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Title: Scenarios for population health inequalities in 2030 in Europe: the EURO-HEALTHY project experience
Authors: Alvarenga, António
Costa, Carlos A. Bana e
Borrell, Carme 
Ferreira, Pedro Lopes 
Freitas, Ângela Mendes 
Freitas, Liliana
Oliveira, Mónica D.
Rodrigues, Teresa C. 
Rodrigues, Ana Paula Santana 
Santos, Maria Lopes
Vieira, Ana C. L.
Keywords: Delphi method; Foresight; Health inequalities; Participatory approach; Policies; Population Health; Scenarios; Socio-technical approach; Stakeholders
Issue Date: 25-Jun-2019
Publisher: BMC
Serial title, monograph or event: International Journal for Equity in Health
Volume: 18
Issue: 1
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’ (worstcase 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.
ISSN: 1475-9276
DOI: 10.1186/s12939-019-1000-8
Rights: openAccess
Appears in Collections:I&D CEGOT - Artigos em Revistas Internacionais

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