What is the future of health and well-being? Right now we are seeing new capacities for our individual, collective, and ecological well-being emerge - out of optimism and growth, but also out of increasing efforts to rebalance the world in light of global challenges and resource constraints.
The challenge before us, in both our communities and our organizations, is to RETHINK the future of well-being not just as an individual experience or just a market force, but as interconnected ECOSYSTEMs of PEOPLE, NETWORKS, and ENVIRONMENTS.
We are living longer but getting sicker, spending more money on health care, while improvements have stalled, struggle with obesity and at the same time malnourishment continues to increase globally and at home. We are at the edge of a decade where many of the basic inputs to well-being ---strong social connections, good physical health, access to basic necessities such as food and water, are increasingly threatened.
No one can predict the future but we can think about it systematically. We can explore different shapes of change ( e.g., growth, constraint, collapse, and transformation.) These are alternative future scenarios that can help us map a wide range of future possibilities. By doing this we can begin to immerse ourselves in the future, provoke our thinking, and imagine a range of individual and organizational responses to the threats and opportunities ahead of us.
Growth scenarios are futures in which current trends and conditions are simply extrapolated forward. For example, if we look back at our recent history, improvements in food safety and quality led to significant health and wellbeing gains in the United States over the past century. Better food-processing capabilities and advances in nutrition sciences, packaging, and even refrigeration not only eliminated many risks to our health but also led to an explosive growth in food markets.
These improvements stemmed through better food processing capabilities as well as advances in nutrition sciences and packaging that has helped eliminate nutrition diseases such as rickets and scurvy
Refrigeration also led to growth in food markets and food grown in one region could shipped to another where that food was out of season, something we rarely acknowledge today and assume we can eat what we want when we want it.
So what does the future of well-being look like in a growth scenario? Well-being is focused on productivity and more CHOICES, that is, market choices, expand the range of experiences around our well-being. In this future, we have to balance these choices with personal responsibility. Everything from the food we eat, the way we live and coordinate our lives, to the places we live, the cars we drive, to the way we parent, and how we keep our homes we’ll see offerings from an expanding well-being economy. Well-being will be a major concern of consumer choices and decisions as we pursue better health and well-being through the purchasing decisions we make whether we are concerned appearance and self-improvement, food and nutrition, sustainability and the environment, energy and productivity, or even just reducing stress and expanding happiness in our lives.
Where do we see this future today? We only have to look at the expanding role of the smart phone in our lives and the expanding number of apps that promise to help us manage our chronic illness, track our calories, and nudge us to better health.
Constraint scenarios describe futures where scarce resources force societies to deal with increasing limitations. At different points in time we have all lived under constraints. The recent economic downturn has forced many communities and families to live in constraint scenario. A good historical example, is the SARS outbreak of 2003, where travel throughout Asia was restricted, schools were closed, as health officials attempted to confine suspected cases of SARS to certain regions or even hospitals. In places like Hong Kong, we even saw some of the first mobile phone services emerge that helped citizens locate SARS infected buildings all in an effort to navigate, modify their movement just-in-time and avoid the risk of being infected.
A good historical example, is the SARS outbreak of 2003, where travel throughout Asia was restricted, schools were closed, as health officials attempted to confine suspected cases of SARS to certain regions or even hospitals.
In places like Hong Kong, we even saw some of the first mobile phone services emerge that helped citizens locate SARS infected buildings all in an effort to navigate, modify their movement just-in-time and avoid the risk of being infected.
So what does the future of well-being look like in a constraint scenario? Under a constraint scenario well-being is focused on COMMUNITY and taking care of others increases personal well-being. It turns out that during hard times, people often are forced to pursue well-being together. Well-being shifts from being primarily an individual pursuit to a more collective concern. Faced with very practical limits—whether its time, money, and attention, we make tradeoffs that we are not necessarily happy about, but by pursuing challenges together, communities find ways to improve and optimize personal well-being in these situations.
Where do we see this future today? Local currencies, time-banking, sharing networks are examples of social well-being strategies emerging out of the communities under constraints. Exchanging time for goods and services gives people access to things they can no longer afford to own independently, think of car sharing networks, so pooling resource provides a solution, and hints at a wide range of responses emerging out of the sharing economy.
Collapse scenarios are futures in which systems are strained beyond the breaking point, causing social disarray.
