Based on the FRESHER results, a first step to improve the health outlook for the European population would involve a consistent implementation of public health policies which have been proven effective in reducing the prevalence of poor diets, sedentary behaviours, obesity, tobacco smoking and harmful use of alcohol across the whole of Europe. The FRESHER project has assessed the impacts of a combination of the most efficient policies aimed at tackling the above risk factors, finding that life expectancy would be prolonged by one month on average between 2018 and 2050, and the incidence of diseases would be reduced. In Southern Europe, a similar combination of policies would bend downwards the increasing trend in new cases of cancer compared to the scenario ‘The Rich Get Healthier’. The policies would shift downwards the trend of the new cases of cancers –the increase of cancer new cases between 2010 and 2050 is estimated at 60% in ‘The Rich Get Healthier’ while 57% when policies are accounted for. For comparison, the ‘Healthy Together’ scenario would lead to an increase in the incidence of cancer of 40%.
Based on its computer simulation analyses, the FRESHER project provides evidence that a consistent implementation and scaling up of established public health policy approaches in tackling major risk factors for chronic diseases would lead to some improvements in the health of the European population. However, those policies alone can, at best, bend the increasing trend of chronic diseases. Radical and innovative solutions are required, only some of which may be in sight today. The Sustainable Development Goals agenda for 2030 adopted in September 2015 by the United Nations offers an opportunity to elaborate and promote new inter-sectorial and global policies which would contribute to the control of NCDs.
Treating chronic diseases more and more efficiently, preventing their complications, optimizing medical drug prescriptions, especially in the oldest segment of the population, and coordinating effectively the care required by patients with multiple morbidities are all key steps in containing further growth in health and social care expenditure. However, the most radical, and most difficult, changes required are those that may reduce the number of people with chronic conditions. These changes include focusing public policies on reducing socioeconomic and health inequalities; new ways of designing urban environments; new attitudes to the production and consumption of food and nutrition, to physical activity and to the use of technology in everyday life; and new and cleaner means of transportation, production and energy generation. New policies and grassroots initiatives must develop around these objectives, aiming at a much larger impact than those public health measures that have been attempted so far to prevent chronic diseases.