complement population public health and policies on the social and environmental determinants of health.

Calls to action for public health in Europe

Based on the results from EuroHealthNet’s Foresight study, public health stakeholders and decision-makers across Europe are called upon to take action in the following areas.

Public health policy and governance

Build consensus around public health objectives that give priority to health equity and wellbeing, rather than limited economic interests.
Establish mechanisms to align economic incentives with health, social, and environmental objectives and restore trust in institutions.
Follow a collaborative approach that brings together different sectors and stakeholders from the public, private, and civil society sectors, locally, nationally, and across the EU.
Foster evidence-based decision-making and generate political will by developing capacity and allocating resources to the generation of evidence and communication on public health.
Conduct Europe-wide studies that seek to identify effective public health policies and promising practices as well as common principles to transform health systems and other settings (such as local and regional communities).
Encourage EU coordination on the Wellbeing Economy through a dedicated European Commissioner, a dedicated group in the European Parliament, and broadened EU health competences.

Public health financing

Focus on cross-sectoral spending for health promotion and prevention as well as health equity, thereby reducing the burden on health and social care services.
Shift incentive structures in European health systems to health outcome-driven systems by developing and demonstrating evidence of impact.
Investigate and apply pro-health taxes aimed at enabling healthy behaviour and sustainable consumer choices.
Increase collaboration between the ministries of finance and health but also other ministries (e.g., education) to ensure comprehensive implementation of health policy.
Explore the validity of new financing models through pilots in limited geographies or populations.

Sustainability and green transition

Develop the necessary evidence that demonstrates the importance of the green transition for population health and wellbeing.
Develop policies that ensure the green transition, include indicators of population health, and utilise health impacts to drive the green transition.
Introduce mandatory health, equity, and environmental impact assessments for new policies, products, and services.
Spend the EU budget only for products, services, projects, etc. that are compliant with its green and sustainable objectives.
Encourage the greening of the supply chain and public procurement procedures aimed at achieving social, health, and environmental objectives.

Health promotion and prevention

Advocate for a Wellbeing Economy approach, that benefits people and the planet and ensures peace, human dignity, equal opportunities, and fairness.
Prioritise health promotion and disease prevention.
Better monitor and regulate commercial determinants of health at EU and national levels.
Enable healthy behaviours for all, raising awareness and integrating health promotion into education and workplaces.
Investigate effective and ethical approaches for early screening of non-communicable diseases and mental health across the social gradient.
Explore personalised approaches to prevention, leveraging advancements in data, AI, digital health, and biomedical research to tailor preventive interventions to improve health.

Equity and society

Ensure that policies prioritise populations in vulnerable situations, enhance social inclusion, and address the root causes of health inequalities.
Offer affordable and sustainable consumption and mobility options, and targeted support for people in vulnerable situations.
Encourage the further implementation of the EU Child Guarantee to reduce inequality and poverty experienced by children, and support a specific focus on health promotion in schools.
Step up action on childhood obesity and increase health literacy across the lifecourse.
Strengthen public universal services, and closely monitor the quality and impacts of private services through health equity impact assessments.
Increase the visibility of health inequality issues in the media and on social media.

Digitalisation in public health

Embed (health) equity into the digital transformation and digital policymaking, for instance by monitoring equity impacts of digital policies.
Ensure digital access and inclusion and make links between digital and social innovation.
Promote digital health literacy and build a public health workforce that has digital and AI competences.
Support the EU wide harmonisation of data collection practices and access to the necessary technologies.
Support the implementation of the European Health Data Space by collaborating with EU institutions and across European borders, identifying challenges and opportunities.

Read our Foresight summary report (.pdf)

Read the full Foresight report (.pdf)

The Health Promotion Documentation Center of Piedmont Region (DoRS), a member of the EuroHealthNet Partnership, has translated a summary of the report into Italian.

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The future of public health in Europe – EuroHealthNet Foresight report

The six themes of this Foresight study

Three overarching recommendations

Calls to action for public health in Europe

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