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Looking Forward to the Future

By Larry Hershfield. Larry Hershfield manages The Health Communication Unit, at the Centre for Health Promotion, University of Toronto.

A. Introduction: What it a futurist?

It's that time of year again! The print and electronic media will be full of predictions for the next year, next decade, next century, and I guess the next millennium. Your very own OHPE is no different: this issue is devoted to futuring.

I have always been very interested in the future and the enterprise of futuring - including Nostradamus, the National Enquirer, the mass media and the private/public/voluntary sectors prognosticators, Faith Popcorn, John Naisbitt on down. This list is quite wide and includes many very different figures and forces (e.g. most would agree Nostradamus is dead and the National Enquirer is busy re-positioning itself!). More about differences a little later - for now, what do the members of my list have in common?

All futurists are motivated by:

* a fascination with the future

* a desire to understand forces and trends,

* a need to identify implications for individuals and collectives, and

* a commitment to doing something.

Why? Leaving fate and luck aside, we, as individuals and as a collective, get the futures--and the governments-- we deserve. Understanding the future in this way means looking forward, not looking backward, trying to get the licence number of the latest trend that just ran you over. In re-reading this last sentence, I realize that it puts a negative slant on the futuring enterprise. And that's a trend in itself! A few years ago, visioning and other forms of futuring were all the rage; optimism was the ethos of that era. But the rate of change and some of the changes themselves have generated a lot of fear (and loathing), as we move into what some futurists are calling the 'Post-Industrial Revolution'.

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B. Futuring and Health Promotion

In the spirit of health promotion, which looks not only at gaps and deficits, but also at capacities and strengths, we could regard futuring as an enterprise dedicated to identifying opportunities - opportunities to learn, understand, gain control, leverage valuable resources and enjoy synergies from powerful emerging trends. We are challenged by budgetary and time constraints, by a lack of resources and by competing agendas, so we must act strategically and adapt to threats of various kinds as we address issues, priorities and objectives.

How is this done? Our initial list of futurists, while sharing the common motivations described above, vary widely in their methodologies. As health promoters, we want a process that:

* addresses health from the broadest perspective, in all its domains, and respecting the broad range of determinants

* is evidence-based, and includes a wide variety of evidence, including lived experience

* includes a variety of perspectives, shared and reflected upon, from multiple disciplines and stakeholders

Many such processes are possible. One ongoing and large process is the Policy Research Initiative's Trends Project Other examples are given in the works of well-known futurists, such as those listed and linked at

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C. The PEST Analysis

I would like to share an important and practical exercise developed by my colleagues and myself, which was part of an environmental scan we are using for our own planning. This particular scanning tool is called the PEST analysis, which asks us to look at Political, Economic, Social and Technological changes in the external environment, and to really consider their implications. The PEST analysis involves three stages:

* doing or gathering research about trends in these four areas

* considering their implications for your own organization

* making choices about actions (including getting connected with others).

In what follows, I will outline one trend in each domain of the PEST and suggest some possible implications and an action step for Health Promoters:


It seems that there is international, national, provincial and local evidence for the long-term 'trend' of dismantling the post-War welfare state. But the New York Times Magazine recently published an article regarding the Gilt Complex (no typo there, just a clever pun) related to the deepening dissatisfaction people feel about prosperity juxtaposed with worsening social problems. In the same vein, Dalton Camp recently wrote about the death of Neo-Conservatism.

My point: I know the health promotion community is dealing with the first trend, but who is thinking about capitalizing upon the second, smaller, newer but counter-vailing trend? This trend should have real implications for how we discuss issues related to broad determinants of health. In terms of taking action and getting committed in relation to this trend, one starting point should be the Health Determinants Partnership--see


Inequalities and inequities are increasing, in the midst of the boom times. Who is planning for the lean years? As a starting point, let us look at the predictions and calls for action across the political spectrum, for example, from the Caledon Institute, the Canadian Council on Social Development, the Fraser Institute and the C.D. Howe Institute etc. Links to these and other Policy Research Institutions can be found at


One social trend that is often discussed is our "aging population", which presents a number of challenges for many systems, including health care. There is a great deal of research, a number of implications, many groups and many possible actions to take with regard to this trend. One good place to look is at the Trends Project Aging 'theme site' at This is one of four theme sites from the Policy Research Initiative's Trends Project; other topics include: Productivity; Population Health and Environment and Sustainable Development. These theme sites feature research from federal and provincial governments, international sources, policy research organisations, academic centres and institutes, as well as resources for researchers such as directories, listservs, and statistical data.


The number of technological changes is overwhelming, and much of this new technology is related to the Information Age. There are many implications of the Information Age. Questions we need to ask include What new technologies are being developed? Who is developing them, and for what purpose? Who is learning about them? One place to start is reading some the work done by Tapscott, Turkle or Negroponte. Concerns in this area include the widening "knowledge gap"; research and links related to this issue can be found at This site includes the recent U.S. study 'Falling Through the Net III', which deals with access to contemporary information technologies in relation to education, income and other factors. At the same time as we are busy "shovelling" information onto the 'information highway', we are also concerned about the quality of information on this highway. One made-in-Canada solution to the problem of how to find a way through the maze of available information, especially information in an electronic format, is, of course, the Canadian Health Network Take a look and get involved!

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D. Concluding remarks

In closing, I say:

* enjoy the pop culture predictions throughout the holiday period

* survive Y2K

* when back at work, consider the implications of these and other trends for you and your community, and take action, with others.