The epidemiological future

Forecasting the epidemiological future of industrialized countries for about thirty or maybe fifty years has been attempted. This will be determined by the future condition of relevant factors of the physical-biological, socio-economic and cultural environment of the population in question and by the socio-demographic structures of the population itself. It is highly probable that substantial development in prevention and curing of diseases, and in a few cases even breakthroughs will occur in the next three decades or so. Also public awareness with respect to health promotion can be expected to rise substantially in the future. Under these circumstances health conscious behaviour and sophisticated medical technology will have a much more serious impact on the health of the population in the future than at present. The aging of the population will become faster as fertility is expected to remain constant at very low levels and mortality will become the major cause of aging. Consequently general mortality will eventually increase, yet infant mortality will further decrease and will be as low as 6.0 per thousand live births by the 2020's. Lifespan prolongation by selective dietary restrictions would become a feasible human option. If some chronic degenerative diseases will be eliminated or will be put at least under control then life expectancy at birth can be as high as 84.3 years. However, it has been suggested that delaying the progression of chronic diseases is more realistic than eliminating them. Consequently the prevalence of chronic disease in the population will increase, along with the associated costs of treatment and care. Yet another school of thinking forecasts the 'compression of morbidity'. It is an open question whether inequalities in health will increase or decrease. AIDS infection will spread dramatically, but mainly in the third world and prevention strategies will use general information, education and counselling in order to increase public awareness with respect to the chances of avoiding infection.