Citizens and professionals and students in the public health domain were asked which future developments they considered most urgent. This information was used to select three challenges, which were then developed into detailed options for action. These are the persistently high burden of disease due to cardiovascular disease and cancer, the steady growth in the group of older people still living on their own while suffering from dementia and other complex issues, and the increasing mental pressure on teenagers and young adults. The findings from wide-ranging stakeholder meetings were used as the basis for the options for action. The following table summarises the main recommendations of the stakeholders. How can we deal with the challenges we are facing? What goals are key in society, what is needed to achieve them, and who can contribute? More detailed descriptions of the options for action are available here (in Dutch).

Options for action in response to three societal challenges

Challenge: Cardiovascular diseases and cancer are health conditions that continue to occur frequently, will still be the cause of the majority of deaths in 2040, and have a major impact on patients’ lives.

Societal goals Courses of action
Working on integrative prevention measures
  • Integrative programmes targeting lifestyle as well as the physical and social environment.
  • Collaboration between government ministries, especially in the context of the physical and social environment.
  • Focus on underlying social issues in vulnerable groups.
Other health care resulting from technology and different organisational structures
  • Ensuring better utilisation of options for self-diagnostics and genetic testing.
  • Effective management of tensions between diverse interests (ethical, legal, health care) in the context of genetic information, for instance via laws and regulations.
  • Working with all stakeholders to determine which care can be provided at home.
  • Responding more effectively to the demand for health care in cases of multimorbidity by means of increased and more wide-ranging collaboration.
  • Developing more knowledge about gender-specific differences in the expression, presentation and treatment of diseases and implementing that knowledge more quickly into medical practice.
Dealing more effectively with physical, mental and societal consequences
  • Focusing more attention on the long-term effects of diseases, both within the health care sector and beyond.
  • Training patients and health care providers in self-management, and in putting it into practice.
  • Offering support to people who are unwilling or unable to manage their own care process, e.g. by using case managers.

Challenge: The group of older people living independently who have dementia and other complex problems is increasing significantly.

Societal goals Courses of action
Better care and support for older people living independently.
  • Organising health care options based on what older people still can manage and would rather do themselves.
  • Supporting older people who have difficulty expressing their preferences and needs.
  • Flexible approach by professionals in response to civic initiatives that go ‘outside the established framework’.

Ensuring an environment that accommodates older people

  • Taking healthy, safe, pleasant ageing into account when structuring the living environment.
  • Defining balanced policy for older people: stronger focus on what they can still do themselves.
Caring effectively for informal carers
  • More support for informal carers: practical tips, social, material and financial support, and offering replacement care.
  • Alertness to informal carers being shy about asking for help.
  • Focus on the care needs of the informal carer, caused by psychological and physical stress.

Challenge: Mental pressure on teenagers and young adults is increasing, and may have consequences for their psychological health.

Societal goals Courses of action
Mental health and staying healthy
  • Increase range of intervention options for teenagers and young adults about coping with pressure.
  •  Adapting the learning environment, e.g. focusing on student well-being.
  • Focusing more on promoting mental health amongst young employees in a work environment.
  • Early identification in locations where teenagers and young adults are and offering appropriate interventions in those locations.
Acceptance of psychological symptoms
  •  Counteract negative image through campaigns and public information.
  • Use ‘experience experts’ to lower the threshold for seeking help.
  • Continuing to work towards a society in which psychological symptoms are not an obstacle to participation.

The major challenges we face are complex in nature. They have multiple causes and demand the involvement of various types of professionals from various areas of health care and policy. These types of problems require an integrative and personal approach. Many different parties need to be involved: from policy makers, health care and public health professionals, researchers and citizens, to societal stakeholders such as patient organisations, health funds, health insurance companies, employers, industry, retailers and schools. In addition, it requires wide-ranging collaboration: not just between various types of health care professionals, but also across the lines of public health and health care. Integrative policy not only requires local collaboration, but also collaboration between government ministries, especially when dealing with the physical and social living environment.