FRESHER – Understanding what shapes our health using foresight

FRESHER explored how future trends could shape the health of European citizens by 2050. By combining quantitative modelling with qualitative foresight, FRESHER developed alternative health scenarios to support smarter, more inclusive health policies. With a focus on non-communicable diseases (NCDs), the project helped policymakers understand long-term health risks, evaluate the impact of public health strategies, and design future-proof solutions grounded in evidence and innovation.

Challenge - Why FRESHER?

What will our health look like in 2050? Will we live longer… and better? Today more than ever, health is a complex issue—shaped by a web of social, economic, environmental, and technological factors. Europe’s healthcare systems are undergoing profound transformations: population ageing, the rise of chronic diseases, and the growing opportunities in prevention and health tech call for urgent, forward-thinking action.

That’s where FRESHER – FoResight and Modelling for European HEalth Policy and Regulation comes in. This Horizon 2020 project used strategic foresight tools to imagine alternative futures for health in Europe and to shape more effective, inclusive policies—designed to anticipate tomorrow’s needs today.

Solution – The FRESHER Approach

Running from 2015 to 2017 and coordinated by Université de Marseille, FRESHER brought together eleven European partners in a multidisciplinary effort to map out future scenarios for health and assess the most effective policy strategies to tackle the risk factors for non-communicable diseases (NCDs). The project focused on three core pillars:

Quantitative Analysis of Non-Communicable Diseases (NCDs): FRESHER developed projections on the future impact of NCDs on both population health and healthcare spending across the EU, using a micro-simulation model adapted from the OECD’s Chronic Disease Policy Model.
Qualitative Exploration of Health Determinants: Through foresight methodologies, experts identified and analysed both emerging and established trends that influence risk factors for chronic disease. This participatory, future-focused dialogue ensured a rich qualitative foundation for scenario development.
Stakeholder Engagement: By involving stakeholders across sectors—via workshops, surveys, and policy forums—FRESHER generated political recommendations and promoted intersectoral dialogue to support healthier behaviours and improved care systems.

The FRESHER process – A compass for uncertain futures

FRESHER’s scenario-building approach followed three structured phases:

Horizon Scanning: Identifying trends, key drivers, weak signals, and uncertainties that influence health and NCD risk factors. This phase included an extensive literature review and three stakeholder workshops in Vienna, Brussels, and Lisbon.
Assessing Importance and Uncertainty: Key trends were assessed and classified using the PESTEL framework (Political, Economic, Social, Technological, Environmental, Legal). Insights were collected through expert surveys, a policy event, and a technical workshop—resulting in potential indicators to track change over time.
Scenario Development: FRESHER produced four plausible future scenarios for 2050 to explore how today’s policy decisions could shape long-term health outcomes. These scenarios were intentionally discontinuous from current trajectories, offering a bold look at possible system-wide transformations. This phase included a second survey, a technical event, a policy workshop, and three regional workshops to contextualise the scenarios locally.

The FRESHER scenarios were used to inform the quantitative model and support European policy dialogue, advancing a “Health in All Policies” approach.

ISINNOVA’s role – A foresight leader in health policy

Andrea Ricci (Lead Researcher) and Giovanna Giuffrè (Senior Researcher) led ISINNOVA’s contribution to FRESHER. They collaborated with the Austrian Institute of Technology in the initial foresight phase and guided the consortium through the scenario development and policy translation phases. Andrea Ricci ensured consistency and integration between the qualitative and quantitative approaches—coordinating dialogue with the OECD to align models and insights. Giovanna Giuffrè designed and led the stakeholder consultation process (surveys, workshops, events), ensuring a highly inclusive and participatory approach.

FRESHER’s legacy – Knowledge that powers better decisions

The impact of FRESHER goes far beyond the life of the project. Its results offer concrete tools for building more effective, evidence-based, and forward-looking health policies across Europe.

FRESHER supported policy formulation by offering decision-makers a set of targeted recommendations to reduce the burden of chronic diseases and mitigate their negative impacts on the wellbeing of European citizens and society at large.
It enhanced understanding of the causal pathways leading to chronic illness, enabling more focused and effective interventions to promote population health.
It developed Fresher Explorer, an open-access web tool designed to compare NCD trends across scenarios and evaluate the impact of public health policies. Continuously evolving, the tool is available to policymakers, researchers, and public health professionals throughout Europe.
It influenced how resources are allocated—offering guidance on how to strike a better balance between prevention and treatment, between biomedical innovation and policy action on broader social and environmental determinants of health.
It strengthened the scientific and technological foundation needed to respond to future health challenges, paving the way for more informed, proactive, and holistic public health strategies.

More info on ISINNOVA’s projects on foresight and health:

FRESHER has received funding from the European Union‘s Horizon 2020 Research & Innovation programme.

Want to explore more?

Visit the FRESHER project results here.

Read the PLOS ONE publication: “How will the main risk factors contribute to the burden of non-communicable diseases under different scenarios by 2050?”

Our project partners:

Inserm, AIT – Austrian Institute of Technology, Unversitè Marseille, Finnish Institute of Health and Welfare, European Public Health Alliance, Istituto Superiore di Sanità, SSCS Zabrze, Universidad de Vigo, OECD, Fourth View Consulting.