The FRESHER project aims to represent alternative futures health scenarios taking into account structural long-term mega-trends in demographic, gender relations, technological, economic, environmental, and societal factors for European countries at the 2050 horizon. The originality of FRESHER is to combine qualitative and quantitative foresight techniques, merging both mega-trends assessment and microsimulation-based forecasts. (More informations on FRESHER)
Quantitative forecasts of the health and economic burden of chronic diseases in 2050 are obtained from the microsimulation model deveolpped by the OECD for the FRESHER projet.
The model reproduces a synthetic representation of the population of a country or a geographical zone over the period 1990-2050. The model simulates country-representative-people's lives from birth to death.
- Synthetic population. Every individual is simulated from birth to death
- Continuous event-time based model. Individual life paths are modified by events which can append at any time and which are competing
Diseases: The model includes the major NCD's: CVD's, Cancers (Breast, Lung, Colorectum and Oesophagus), Diabetes, COPD, Dementia, Injuries.
Risk factors: The model includes most of the key determinants of non-communicable diseases: Alcohol, Blood pressure, BMI, Diabetes, Physical Activity and Smoking.
- GBD 2015
- OECD CDP-Alcohol
- GBD 2015
- NCD RISC
- FRESHER analysis based on national reimbursement database for France and Estonia
The baseline scenario, Demography only, uses the United Nation population projections, and all risk factors and relative risks are held constant as observed in 2015. Therefore, the change in epidemiology observed in the baseline 2050 projections are only the results of the change in population structure (more older people who will develop chronic diseases).
The FRESHER project aims to represent alternative futures health scenarios taking into account structural long-term mega-trends in demographic, gender relations, technological, economic, environmental, and societal factors for European countries at the 2050 horizon. The originality of FRESHER is to combine qualitative and quantitative foresight techniques, merging both mega-trends assessment and microsimulation-based forecasts (more info).
Four Scenarios for the Future of Health in Europe
- The rich get healthier: staying the course
- We will health yoy: sustained innovation for a healthy workforce
- Healthy together: promoting health and well-being for all
- Desolation health: how it could go wrong:
The four scenarios have been integrated into the model through an expert's consultation was carried out in 2017. We have surveyed health experts about the evolution of key behavioral risk factors -at the 2050 horizon- under each of the four foresight scenarios that describe possible structural mega-trends. The incidence (by age and risk profile) and the case fatality do not change among scenarios.
Expert-based predictions of risk factors are complemented with objective measures of the "Best" and "Worst" case scenarios that assume all countries will converge to the minimum (best) and maximum (worst) values as they are observed in 2015 in European countries. It is interesting to note that experts' predictions for smoking rates fall between the Best and Worst case scenarios. The picture is different for obesity. Experts predicted that in two scenarios (The Rich Get Healthier and Desolation Health), obesity rates will significantly increase, to a higher level than what is observed today in Europe (Figure 10).