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Table 1 Overview of the three scenario structures, composed by drivers and drivers’ configurations

From: Scenarios for population health inequalities in 2030 in Europe: the EURO-HEALTHY project experience

PESTLE category Drivers Worst-case
(increase in inequalities)
To the best of our knowledge Best-case
(decrease in inequalities)
Political Cohesion funds (or other funds) for less-favoured regions Reduction Maintaining Maintaining
Political commitment and public support towards universal access to healthcare Weak Weak Strong
Public expenditure in the healthcare system Reductions Priority with often insufficient funding Increases
Social protection policies for the elderly Significantly weaker Significantly weaker Significantly stronger
Investments in national social security systems Significantly lower Without significant change Significantly higher
Extent of compulsory education Limited and non-harmonized Extension with weak harmonization Throughout the EU and increasingly harmonized
Quality of Public Education Decrease A priority with often insufficient funding Increase
Economic Healthcare efficiency Significant decrease Without significant change Significant increase
Financial, Economic and Social crises Deeper and long lasting Occasional and regular Mitigated cyclical global crises
People's material deprivation Increase Small decrease Significant decrease
Economic inequalities Increase Increase Decrease
Social Insurance Schemes Weakening Without significant change Strengthening
Unemployment rate in Europe Significantly higher Without significant change Significantly lower
Long-term structural unemployment Significant growth Without significant change Significant decrease
Unemployment among 55+ Significant increase Significant increase Decrease
Employment precariousness Significant increase Small increase Decrease
Employment with low income Significant increase Small increase Decrease
Social Concentration of people at of poverty and social exclusion Higher Higher Lower
Medical quality and effectiveness of healthcare services Deterioration Improvements with many dissimilarities Significantly higher
Access to healthcare More limited More limited Widening
Quality and accessibility of the primary healthcare services Significant reduction Maintaining Steady growth
Access and Quality of Emergency Medical Services (EMS) in remote and/or rural areas Significantly lower Without significant changes Significantly higher
Smoking restriction policies Softer Stricter Stricter
Diet and nutrition Significantly less healthy Limited improvement Significantly more healthy
Sedentary lifestyles Increase Limited reduction Reduction
Non-communicable diseases like diabetes and hypertension Increase Increase Decrease
Food security Compromised Without significant change Improved
Technological Medical innovation (improved and affordable medicines, medical research and technologies) Stagnation Slow growth Rapid growth
Environmental Quality of the built environment Decrease Without significant change Significant improvement
Quality of the natural environment Decline Without significant change Improvement
Quality of the outdoor air Decline Sustain the current levels Improvement
Climate change adaptation Maladaptation Limited adaptation Improved resilient adaptation
Climate change mitigation Disengagement Limited action Engagement
Priorities in terms of economic model: green-based vs. fossil fuel-based Fossil fuel-based Slow transition Green-based
Development and penetration of renewable energy production (water, wind, sun) Slowdown Increase Significant and rapid increase
Legal EU environmental policies and regulations (air, water, soil, waste, noise, chemicals) Ineffective Limited improvements in effectiveness Effective