The future of health futures

Health futures represents the application of various futures tools to the arenas of health and health care. This special issue of Futures reflects the significant growth of health futures. Health and health-care systems can be far better by the early 21st century, or they could be worse. Health futures enables individuals, organizations and communities to understand better the threats and opportunities facing their health, both of which are profound. The International Health Futures Network is an indicator of the growth of this subfield of futures. The future of health futures will be shaped by the ability of futures techniques and those who use them to provide value to organizations and individuals. Better networking among health futurists, expert systems, and the ability to measure and communicate quality will be essential.     

The future of health futures : Another perspective

A good ‘market’ for health futures and easy access to relevant information are among the reasons that health futures is currently centred in the wealthy nations. Interest in health futures is growing in the less developed countries, however, in part because of efforts by WHO and its regional office. Many benefits can be expected if the field becomes more international, including an influx of fresh ideas about health futures study designs and about innovative approaches to health care. A shift to a more global orientation is also imperative simply because health futures deals with the well-being of human beings, and most human beings live in the less developed countries of the world.     

What future for health futures in Latin America and the Caribbean?

The Pan American Health Organization (PAHO), Regional Office of the World Health Organization, is a United Nations agency specializing in providing technical cooperation in health to the countries of Latin America and the Caribbean. A futures approach has much to offer in this endeavour, and PAHO is making health futures tools available to its Member States through a variety of activities. The purpose of promoting futures thinking and the application of futures tools is to improve health-policy planning and public health action within the framework of the ‘Health for All’ vision and PAHO's current Strategic and Programmatic Orientations.     

Futures studies and public decision in Sweden

Futures studies are a decisive part of the public decision process in Sweden, where they appeared after World War II and gained momentum from the 1970s on.Based on a series of interviews conducted in Stockholm in December 2003, this paper presents the main players involved in futures studies in Sweden. It focuses especially on the activities of the Institute for Futures Studies, and that of the Lindbeck Commission on the Future of Sweden, which was a resounding success.The paper gives a detailed account of the interplay between this various actors. There is a strong independence between the public decision making system and the producers of futures studies. Nevertheless, futures studies prove an important instrument for public policy in Sweden, as they raise awareness in the public debate, serve as a tool for consultation, and help define scientific and technological priorities.     

Some practical hints for newcomers to health futures

The three authors of this article are all relative newcomers to the health futures field. One is based within an academic Institute of Public Health, another at the regional tier of the UK National Health Service (NHS), and the third within the NHS Executive Headquarters. The common bond between them is a desire to contribute to the development of new ways of planning for health and a wish to see health futures actively engaged with health services to bring about effective change. With the aim of providing practical advice for others who are beginning to take an interest in health futures work, they look back on their own personal experiences and summarize the lessons they have learned.     

“Every today was a tomorrow”: An integral method for indexing the social mediation of preferred futures

The visions we hold of the future, whether they are of utopias or dystopias, are not simply a matter of personal imagination. Our conceptions of the future are mediated to us as much as they are privately created by us. To this point, futures studies have not developed an integrative and broad-based framework for considering the social mediation of futures. Understanding how social mediation impacts on our futures visioning requires an interpretive framework that can cope with the multilayered nature of futures visions, the worldviews that are associated with them and a theory of mediation that can be applied within such a context of ‘depth’. Using theory-building methodology, the current paper attempts this task by describing a theory of social mediation that builds on the integral futures framework. An application of the framework explores the relationship between various scenarios of health care futures, their associated worldviews and the mediational factors that influence our visions of future health care systems.     

Beyond medicine : Health challenges and strategies in the 21st century

The future of health involves much more than the future of medical care since the major factors affecting health are environmental, social and economic ones. Health has generally improved in the past century, but the continuation of this trend is threatened by population growth, urbanization environmental change, poverty, inequity, war, existing communicable and chronic diseases, and possible new ones. New policies and strategies emerging to deal with these challenges include the formulation of healthy public policy, investing in health, and the development of new structures and processes of governance. Integrated national studies focused on human well-being and environmental health are one means through which the futures field could contribute to the improvement of health in 21st century. Visioning workshops and other participatory futures activities are equally important, since they enable people and communities to take part in the definition and achievement of their preferred health futures.     

Peru in the 21st century : Challenges and possibilities

The Peruvian 21st century study, initially conceived in 1981 and still going on, is a large programme consisting of several interlinked projects. Simulations have been done on the future of 10 key national sectors, and these simulations have then been integrated to produce scenarios describing alternative feasible futures. At the same time, a group of desired scenarios has been constructed using personal interviews and a consultation process. There has been initial work on a third project examining key external factors affecting Peruvian development. Still to be undertaken are projects identifying specific development strategies and analysing the national planning process. Especially noteworthy products of the study are the user-friendly spreadsheet models, which make the feasible futures component of the study highly accessible to interested decision makers.     

