| Decline in health and well-being : Regular or chronic effects on physical and mental health and well-being that require substantial medical attention and/or limit daily activities. Includes, but is not limited to: conditions associated with aging, excessive consumption habits, and climate change (including heat waves) and pollution. The question in this article is what risks a decline in health and well-being entails. To this end, I examine this phenomenon from a socio-economic-societal, (geo-)political & military and demographic perspective. The question thus becomes: ‘What are the socio-economic-societal, (geo-)political & military and demographic implications of a decline in health and well-being ?’ | In this text I write in my own capacity, not that of any organization. The 2025 Global Risk Report – WEF gives this definition (quotes from documents have been translated using a translation program) |
Author: Manu Steens
Contents
What does the WEF’s 2025 Global Risk Report tell us?
On page 45 it says: ‘Adverse outcomes of frontier technologies, Intrastate violence, and Decline in health and well-being – are all related to ‘ Section 2.4 : Losing control of biotech? ‘, which provides an in-depth analysis of risks in the sector.
Advances in biotech are leading to increasingly fast progress in medicine and explain, perhaps, some of the increased optimism regarding the decline in health and well-being risk. But this progress comes alongside new low-probability, but high impact risks. These include interstate or Intrastate violence from biological terrorism, and adverse outcomes of frontier technologies involving accidental or malicious misuse of gene editing technologies or of brain-computer interfaces.’
Socio-economic-societal risks of the decline in health and well-being
First of all, there are some consequences and risks on a socio-economic level.
Healthcare costs for the elderly and the chronically ill will increase and will put increased pressure on healthcare budgets of governments and insurers. Especially in Western Europe, where most people have health insurance.
Loss of labor productivity due to increasing absenteeism and even early retirement from the labor market. This occurs due to the unsustainability of the working situation of employees.
There will be an increase in financial stress for families because a higher personal contribution for medical care and informal care will not be absent. Ultimately, the insurance companies will choose their own wallet. Nevertheless, an increase in informal care is to be expected.
Psychological stress and physical strain on caregivers is also an issue.
These situations will lead to increased social inequality with some key indicators:
- The health gap between different population groups is widening because this situation hits vulnerable groups harder.
- Accessibility problems in healthcare institutions and medical practices occur due to rising costs and waiting lists . Vulnerable groups are also hit harder here because the financial feasibility of a visit to a hospital or doctor will be less for them.
- Geographic inequality may be a phenomenon, in the sense that differences in the availability of care occur between urban and rural areas because most hospitals, healthcare institutions and doctors reside in cities, and the latter prefer to care for people in their neighbourhood.
Social and societal risks
Social cohesion may be weakened by increasing isolation of people with health problems. At a certain age, patients are more likely to become socially isolated, especially when they are single. However, in the long term, there will not only be problems for those in need of care. There will also be intergenerational tensions because the younger generation will contribute to the distribution of healthcare costs between generations. This may lead to conflicts. (See Debora Janet Price and Mayumi Hayashi who write in ‘The Politics of Intergenerational Conflict: A Comparative Study of the UK and Japan’: “In some (but not all) advanced economies these disputes are crystallising around the concept of intergenerational equity with a noticeable re-positioning of older people as the selfish welfare generation.”)
All of the above suggests as an important parameter in the future problems the creation of institutional pressure. There will be an overload of the health care system due to the future shortages of health care personnel , beds and materials, as we could see with Covid19. What we are already seeing, not as a result of ill health but as a result of increasing poverty, are challenges for social services . There will be an increasing demand for benefits from food banks and social institutions, because people can no longer make ends meet due to the ill health of the sole breadwinners .
As the working class becomes less healthy, paying taxes will become more difficult. This will have a major indirect effect on pension systems . Their affordability will then become unachievable.
However, societal resilience as in the sense of disaster preparedness will not simply decline. After all, in many countries there is a collective capacity of malleable social behavior to respond to crises. It is currently one of the important political objectives to develop. However, disaster preparedness involves more than just stockpiling emergency supplies and a first aid kit. It requires a correct mentality, for which you also need good health. (In the document ‘The Relationship between Social Mentality and Health in Promoting Well-Being and Sustainable City ‘ Zhen Liu, Guizhong Han, Jiajun Yan, Zhichao Liu and Mohamed Osmani write: “Hence, future research could explore the influencing factors and cultivation methods toward a healthy social mentality from the perspective of methodology and toward achieving SDG 3, providing healthy lives and promote well-being for all at all ages”.)
