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Non-communicable diseases (NCDs) such as cardio-vascular problems, diabetes, cancer, multi-skeletal disorders, depression, neurologic disorders and many more are the major cause of health problems and death in OECD countries. These diseases develop earlier among underprivileged people. Chronic-degenerative diseases, however, are to a large degree avoidable. In our foresight project FRESHER (FORESIGHT AND MODELLING FOR EUROPEAN HEALTH POLICY AND REGULATION) we discuss policy options with stakeholders from health, research, care, patient organisations, insurances and policy-making that go beyond the usual activities and pose alternatives that promise to be more successful. From an analysis of trends that affect NCD development far beyond the usual determinants of tobacco and alcohol consumption, salt, sugar and fat intake or sedentary behaviour the most relevant and significant trends are combined to four scenarios depicting possible futures. The options for alternatives presented contribute to the discussion of policies for the future in a comprehensive approach to “health in all policies” in the EU. NCDs are not a matter of medicine and health only. Thus the traditional approach of health policy has to be extended. Out of the box thinking is needed to pay tribute to the complexity of future health systems that need to include aspects like equity, literacy, mobility or urban planning. A systematic and holistic approach is required to address all drivers and determinants leading to a healthy life and well-being.

Drivers, trends and scenarios for the future of health in Europe. Impressions from the FRESHER project