Making visions visible for long-term landscape management

Results generated by planning and futures studies are often too abstract to provide a clear vision of the future to non-specialists. In this study the role of 3D visualization and the challenges in developing and communicating visible visions for our future landscapes is explored. While traditional visualization techniques have been well-known for several hundreds of years digital 3D visualizations are still not yet taken advantage of in long-term planning or in futures studies in general to their full potential. As part of an iterative consultation and participation process a long-term vision for the landscape and land management of the Alport Valley in the Peak District National Park, UK is developed in order to improve the valley's special landscape character, to enhance the valley's visual and recreational attractiveness, to regenerate the woodlands in ways that maximize the long-term benefit of ecology, wildlife and landscape and to get a good balance between wooded areas and open moorland.An early integration of 3D visualization in the planning process offers a wide range of opportunities for exploring alternative futures but it also poses challenges to the expert planners such as being able to react timely, with a high degree of realism and interactively to incorporate new inputs from participating stakeholders. Furthermore, the planner is forced to translate a vision into concrete geographically referenced data. Only then the vision can be visualized. The full potential of 3D visualizations in the planning disciplines and in futures studies is still to be explored. The visualizations could be the basis to communicate the vision - the views of the future - and to share the vision with others in order to influence future change.     

A vision for Nicaragua : Health services in the new century

Nicaragua is facing a crisis in health and health care, and a health futures programme has been initiated to focus concern and mobilize key actors. Two national scenario workshops have been held at which participants constructed several scenarios describing alternative health futures for the country, with particular emphasis on the organization of health services. One or these, a scenario of profound change, was selected by the participants as their vision of the preferred future. It involves more emphasis on health promotion, decentralization of health-care services, broader participation in health matters, improved training for health professionals, and a stronger role for universities and other educational and research centres. Implications of the selected scenario regarding health policies and actions have been identified, among them being the adoption and implementation of the Ottawa Charter on Health Promotion, the organization of local health service networks, and the more active involvement of health professionals in the designing of health systems.     

Health trend assessment in Indonesia Futures studies at the provincial level

Health trend assessment studies have been carried out in Indonesia at the national and provincial levels, to provide input into long-term national development plans and to build up the capacity for local health planning in anticipation of decentralization. Provincial health trend assessment studies have been done in five provinces by teams from local health and planning authorities and the local school of public health. These provincial teams have all used background documents and standard procedures developed by a national team and have gone through the same methodological training. Out of the experience have come specific ideas about how trend assessment and similar activities can be strengthened. Among the recommendations are the establishment of national research centres for trend analysis, efforts to improve availability and reliability of relevant data, the training of a cadre of health professionals familiar with futures methods, and continued promotion by WHO and other agencies of long-term health planning and health futures.     

The International Health Futures Network (IHFN)

The International Health Futures Network (IHFN) provides an opportunity for those oriented towards health futures research, leadership and strategic policy-making to discuss the future of health and health care, share new ideas and visions and deepen their understanding of international health-care issues. IHFN members are committed to an ambitious vision of “improving health status worldwide by applying and advancing health futures”.     

Things are different today: the challenge of global systemic risks

While most OECD countries have been rather successful in reducing risks to human lives, health, and the quality of the environment, the record for new global risks such as climate change, pandemics, financial breakdowns, and social inequality is much less convincing. This is the challenge of systemic risks. Since the global financial crisis, it has received rapidly growing attention. However, considerable conceptual confusion mars research on and practical responses to this challenge. We undertake an effort of conceptual clarification, starting with the paradigmatic example of the financial crisis. This leads to a view of global systems as involving an interplay between micro- and macrodynamics internal to the system, with the system simultaneously interacting with its environment. Such dynamics typically show periods of stability, punctuated by situations opening up several possible futures. Alternative global futures, like other prospects, constitute risks for an agent if she considers some of these futures as less desirable than others. Agents may have lexicographic preferences over futures they would like to avoid, so as to consider some futures as just undesirable, but others as catastrophic. If an agent expects some of the relevant futures at a bifurcation point of a global system to be catastrophic in this sense, they are faced with a systemic risk.     