We only have to think of Hurricane Katrina and its aftermath in 2005 and 2006 to imagine a collapse scenario. Katrina triggered a cascading collapse of medical and well-being infrastructure in affected areas.
The natural disaster severely disrupted basic health resources such as housing, clean water, and food. Federal, State, and Local governments did not have adequate plans to keep hospitals functioning, many transportation options for more distant health services were destroyed, and medical records for many residents of the Gulf Coast were scattered.
Many lives were devastated.
So what does the future of well-being look like in a collapse scenario? This is a future where well-being is focused on SECURITY and escape from real and perceived threats. Imagine our well-being in a world where trust is declining in institutions, neighbors, and our collapsing world around us strains even our strongest ties with other people and resources in our social networks. In a world where the institutions around us can no longer buffer us from the risks we face whether those risks are to our health or safety we retreat to protected enclaves. Think gated communities. This is not a desirable future but one where the signs are always around us. Collapse scenarios can be local and constrained to a region or can be more far-reaching triggered by natural disasters or an economic disruption, and the housing industry collapse for example. Uncertainty and lack of access to basic resources leaves populations stressed and anxious and people adopt extreme practices such as hoarding food or self-quarantining themselves to avoid the world and dangers around them.
Tremendous possibilities and uncertainties
Where do we see this future today? We only need to experience another natural or man-made disaster to move us into a collapse scenario. But collapse scenarios are also about the decline of trust in institutions and their inability to provide the protection promised in our social contract with them. We only have to think about the current state of risk around our personal data and how health data breaches and the resulting medical and financial identity theft patients experience as a potential collapse scenario in the making.
And, its not just our health data being collected. There is a whole personal data ecosystem out there whether you know it or not.. Think of it as the digital record of everything a person makes and does online and in the real world
But, new services like www.personal.com emerging out of this concern give people the means to safely share their data and put more of the security directly in their own hands.
Transformation scenarios are futures in which fundamental change signals a break from the past.
For example, in the late 19th century, germ theory transformed our understanding of the root causes of diseases and laid the groundwork for unprecedented breakthroughs in biochemical treatments.
With the synthesis of the 1st psychopharmaceutical drug in the 1950s, we turned once intractable mental health conditions into relatively manageable emotional states.
So what does the future of well-being look like in a transformation scenario? Well-being in a transformational scenario is ecological and collaboration builds capacities for holistic well-being. In this future, we begin to understand our selves as elements of and parts of an ecosystem that includes our relationships; as well as industries, communities; health, medicine, and everyday choices. We are beginning to see the connections necessary to build our collective capacities for well-being. Well-being is about feeling aligned at all scales—bodies, networks, and environments. This leads to more integrated and holistic approaches to well-being.
Where do we see this future today? Transformation scenarios unfold over longer time horizons but the seeds of transformation are around us. Part of this transformation scenario may be a future where we strike a more optimal balance with the microbes that help us and those that harm us. As we learn more about the distinct versions and attributes of the microbial ecosystems in our guts and homes, we may find ways to work with these microbes rather than be at war with them, to pursue better health and well-being in our bodies and homes. (my.microbes social network of enterotypes)
transformation: my.microbes social network of enterotypesBack in 2011, a group of swiss scientists created MyMicrobes, a combined medical study and social network. They have identified three different enterrotypes, distinct versions of this microbial ecosystem in the guts of different people. While back then, only about 300 people in the world knew their enterrotypes, now in 2021 most Europeans and almost 30% of north Americans now know their enterrotypes. Researchers in India have been busy reconciling this typology with Ayurvedic dietary types. ((click))
Asthmapolis and participatory public health
Crowdsourcing public services
It’s our hope that these alternative future scenarios will provoke new thinking and insight into how you and your organizations can thrive in the future. Together these scenarios map out four corners of possibility. Together they challenge us to RETHINK the future of well-being not as individual experience or just a market force, but as interconnected ECOSYSTEMs of PEOPLE, NETWORKS, and ENVIRONMENTS.
The future will contain elements from all four future scenarios and we’ll see growth, constraint, collapse, and transformation coexist in different ways and at different scales in the future.
As you go through each scenario in more depth with our Map think of it as an exercise of immersion and readiness. The map is a guide for thinking about the future systematically and a tool for identifying resilient responses regardless of which scenario unfolds over the next decade.