These socio-economically weakening factors have the important consequence of increasing vulnerability to external shocks, in particular pandemics or extreme drought, heat and cold problems as a result of climate change.
(Geo)political and military risks of deterioration in health and well-being
Geopolitical risks
Geopolitical risks are linked to instability and conflict, among other things. In addition, a struggle can arise over the increasingly scarce resources. I have written before about increasing competition for clean water, fertile land and food supplies . These shortages can increase when climate change, among other things, worsens the health crises . People will go to war to create the best situation for their own people. (In ‘ The Just War Tradition – Applying Old Ethics to New Problems’ Davis Brown and Henrik Syse write that “Just War requires… (3) a Net Benefit…”)
This is not unrelated to migration and border conflicts . People will attempt to flee areas with serious health risks through mass displacement.
States weakened by health problems may lose their administrative capacity, for example through interstate or intrastate conflicts , or through system collapse.
International power relations are important because of their shifting global influence. ‘Healthier states’ and ‘states with greater adaptability’ become more powerful relative to ‘unhealthy, less adaptable states’.
This creates dependency relationships. Vulnerable countries become dependent on international aid for health care. This encourages pharmaceutical geopolitics. The countries that have mastered strategic control over medicines and pharmaceutical technology will be able to use this as a means of power .
Military risks
There are also military risks. The most important is reduced readiness . This can happen even to countries that invest sufficiently in military procurement.
But due to a decrease in suitable recruits for military service, there is a smaller deployability and capacity, both in terms of personnel and deployable weaponry, because there are fewer (healthy) people to operate the equipment. Or to provide the logistical needs. The logistical challenges also concern more resources needed for the medical support of the troops.
One of the new military threats to weakened health is biosecurity risk. Using a biological weapon could trigger a pandemic. Regardless of the dangers on a global scale, this creates a perverse or terrorist opportunity for hybrid warfare. Health crises could be created for strategic advantage.
However, there are also operational limitations to military operations in areas with health risks due to the increasing complexity of operations.
Political risks also pose domestic stability issues.
The first thing that occurs is civil discontent. Citizens make their dissatisfaction with failing health care public. This can lead to protests and political instability. In such situations, extremism can more easily arise, due to unequal access to care and increasing existential insecurity. (Zarina Rashid, Shahir Rashid write in the ‘Pakistan Journal of Humanities and Social Sciences’ in their article ‘ Political Instability Causes & Affects ‘: “Political instability and social hopelessness Create the desperation that fuels religious Extremism”) In a democracy, this leads to a weakening of democracy. Institutions cannot adequately address health crises at that time, which leads to distrust of the government.
The governance of the country as an organization in a democracy is then accompanied by a shift in budgetary priorities towards health care at the expense of other sectors. This can be accompanied by centralization of power and increased state control.
Demographic risks of decline in health and well-being
A first effect is the changing population structure
There will be an ageing population with reduced vitality compared to previous generations. The older population will face more complex and changing health problems and will remain dependent on care for a longer time.
There is a decline in healthy life expectancy. Even if people live long, they spend more years with chronic conditions.
There is an unequal impact between generations because many diseases differ in severity across age groups. Certain groups are disproportionately affected by specific diseases, such as measles and other childhood diseases.
Second, there is a change in fertility and family formation
Decreasing health conditions can result in declining fertility rates. This can be due, for example, to environmental pollution, hormone disruptors and lifestyle factors. Thus write Niels E Skakkebæk, Rune Lindahl-Jacobsen, Hagai Levine, Anna-Maria Andersson, Niels Jørgensen, Katharina M Main, Øjvind Lidegaard, Lærke Priskorn, Stine A Holmboe, Elvira V Bräuner, Kristian Almstrup, Luiz R Franca, Ariana Znaor, Andreas Kortenkamp, Roger J Hart, Anders Juul in their abstract of the article ‘Environmental factors in declining human fertility’: “We hypothesize that these reproductive health problems are partially linked to increasing human exposures to chemicals originating directly or indirectly from fossil fuels.”
People in unhealthy environments are starting parenthood later. One of the factors for this may be the rising cost of child rearing. Young families will experience more financial and time pressure due to health problems.
Third, the labor force is changing
The active working population is shrinking because fewer people are able to work full-time or long-term due to health problems. This will make certain population groups dependent on others. The smaller number of healthy workers who have to care for more people in need of care will not be able to continue this for a full career and will themselves become dependent on care. Sickness absence therefore causes a reduced economic output.