Thirty Years of Strategic Foresight Shaping Public Health in the Netherlands
1
RIVM - National Institute for Public Health and the Environment, Bilthoven, Netherlands
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
ABSTRACT:
Strategic foresight has become an increasingly important lens for guiding the future of public health in the Netherlands over the past three decades, moving from ad hoc scenario exercises to a more embedded, systematic practice within national institutes and policy processes. Dutch foresight work has progressively combined long-term trend analysis, participatory scenario development, and quantitative modelling to explore how demographic change, lifestyle patterns, technological innovation, environmental pressures, and social inequalities may shape population health and health systems up to mid-century. This evolution has supported a shift from reactive planning to anticipatory governance, where uncertainty and complexity are treated as core features of decision-making rather than exceptions. Over roughly 30 years, strategic foresight has been used to develop successive public health foresight studies, inform prevention priorities, and stress-test policy options against divergent futures, such as scenarios of accelerated ageing, digital transformation, or climate-related shocks. Methods have diversified from expert-driven narratives to more inclusive, stakeholder-based approaches that incorporate perspectives of municipalities, professionals, citizens, and other sectors such as social care, environment, and food systems. Foresight has also become more tightly linked to quantitative tools, including burden of disease projections and monitoring frameworks, which anchors long-term visions in robust epidemiological evidence. These developments position strategic foresight as a critical capability for designing resilient, equitable, and prevention-oriented health policies in the Netherlands. By connecting long-term scenarios with near-term decisions, foresight helps highlight trade-offs, co-benefits across sectors, and windows of opportunity for transformative change in public health. The Dutch experience offers a practical model for other countries seeking to institutionalize foresight as a core function of modern public health governance.
Strategic foresight has become an increasingly important lens for guiding the future of public health in the Netherlands over the past three decades, moving from ad hoc scenario exercises to a more embedded, systematic practice within national institutes and policy processes. Dutch foresight work has progressively combined long-term trend analysis, participatory scenario development, and quantitative modelling to explore how demographic change, lifestyle patterns, technological innovation, environmental pressures, and social inequalities may shape population health and health systems up to mid-century. This evolution has supported a shift from reactive planning to anticipatory governance, where uncertainty and complexity are treated as core features of decision-making rather than exceptions. Over roughly 30 years, strategic foresight has been used to develop successive public health foresight studies, inform prevention priorities, and stress-test policy options against divergent futures, such as scenarios of accelerated ageing, digital transformation, or climate-related shocks. Methods have diversified from expert-driven narratives to more inclusive, stakeholder-based approaches that incorporate perspectives of municipalities, professionals, citizens, and other sectors such as social care, environment, and food systems. Foresight has also become more tightly linked to quantitative tools, including burden of disease projections and monitoring frameworks, which anchors long-term visions in robust epidemiological evidence. These developments position strategic foresight as a critical capability for designing resilient, equitable, and prevention-oriented health policies in the Netherlands. By connecting long-term scenarios with near-term decisions, foresight helps highlight trade-offs, co-benefits across sectors, and windows of opportunity for transformative change in public health. The Dutch experience offers a practical model for other countries seeking to institutionalize foresight as a core function of modern public health governance.
| eISSN: | 2654-1459 |
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