The web articles in the ‘Future trends’ section of the Synthesis show how our public health and health care will develop over the next 25 years if we pursue our current course and do not take any additional measures. Collectively, all these trends offer an impression of the challenges that our society faces. This web article describes which of these trends are considered most urgent by citizens and by professionals and students in the public health domain. What trends should we address now as a society, taking action to prevent future problems? The most urgent issues were identified using a survey. The results of the survey were used to select three challenges for which options for actions have been elaborated in this Public Health Foresight Study. The options for action are based on wide-ranging stakeholders meetings. This Synthesis consists of three web articles based on the options for action: one summarising the most important stakeholder recommendations for the options for action, one covering a number of general opportunities and themes for policy and society, and one listing focal areas for the knowledge and innovation agendas. (The latter web article is only available in Dutch).

Key messages

Key challenges for the future according to citizens, professionals and students
Out of all the trends identified in the Trend Scenario and the Thematic Foresight Studies in the VTV–2018, citizens consider the threat of antibiotic resistance to be the most urgent societal challenge for the future. Professionals and students in the public health domain also consider it an urgent challenge. Other issues that are perceived as extremely urgent include deaths due to cardiovascular disease and cancer, the twofold increase in the number of people suffering from dementia, and the increase in health care expenditures. Professionals consider the deficit in healthy life expectancy in people with a lower socio-economic status to be the most urgent issue, while students believe it is the increased pressure on teenagers and young adults.

Survey results show some overlap, but also differences between respondents

Together, the Trend Scenario and the Thematic Foresight Studies of the VTV-2018 describe a large number of future developments. These trends are all significant for public health and health care in the Netherlands. A questionnaire was developed to assess what different groups in society viewed as most urgent. To that end, the Trend Scenario and Thematic Foresight Studies were summarised in 41 developments. Next, citizens and professionals and students in the public health domain were asked to express their opinions on the urgency of these future developments.

The survey results show that all three groups of respondents consider the threat of antibiotic resistance to be an urgent challenge for society. Citizens and professionals also view the twofold increase in the number of people suffering from dementia, and the twofold increase in health care expenditures as urgent priorities. Citizens and students consider it an urgent development that cardiovascular diseases and cancer continue to cause the majority of deaths. In addition to overlap, we also observe differences. Professionals view the socio-economic differences as extremely urgent, while citizens and students consider this issue to be less urgent. Students believe that the increased mental pressure on teenagers and young adults is the most urgent issue. Developments related to lifestyle and technology were often listed as the least urgent (see infographic).

The results of the survey were used to select three challenges to focus on. Options for action in response to these challenges are provided in detail in this Public Health Foresight Study. 

Deze infographic geeft de resultaten van een vragenlijst weer waarin respondenten is gevraagd welke van 41 toekomstige ontwikkelingen zij het meest en minst urgent vinden.

 Download infographic

Footnote: One of the trends that was included in the questionnaire was: ‘Mental disorders remain the main cause of burden of disease.’ This was based on the figures that were published originally in the Trend Scenario in June 2017. These results were however modified in June 2018, because improved figures had become available. Mental disorders still cause a high burden of disease, but are no longer the disease group that ranks number one. For more information, see the Trend Scenario.

Text version

Most urgent

Citizens consider most urgent:

  1. Threat of antibiotic resistance
  2. Cardiovascular disease and cancer will remain the main cause of death
  3. Number of people with dementia will double
  4. Correct use of green and water for dealing with the effects of climate change
  5. Healthcare expenditures will double

Professionals consider most urgent:

  1. Lag in healthy life expectancy among people with lower socio-economic status
  2. Number of people with dementia will double
  3. Number of people who experience insufficient control over own life will increase
  4. Healthcare expenditures will double
  5. Threat of antibiotic resistance

Students consider most urgent:

  1. Increasing mental pressure on youngsters and young adults
  2. Threat of antibiotic resistance
  3. Cardiovascular disease and cancer will remain the main cause of death
  4. Mental disorders remain the main cause of burden of disease
  5. The number of people who are overweight will increase

Least urgent

Citizens consider least urgent:

  1. Three times as many people with a lower socioeconomic status smoke, compared to people with a higher socioeconomic status
  2.  In 2040, one in seven adults will smoke
  3. Most people do not adhere to the guidelines for healthy nutrition
  4. Almost one in ten adults is an excessive drinker
  5. New technologies, such as genetic engineering, raise ethical dilemmas

Professionals consider least urgent:

  1. The increase in healthcare expenditures is for the largest part caused by technology
  2. The increasing use of data will lead to risks for breaches of privacy
  3. New technologies may cause new risks for population health
  4. Flexibilisation of labour and robotisation may have a negative impact on health
  5. Most people do not adhere to the guidelines for healthy nutrition
  6. In 2040, one in seven adults will smoke

Students consider least urgent:

  1.  For some groups of employees, it will be difficult to keep up with the digitisation
  2. The increase in healthcare expenditures is for the largest part caused by technology
  3. In 2040, one in seven adults will smoke
  4. Almost one in ten adults is an excessive drinker
  5. The increasing use of data will lead to risks for breaches of privacy