Table 4 List of 178 potential drivers included in round 2 of the Web-Delphi, and distribution of the answers in that round
From: Scenarios for population health inequalities in 2030 in Europe: the EURO-HEALTHY project experience
PESTLE category | Driver | SD | D | NAD | A | SA | DK/ DWtA |
|---|---|---|---|---|---|---|---|
Political | Strength of liberal political orientations | 7% | 7% | 10% | 33% | 38% | 5% |
Political | Capacity to produce EU agreements | 7% | 40% | 48% | 5% | ||
Political | EU integration process | 2% | 26% | 55% | 17% | ||
Political | Confidence in EU policies | 2% | 2% | 43% | 48% | 5% | |
Political | Cohesion funds (or other funds) for less-favoured regions | 2% | 7% | 43% | 48% | ||
Political | Political commitment and ideological support towards universal access to healthcare | 2% | 5% | 10% | 29% | 55% | |
Political | State involvement in public health | 2% | 2% | 12% | 33% | 50% | |
Political | Commitment to appropriateness of the healthcare systems in the EU | 5% | 31% | 36% | 26% | 2% | |
Political | Market oriented reforms in healthcare (including privatization of healthcare) | 7% | 10% | 14% | 31% | 38% | |
Political | Priority for investment in innovation in health | 5% | 7% | 14% | 45% | 29% | |
Political | Social protection policies for the elderly | 7% | 5% | 40% | 48% | ||
Political | Investments in national social security systems | 2% | 10% | 48% | 40% | ||
Political | Global political evolution (e.g. the aftermath of the United States elections; Syria war, etc.) | 2% | 12% | 26% | 29% | 31% | |
Political | Power of populistic, protectionist and nationalist radical political projects in the EU | 5% | 7% | 19% | 29% | 38% | 2% |
Political | Political stability in the EU and its Member-States (e.g. Brexit) | 2% | 7% | 21% | 50% | 17% | 2% |
Political | Municipalisation [i.e. power to the municipalities] | 5% | 10% | 33% | 33% | 17% | 2% |
Political | Application of road regulations/rules | 10% | 31% | 48% | 2% | 10% | |
Political | Degree of penalization associated with traffic policies to reduce traffic accidents | 2% | 12% | 31% | 38% | 7% | 10% |
Political | Policies for reducing traffic accidents in Eastern countries | 29% | 48% | 19% | 5% | ||
Political | Levels of investment in road safety | 5% | 26% | 48% | 19% | 2% | |
Political | Austerity policies | 7% | 5% | 10% | 31% | 43% | 5% |
Political | Growth of compulsory education | 5% | 7% | 40% | 45% | 2% | |
Political | Privatization of education | 10% | 17% | 19% | 31% | 21% | 2% |
Political | Investment in the modernization of the built environment | 5% | 21% | 40% | 33% | ||
Economic | Financing of the healthcare sector (in proportion of the Gross Domestic Product) in more economically vulnerable countries | 2% | 2% | 10% | 55% | 29% | 2% |
Economic | Social insurance schemes | 2% | 7% | 10% | 40% | 40% | |
Economic | Financial pressure on healthcare systems | 5% | 7% | 10% | 50% | 29% | |
Economic | Public expenditure in the healthcare system | 2% | 7% | 50% | 40% | ||
Economic | Healthcare costs | 2% | 5% | 17% | 36% | 40% | |
Economic | Constraints on fiscal policies | 2% | 33% | 43% | 14% | 7% | |
Economic | Economic evolution in EU countries with a younger population compared to the economic evolution in EU countries with an older population | 2% | 24% | 55% | 12% | 7% | |
Economic | Economic growth of some EU countries, namely of the ones from the former Eastern block | 2% | 24% | 64% | 10% | ||
Economic | Evolution of socioeconomic conditions and wealth in less developed countries/areas in Europe | 2% | 7% | 57% | 31% | 2% | |
Economic | Economic evolution (e.g. Gross Domestic Product, productivity) | 5% | 24% | 43% | 26% | 2% | |
Economic | Economic evolution in some countries of the Southern Europe (compared to the other EU countries) | 2% | 17% | 52% | 26% | 2% | |
Economic | Economic and social crises | 5% | 43% | 52% | |||
Economic | Financial crisis | 2% | 10% | 38% | 50% | ||
Economic | Concentration of capital accumulation | 2% | 5% | 24% | 36% | 33% | |
Economic | People's economic stress | 2% | 14% | 38% | 45% | ||
Economic | Economic inequalities | 2% | 2% | 21% | 74% | ||
