Abstract

Every four years, the National Institute for Public Health and the Environment (RIVM) looks ahead to developments in public health and health services. This time, the Public Health Foresight Study (PHF-2024) describes five major challenges on the way to 2050. The PHF-2024 also outlines a number of possible measures to address these challenges.

The PHF-2024 makes it clear that the Netherlands is not yet fully prepared for these challenges. The PHF also shows that the challenges are interrelated and thus need to be addressed together. Firm health policies are therefore needed in the coming years, with concrete goals.

Choosing a healthy future means sustaining policies for a long time. It is also important that policies that are already in place, such as smoke-free policies and policies that encourage physical activity, remain in place and that, for example, poverty and poor housing conditions are taken into account. Finally, it is important to evaluate policies to learn lessons for the future.

Population ageing is and remains the most important societal development when it comes to public health. More new forms of housing are needed where older people can live together, help each other and get the attention they need. Furthermore, it is important to have a social discussion about which treatments, types of care and end-of-life decisions are necessary and desirable. At the same time, many elderly people remain vital after they retire. It is therefore important for elderly people to continue to participate in society. These points make up the first challenge.

The second challenge is the large health inequalities in the Netherlands. On average, people with better social status live 14 years longer in good health than groups that are worse off. A lack of socioeconomic security is important here, often combined with poorer living situations or working conditions. It is therefore necessary to improve the conditions in which these people live.

Thirdly, young people have increasingly unhealthy lifestyles. For instance, more young people will be overweight, at an increasingly younger age. Young people are also increasingly likely to have mental health problems. As young people are the future, it is important to invest in their physical as well as mental health.

The fourth challenge is how good care can continue to be provided in the face of increased demand for care and ever-increasing staff shortages. There will also not be enough informal carers in proportion to the demand. This could overburden them.

The fifth challenge is about a healthy design of the living environment to be better prepared for the effects of climate change. Examples are heat stress and flooding. In many places, measures are already being taken to protect the Netherlands from this, such as more greenery and water in cities and villages. A green environment also has health benefits: it encourages people to meet, relax and exercise.