Normative uncertainties in public health foresight

Abstract Background People value health differently, based on the norms and values. This is important when looking into the future trends in health and health care., and the perception of challenges they may arise from these trends. Methods Together with stakeholders from a broad range of health-related professions, we identified several challenges for public health and healthy environments. Professionals working on these subjects came up with different goals and different ways to achieve them. These normative goals in health policies provide uncertainties in foresight, because they can be either synergetic or conflicting. Results In the Dutch Public Health foresight study of 2014 four societal challenges for public health and healthcare were identified and formulated, as follows: (1) to keep people healthy as long as possible and cure illness promptly; (2) to support vulnerable people and enable social participation’ (3) to promote individual autonomy and freedom of choice; and (4) to keep healthcare affordable. In 2022 we will update and deepen these perspectives on public health and at the same time we will broaden the usability of working with this method by focussing on environmental health. Conclusions To explicitly distinguish different perspectives on health leads to a better understanding and dealing with normative uncertainties by taking into account the trade-offs between competing interests and values. The challenge then is to identify policy options that have positive effect from different perspective, the win-wins.


Background:
People value health differently, based on the norms and values.This is important when looking into the future trends in health and health care., and the perception of challenges they may arise from these trends.Methods: Together with stakeholders from a broad range of healthrelated professions, we identified several challenges for public health and healthy environments.Professionals working on these subjects came up with different goals and different ways to achieve them.These normative goals in health policies provide uncertainties in foresight, because they can be either synergetic or conflicting.

Results:
In the Dutch Public Health foresight study of 2014 four societal challenges for public health and healthcare were identified and formulated, as follows: (1) to keep people healthy as long as possible and cure illness promptly; (2) to support vulnerable people and enable social participation' (3) to promote individual autonomy and freedom of choice; and (4) to keep healthcare affordable.In 2022 we will update and deepen these perspectives on public health and at the same time we will broaden the usability of working with this method by focussing on environmental health.

Conclusions:
To explicitly distinguish different perspectives on health leads to a better understanding and dealing with normative uncertainties by taking into account the trade-offs between competing interests and values.The challenge then is to identify policy options that have positive effect from different perspective, the win-wins.
Abstract citation ID: ckac129.123How can policymakers incorporate uncertainty (as modelled through foresight) into policy evaluation?

Background:
Using a robust policy evaluation framework is critical to inform policymakers about the relevance of a policy in a structured way, clarifying its implications and providing arguments and criteria to compare competing options and decide which policy should be prioritised.In the current context of complex societal, environmental and public health challenges, decision-makers demand tools that allow a comparative assessment of the effectiveness of multisectoral policies and their comparison under different scenarios.

Methods:
This presentation will detail a socio-technical ''desirabilitydoability '' framework (2xD).In 2xD, an additive value model is constructed to measure the desirability of public policies, and their doability is appraised under two contrasted scenarios.For these purposes, the MACBETH approach is used in developing the three group modelling phases of 2xD: (I) Structuring facilitated workshops, (II) Evaluation decision conference, and (III) Desirability-doability decision conference.Tailor-made interactive protocols or questioning procedures are used to elicit group judgements, based on which objective-specific value scores are assigned to the policies, and the objectives are weighted (in II).Finally, we elicit doability scores for the policies under each scenario (in III).

Results:
We present how the 2xD framework was applied in Lisbon's urban health policymaking setting and discuss case insights regarding the role of scenario analysis in the appraisal and selection of policies.

Conclusions:
The 2xD framework advances knowledge on how to assist policymakers in evaluating and selecting policies and contributes to the literature on overall policy formulation and evaluation.Specifically, the framework enabled a group of policymakers to balance (multicriteria) desirability versus doability of policies under the light of two contrasting scenarios, therefore incorporating uncertainty in their decision-making process.