Reimagining the aspirations of public health for the coming decade

The past 10 years have challenged and reshaped public health in ways that were difficult to imagine more than a decade ago. This situation calls on public health to think clearly about where the field is headed and to anticipate where the field needs to be so as to emerge stronger from the moment. Five trends will be shaping health in the coming decades: population ageing, urbanisation, climate change, changing relationships with institutions, and the emergence of transformative technology. These trends are driving-and coinciding with-shifting disease burden, including the rise of non-communicable diseases, the growing importance of neurological diseases and brain disorders, the continued and more unpredictable effects of infectious diseases, widening health gaps, and increasing demands on health systems. These challenges present clear opportunities and should focus public health on five key aspirations moving forward: creating longer, healthier lives through a reckoning with the conditions for healthy ageing, grappling with new-and primarily commercial-determinants of health, efforts to build better health systems, the embrace of new technologies, and a reimagination of how the field thinks, talks, acts, and communicates its work.