Global Trends 2020

Choices over healthcare

While technology has been a core part of the giant leap in global life expectancy and standards of health, it has also facilitated misinformation and anxiety. There is an enduring sense that health should be assessed face-to-face, between human and human – not man and machine.

There is a tension between trust in medicine – the propensity to follow a doctor’s advice, and health self-reliance – the inclination to find out information on healthcare independently, including the desire for self-control and alternative therapies. The tension between these values is illustrated by their distance on our Global Values Map (see page 28).

More than three-quarters (78%) globally want more control of their healthcare. This feeling is stronger in eastern countries, such as India and Indonesia, and parts of South America – where between 80-90% of people agree. In western Europe, people are happier with the status quo, more likely to put their faith in doctors, and least likely to do their own medical research on the side.

This may be due to differing standards of medical care, but the pattern does not entirely support this theory; Britain bucks the trend of western Europe contentment. In Spain, for example, just one in three try and find out healthcare information by themselves, while in Britain nearly three-quarters feel the need to consult Doctor Google. America is similarly inclined to seek a second, digital opinion: 71% research independently. Education also plays into this dynamic. The highly educated are 8% more likely to want to find out information by themselves. As education levels increase globally, this desire for multiple points of information will be something healthcare systems will need to facilitate.

A less deferent population can be challenging. While 73% believe in all recommended vaccines, 19% disagree that they are all beneficial. In some European countries, such as France and Sweden, less than two-thirds believe all recommended vaccines are beneficial; in China, the figure is as low as 54%. Despite the cultural myth of the anti-vaxx American, the US (and Britain) are in fact more likely than average to believe in the recommended vaccinations. More than eight in ten Americans endorse vaccines. This figure, however, becomes less positive when one considers that the optimum rate for ‘herd immunity’ is 95% for some diseases, such as measles. If this scepticism translates into action, or rather, inaction, we could see the re-emergence of ‘eradicated’ diseases. Indeed in 2018, the World Health Organization (WHO) took away the UN’s measles elimination status, due to a significant increase in cases. In 2019, vaccine hesitancy was among the top ten global health threats identified by the WHO.

The future is here, and yet, we are not living in the sci-fi paradise many imagined; we still believe that science and medicine have limits. Despite the increase in global life expectancy, continuous medical research and advancements in biotech, half of us believe in immortality through science, where medical conditions and diseases will be curable in the future, and 32% expect to live to over 100.

Indeed, there is an almost inverse correlation between long life and optimism on this front. Japan, which has the highest life expectancy in the world, has the lowest number of people expecting to live to over 100. Most of Europe are equally pessimistic. In Britain, just one in five of us expect to live to be 100. Italy is home to Sardinia, one of five ‘Blue Zones’ in the world where residents are expected to live to over 90 years old – and yet less than a quarter expect human lives to pass the century mark.

Our relationship with medicine is complex, and likely to change further as we enter the 2020s. It is likely that the external pressures of technological progress, busy lives, overpopulated cities and scarce resources – married with the human desire for control and transparency – will continue to push us towards finding new solutions to medical care.

While the majority of us trust official medical advice, people increasingly challenge medical experts, and we cannot ignore the risk that this will lead to phenomena like vaccine avoidance to develop in other areas. As Ipsos has previously explored in the ‘Global Trustworthiness Index’, scientists and doctors are among the most trusted professions in society. We must ensure the fragile balance between trust, control and knowledge is maintained as technology expands its role in healthcare and people assert their right to choose. The Coronavirus epidemic highlights how despite medical progress, humanity faces plenty of threats from drug-resistent microbes, new epidemics in our megacities and more.