Economic | Early retirement in some countries of the Southern Europe (compared to the other EU countries) | 12% | 52% | 26% | 7% | 2% | |
Economic | Pension levels and differences in working after retirement | 2% | 19% | 57% | 21% | ||
Economic | Proportion of economically dependent population | 2% | 21% | 45% | 31% | ||
Economic | Evolution of financial burden share between generations within families | 5% | 26% | 45% | 24% | ||
Economic | Financial pressures leading to cuts in social expenditures (e.g. pensions) | 2% | 7% | 40% | 50% | ||
Economic | Differences in pension regimes within the EU (e.g. differences in national net pension replacement rates) | 2% | 29% | 45% | 21% | 2% | |
Economic | Poverty levels | 7% | 21% | 71% | |||
Economic | Social benefits | 12% | 43% | 45% | |||
Economic | Global economic integration and interrelations | 7% | 21% | 45% | 21% | 5% | |
Economic | Inclusion of the refugees on the labour market | 2% | 10% | 21% | 40% | 26% | |
Economic | Unemployment rate in Europe | 2% | 2% | 48% | 48% | ||
Economic | Long-term structural unemployment | 2% | 33% | 64% | |||
Economic | Unemployment in late ages | 7% | 43% | 50% | |||
Economic | Employment precariousness | 2% | 52% | 43% | 2% | ||
Economic | Employment with low income/limited social benefits | 7% | 43% | 50% | |||
Economic | Unemployment in countries of the Southern Europe (compared to the other EU countries) | 7% | 21% | 43% | 24% | 5% | |
Economic | Employment opportunities for people with low qualifications | 2% | 17% | 64% | 17% | ||
Economic | Employment opportunities for medical/health personnel | 2% | 14% | 29% | 45% | 10% | |
Economic | Disparities in industry production | 14% | 50% | 24% | 7% | 5% | |
Economic | Investment in formal education | 2% | 24% | 45% | 29% | ||
Economic | Demand for qualified workers | 10% | 33% | 48% | 7% | 2% | |
Social | Refugees and migrants’ fluxes | 7% | 17% | 60% | 14% | 2% | |
Social | Migrations to the most economically developed North-West European countries | 7% | 26% | 57% | 7% | 2% | |
Social | Emigration from EU countries already affected by population ageing and decrease in natality | 12% | 26% | 48% | 12% | 2% | |
Social | Urbanisation (attractiveness of urban areas) | 7% | 31% | 50% | 12% | ||
Social | Concentration of people in suburban areas | 7% | 33% | 45% | 14% | ||
Social | Concentration of people at risk (e.g. poverty) in problematic neighbourhoods | 2% | 7% | 48% | 43% | ||
Social | Differential in regions’ ability (political and/or economic) to attract young people, including migrants and refugees | 5% | 21% | 55% | 17% | 2% | |
Social | Population ageing | 14% | 19% | 31% | 36% | ||
Social | Quantitative evolution of the young population | 14% | 36% | 36% | 10% | 5% | |
Social | Birth rates across EU countries | 14% | 43% | 33% | 10% | ||
Social | Birth rates in some countries of the Southern Europe (compared to the other EU countries) | 14% | 45% | 33% | 7% | ||
Social | Ageing pace in Central and Eastern Europe compared to other EU countries | 12% | 43% | 40% | 5% | ||
Social | Regional differences in ageing patterns at a European level | 12% | 40% | 40% | 7% | ||
Social | Life expectancy | 12% | 19% | 43% | 21% | 5% | |
Social | Healthy life expectancy | 10% | 17% | 29% | 38% | 7% | |
Social | Differential in regions’ health expectancy | 7% | 19% | 50% | 17% | 7% | |
Social | Voting power of the elderly population | 2% | 12% | 60% | 21% | 5% | |
Social | Population growth in relation to the “housing capacity” | 7% | 55% | 29% | 5% | 5% | |
Social | Awareness of the road safety problematic | 17% | 45% | 31% | 5% | 2% | |
Social | Road safety campaigns and education | 2% | 10% | 38% | 40% | 7% | 2% |
Social | Social pressure for “bridging the gap” in terms of built environment | 5% | 29% | 62% | 5% | ||
Social | Overall quality of road infrastructure | 2% | 2% | 31% | 55% | 7% | 2% |
Social | Quality of the roads in Southern and Eastern Europe | 2% | 7% | 29% | 52% | 7% | 2% |
Social | Vehicles quality and safety | 2% | 36% | 50% | 10% | 2% | |
Social | Metropolization | 2% | 45% | 45% | 5% | 2% | |
Social | Traffic density | 5% | 38% | 38% | 19% | ||
Social | Disparities in medical standards | 2% | 17% | 43% | 36% | 2% | |
