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International Futures Help System

Dominant Relations: Health

Health forecasting systems typically can help us either (1) to understand better where patterns of human development appear to be taking us with respect to global health, giving attention to the distribution of disease burden and the patterns of change in it; or (2) to consider opportunities for intervention and achievement of alternative health futures, enhancing the foundation for decisions and actions that improve health. 

Broad structural models (e.g., that of the Global Burden of Disease or GBD) assist in the first purpose by relating deep or distal development drivers to outcomes.  More specialized structural formulations and the inclusion of proximate drivers open the door to the second, allowing for consideration of interventions in the pursuit of alternate health futures.  A more hybrid and integrated model form like that of IFs can help with both purposes and provide a richer overall picture of alternative health futures.

The figure shows the general structure.  Formulations based on distal drivers (the GBD methodology) sit at its core.  There is no inherent reason, however, that income, education and time (the distal drivers of the GBD approach) should be equally capable of helping us forecast disease in each of the major categories (let alone each of the specific diseases) that the GBD models examine.  For example, distal driver formulations tend to produce forecasts of constantly decreasing death rates.  Yet we know, for instance, that smoking, obesity, road traffic accidents, and their related toll on health tend to increase in developing societies among those who first obtain higher levels of income and education; with further societal spread of income and education, at least smoking and road traffic deaths (and perhaps also obesity) typically decline. [1]

Envisioning a hybrid and integrated health forecasting approach

A hybrid model can therefore help us identify opportunities for interventions to improve health futures. These interventions might also occur in the form of super-distal drivers (for example, policy-driven human action with respect to health systems).  The sociopolitical and environmental modules in IFs act in part as super-distal foundations for variables such as undernutrition and indoor air pollution which, in turn, facilitate analyses of proximate risk factors and human action around them. 

The integrated nature of the IFs modeling system further allows us to think about feedback loops between health outcomes and larger development variables such as economic progress and population structure.

[1] It is partly for this reason that the creators of the GBD models added exogenous specification of smoking impact to the otherwise mostly monotonically (one-direction only) changing specifications.