Delphi in a future scenario study on mental health and mental health care

The article highlights methodological issues of futures research on mental health (care). In particular the limited relevance of quantitative psychiatric epidemiology is emphasized. The mental health sector in the Netherlands is characterized as a balance of power between professionals, institutions, insurance companies, patient organizations and local and national governments. To value shifts in this balance and to assess future interventions and policies, opinions of people who know the sector well are indispensable. Delphi with its main characteristics of anonymity, iteration and feedback to the participants and being a predominantly qualitative method for data collection was chosen to gather this type of information. Finally the Delphi method as a tool in policy-oriented futures research is discussed. The strength of Delphi must be found in its capacity to generate new options for intervention and to enhance consciousness of the future in order to reinforce rationality of decision processes. Clarifying dissensus on the issues under study proved to be as relevant as the elucidation of consensus.     

Integral futures based on the paradigm approach

The study discusses the interpretation of integral futures in the context of paradigm. The dynamic matrix model of futures paradigm has been developed for carrying out meta-analysis of futures. As a result of meta-analysis integral futures and its new paradigms are defined by way of reconstructing futures paradigm history as responses to changing societal needs and through the outcomes of dynamic and comparative analysis of futures paradigms. The study sets the argument that integral futures: (a) is entering a new phase in development of futures that responds to societal demands for sustainability, democratic participation and continuous knowledge production and integration, (b) it is the phase of cooperation building between theoretical and practical futures, (c) it is the complementary development of co-evolutionary and participatory paradigms, and (d) it unfolds further research perspectives for futures.     

Health scenarios and policy making Lessons from the Netherlands

A decade ago the Dutch government established the Steering Committee on Futures Health Scenarios (STG) to organize and facilitate research and debate on alternative futures in public health. The STG has since carried out dozens of scenario projects on specific health topics, and the resulting reports have played an important role in the decision-making process within the health sector. The researchers, policy makers, and administrators who have been involved with STG activities have also learned a great deal about which methodologies, processes and organizational arrangements are best for this kind of enterprise. Those lessons are shared here for the benefit of other health agencies interested in carrying out similar programmes.     

期货投资基金与期货市场发展探讨

现代期货市场在套期保值和价格发现功能基础上演绎出丰富的功能类型。在发达国家,期货投资基金规模庞大,具有成熟的交易策略和交易技术,已经成为期货市场所有功能有效发挥的中坚力量。中国要全面提升期货市场功能,确保价格安全和产业安全,应加快探索期货投资基金的具体模式、市场结构和法律框架,将期货投资产业链中的各要素进行重新整合,确立不同品种期货的产业集群式发展模式。为此,政府应主动打破路径依赖,实现以投资者结构多样化为基础的期货市场全面创新。     

中国农产品期货主力及近月合约套期保值效果研究

主力合约和近月合约的偏离是中国期货市场特有的现实问题,它在一定程度上阻碍对中国期货市场功能的发挥。文章以ZCE棉花和DCE豆一期货为代表对中国农产品期货市场进行研究,研究发现,中国ZCE棉花和DCE豆一期货的近月合约套期保值效果明显优于主力合约套期保值效果,但均远远低于发达期货市场的套期保值效果。根据研究结果,本研究结合实际提出几个有针对性的措施,以利于中国农产品期货功能的发挥。     

Futures-Style Options on Euro-deposit Futures: Nihil sub Sole Novi?

Euro-deposit futures play a relevant role among the derivative products traded in official markets. As opposed to most futures contracts, the underlying instrument is not represented by a traded asset but by a linear transformation of an interest rate, the Libor. The options written on Euro-deposit futures that are traded at the London International Financial Futures & Options Exchange (LIFFE) are subject to daily marking to market, as the underlying futures; thus, they are called futures-style options or pure futures options. These options are often priced with the Black (1976) formula, whose use entails several shortcomings. A more realistic alternative is represented by the univariate Cox, Ingersoll and Ross (1985) model. The closed-form solutions for the prices of Euro-deposit futures and futures-style options on Euro-deposit futures obtained in the CIR model are two major original contributions presented in this paper. Other original contributions involve the determination of the relation between futures rates and forward rates and the derivation of the equivalent portfolio for the hedging of futures-style options on Euro-deposit futures.     

恒生指数和沪深300股指期货套期保值效果对比研究

本文利用OLS、ECM、ECM-GARCH模型对沪深300股指期货和恒生指数期货的最优套期保值率进行了估算,并在风险最小化框架下对它们的套期保值效果进行了对比研究。结果发现:无论是哪种股指期货,不考虑期现货间存在的协整关系会使估算的最优套期保值率偏高,影响套期保值效果;其次是虽然在样本内外,沪深300股指期货的套期保值效果比恒生指数期货的好,但是沪深300股指期货套期保值效果的稳定性比恒生指数差。此时,ECM-GARCH和OLS模型分别为样本内外投资者利用沪深300指数期货进行套期保值时的最佳选择;对于恒生指数股指期货,最优模型是ECM。