Social | Medical quality | 5% | 17% | 38% | 40% | ||
Social | Medical effectiveness of healthcare services | 2% | 12% | 45% | 40% | ||
Social | Access to healthcare | 5% | 33% | 62% | |||
Social | Access to hospital emergency room | 5% | 10% | 52% | 33% | ||
Social | Quality and accessibility of the primary health care services | 5% | 38% | 57% | |||
Social | Access to healthcare services in rural areas | 10% | 40% | 48% | 2% | ||
Social | Quality of Emergency Medical Services (EMS) in remote and/or rural areas | 2% | 10% | 50% | 36% | 2% | |
Social | Emergency Medical Services efficiency | 5% | 19% | 45% | 31% | ||
Social | European medical network | 7% | 36% | 45% | 12% | ||
Social | European citizens’ health literacy and collaboration capacity as patients | 29% | 43% | 29% | |||
Social | Educational and public health campaigns | 10% | 21% | 43% | 26% | ||
Social | Education and training of health professionals | 10% | 24% | 43% | 24% | ||
Social | Mobility of health professionals between countries and regions | 10% | 36% | 40% | 12% | 2% | |
Social | Concentration of equipment and clusters of medical activities | 5% | 43% | 36% | 17% | ||
Social | Availability of health infrastructures | 2% | 19% | 48% | 31% | ||
Social | Coverage of National Health Service | 5% | 52% | 40% | 2% | ||
Social | Response capacity of the health sector (quality of emergency/first respondents and hospital care) in less developed countries | 12% | 55% | 31% | 2% | ||
Social | Quality of healthcare organization and management | 5% | 10% | 48% | 38% | ||
Social | Knowledge sharing | 2% | 33% | 36% | 26% | 2% | |
Social | Availability of information on better lifestyles | 5% | 36% | 36% | 24% | ||
Social | Quality of the education in the EU | 17% | 52% | 31% | |||
Social | Academisation of the society | 7% | 40% | 40% | 10% | 2% | |
Social | Low qualifications in the EU | 29% | 64% | 7% | |||
Social | Impacts on the quality of jobs and enthusiasm for Tertiary Education | 38% | 52% | 5% | 5% | ||
Social | Monitoring of education results | 7% | 55% | 36% | 2% | ||
Social | Capacity of Eastern European countries to cope with the collapse of the soviet society [i.e. with the loss of some of its key features, for instance in education] | 10% | 45% | 38% | 5% | 2% | |
Social | Educational attainment as an aspiration of EU countries | 10% | 29% | 50% | 7% | 5% | |
Social | Objectives in education in the EU | 5% | 43% | 36% | 14% | 2% | |
Social | Levels of education and literacy | 2% | 2% | 69% | 24% | 2% | |
Social | Flexibility of academic curricula in the EU | 2% | 12% | 48% | 31% | 2% | 5% |
Social | University fees | 7% | 40% | 36% | 12% | 5% | |
Social | Academisation of job profiles | 14% | 50% | 29% | 2% | 5% | |
Social | Existence of vocational training | 10% | 36% | 43% | 7% | 5% | |
Social | Differences in cultural traditions | 19% | 31% | 36% | 10% | 5% | |
Social | Globalization of style life | 17% | 31% | 43% | 5% | 5% | |
Social | Awareness regarding the impact of lifestyles on quality of life | 14% | 17% | 50% | 14% | 5% | |
Social | Stress | 7% | 17% | 33% | 40% | 2% | |
Social | Awareness campaigns tackling alcohol consumption | 12% | 12% | 52% | 24% | ||
Social | Awareness regarding the impact of smoking | 10% | 14% | 48% | 29% | ||
Social | Smoking restriction policies | 2% | 2% | 48% | 48% | ||
Social | Smoking among women | 12% | 40% | 48% | |||
Social | Smoking among manual workers | 14% | 52% | 31% | 2% | ||
Social | Taxation and control of unhealthy food consumption | 2% | 10% | 57% | 31% | ||
Social | Diet | 5% | 17% | 38% | 40% | ||
Social | Disparities in health behaviours | 7% | 10% | 52% | 31% | ||
Social | Sedentary lifestyles | 17% | 43% | 40% | |||
Social | Evolution of Non-communicable diseases like diabetes and hypertension | 2% | 10% | 43% | 43% | 2% | |
Social | Social mobility (change in hierarchies in socio-economic positions) | 7% | 14% | 52% | 26% | ||
Social | Motorization in Eastern countries | 7% | 45% | 38% | 5% | 5% | |
Technological | Medical innovation (new medicines and technologies) | 5% | 17% | 45% | 31% | 2% | |
Technological | Technology and medical devices at home | 10% | 19% | 45% | 24% | 2% | |
Technological | Technology and innovation costs in healthcare systems | 7% | 17% | 50% | 26% | ||
Technological | Evolution of vehicles batteries’ autonomy | 19% | 40% | 31% | 10% | ||
Technological | Knowledge and innovation in technology and materials for road safety | 10% | 33% | 45% | 7% | 5% | |
Technological | Innovation in technology and materials for the built environment | 10% | 33% | 40% | 14% | 2% | |
Technological | Innovation in housing (new forms of housing) | 14% | 33% | 33% | 14% | 5% | |
Technological | Price of technology and materials for road safety and for the built environment | 7% | 38% | 38% | 14% | 2% | |
Technological | Acceleration in industry development in less developed countries | 14% | 33% | 38% | 12% | 2% | |
Technological | Pace of change in manufacturing in Europe (industry 4.0) | 14% | 43% | 26% | 12% | 5% | |
Technological | Automation of industrial production | 7% | 40% | 33% | 14% | 5% | |
Technological | Internet access | 2% | 5% | 33% | 48% | 12% | |
Environmental | Quality of the living environment | 2% | 2% | 50% | 45% | ||
Environmental | Quality of the outdoor air | 2% | 38% | 60% | |||
Environmental | Climate change | 2% | 14% | 43% | 38% | 2% | |
Environmental | Climate change actions and policies | 5% | 17% | 43% | 33% | 2% | |
Environmental | Concerns related to natural resources efficiency (e.g. energy efficiency) | 7% | 26% | 43% | 24% | ||
Environmental | Energy efficiency efforts | 10% | 19% | 52% | 19% | ||
Environmental | Recycling: taxation and quotas | 12% | 29% | 45% | 14% | ||
Environmental | Social and political awareness/preoccupation with the physical environment, namely air and noise conditions | 7% | 14% | 55% | 24% | ||
Environmental | Gap in “environmental awareness” between more developed and less developed countries | 2% | 24% | 48% | 26% | ||
Environmental | Priorities in terms of economic model: green-based vs oil-based (e.g. evolution of the number of environmental friendly vehicles) | 5% | 10% | 45% | 36% | 5% | |
Environmental | Development of sustainable energy production (water, wind, sun) | 21% | 38% | 40% | |||
Environmental | Industrial development sustainability | 2% | 7% | 29% | 38% | 24% | |
Environmental | Regional differences of the building construction boom | 14% | 29% | 52% | 5% | ||
Environmental | Coordination of environmental-focused political measures | 7% | 21% | 57% | 14% | ||
Environmental | Environmental protection policies focused on industrial manufacturing | 7% | 17% | 57% | 17% | 2% | |
Environmental | Environmental protection policies focused on vehicles circulation | 5% | 14% | 60% | 19% | 2% | |
Environmental | International and worldwide environmental agreements | 7% | 14% | 45% | 31% | 2% | |
Environmental | United States of America commitment towards the Paris Agreement on climate change global action | 10% | 14% | 48% | 26% | 2% | |
Legal | EU Legislation/ Directives and its transposition into the legislation of each country | 10% | 33% | 43% | 10% | 5% | |
Legal | Adaptability of EU regulations (especially inside the Eurozone) to Member-states specificities | 7% | 45% | 33% | 12% | 2% | |
Legal | Commitment to follow EU directives and World Health Organization guidelines | 5% | 19% | 52% | 21% | 2% | |
Legal | EU legislation / directives on built environment | 7% | 21% | 57% | 10% | 5% | |
Legal | National building construction rules and legislation | 12% | 31% | 40% | 10% | 7% | |
Legal | Differences in road safety national legislation | 2% | 7% | 29% | 55% | 2% | 5% |
Legal | EU environmental policies and regulations | 5% | 17% | 64% | 12% | 2% | |
Legal | Requirements of compliance to environmental regulations for market purposes (e.g. quality of fuel) | 2% | 24% | 55% | 17% | 2% | |
Legal | Evolution of intellectual property rights in health | 2% | 12% | 43% | 24% | 14% | 5% |
Legal | Impact of the TTIP (Transatlantic Trade and Investment Partnership) project in the access to the latest advances in medicines, diagnostic tools, and other life-saving medical technologies | 5% | 5% | 45% | 26% | 17% | 2% |
Legal | Integration of EU labour markets | 10% | 38% | 38% | 10% | 5% |